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Continuous Passive Motion (CPM)

Continuous Passive Motion (CPM). Chapter 15. Purpose. Produce passive joint motion Effects: Enhance nutrition Increase metabolic activity Stimulate tissue remodeling and regrowth of healing tissues: Articular cartilage Tendons Ligaments. Specific to Body Area and Motion.

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Continuous Passive Motion (CPM)

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  1. Continuous Passive Motion(CPM) Chapter 15

  2. Purpose • Produce passive joint motion • Effects: • Enhance nutrition • Increase metabolic activity • Stimulate tissue remodeling and regrowth of healing tissues: • Articular cartilage • Tendons • Ligaments

  3. Specific to Body Area and Motion Knee Flexion/Extension Wrist Flexion/Extension Wrist Radial/Ulnar Deviation Finger Flexion/Extension GH Flexion/Extension GH Internal/External Rotation

  4. Types of CPM devices • Free Linkage • Anatomic • Nonanatomic

  5. Free Linkage Design • Moves the limb through ROM by grasping it proximal and distal to the joint • Adjustable to patient • Contraindicated for unstable joints

  6. Anatomic Design • Mimics natural motion of involved joint and the proximal joints • Most suitable for knees

  7. Nonanatomical Design • Does not attempt to replicate natural joint motion • Compensatory movement occurs between limb and CPM unit

  8. Physiological Effects of CPM • Encourages the remodeling of collagen along the lines of force • Reduces: • The negative effects of joint immobilization • Functional shortening • Cross linking of collagen • Capsular adhesions • Enhances the tensile strength of • Tendons • Allografts • Skin • Stimulate repair of articular cartilage

  9. Physiological Effects • Fluid pressures • Extension: • Most joint volume • Low pressure • Flexion: • Least joint volume • High pressure • Changes in pressure creates a pumping effect • Circulates synovial fluid • Assists in the removal of: • Hemarthrosis • Periarticular edema • Blood from tissues surrounding joint

  10. Range of Motion • Total end range time (TERT) • Delivers a low load, prolonged stress • Increases ROM as TERT increases • Helps patient overcome the apprehension of moving joint after surgery • Decreases rate of atrophy • Limits functional shortening of muscle • No increase on cardiovascular system

  11. Joint Nutrition • Stimulates circulation of synovial fluids • Increases nutrient uptake • Meniscus • Articular cartilage

  12. Edema Reduction • Not clearly understood • Varies according to: • The body part • Condition being treated • The passive movement of the limb and the elevation of the body part could assist in venous and lymphatic return by milking the muscle

  13. Pain Reduction • Movement of joint activates the gate control pain theory • Other effects such as decreased edema could also decrease pain • Not used as an acute pain-control technique

  14. Ligament Healing • ACL does not receive the same nutritional benefits from CPM as cartilage because of its separate synovial lining • Effective in allograft-augmented medial collateral ligament reconstruction

  15. Contraindications • Unwanted joint motion and overstressing • Unstable fractures • Spastic paralyses • Uncontrolled infection • Deep Vein Thrombosis

  16. Clinical Applications • A CPM technician will use the manufacturers protocol to administer treatment following surgery • Precaution: • CPM devices should not be used in the presence of flammable gases

  17. Treatment Duration • Long term bouts: patient continuously attached • 1-hour 3 times per day • 6 to 8 hours a day post-surgery • In home treatments with home visits by physical therapist

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