CONTINOUS PASSIVE

MOTION
AFIFAH 20160606049
TASYA SALSALIANTIKA 20160606066
COUNTINOUS PASSIVE MOTION
IMPROVES SHOULDER JOINT INTEGRITY
FOLLOWING STROKE
 WHAT IS CPM?
Continuous passive motion (CPM) is the antithesis of immobilization, a
common postsurgical management technique. To deter the unwanted
effects of immobi- lization, CPM devices deliver gentle stresses to the heal-
ing tissues. Still predominantly used for knee injuries, CPM units have been
designed for the hand, wrist, hip, shoulder, elbow, and ankle (Fig. 15-1).
Although passive motion can be applied through a dedicated CPM unit, it
can be delivered manually by the clinician, but for a much shorter time.
 INDICATIONS

After surgery or chronic pathology to the knee and shoulder

extensor mechanisms
Joint contractures
Following meniscectomy
After knee manipulations
After joint debridement for arthrofibrosis
Tendon lacerations
After osteochondral repair
For enhancing the reabsorption of a hemarthrosis Thrombophlebitis
Following surgical correction of chondromalacia
patellae
 CONTRAINDICATIONS

*Cases in which the device causes an unwanted translation of opposing

bones, overstressing the healing tissues
*Unstable fractures
*Spastic paralyses
*Uncontrolled infection
 PRIMARY EFFECTS

Improved nutrition of articular structures

Increased metabolic activity of articular structures
Increased remodeling of collagen along the lines of
stress
Increased tensile strength of healing tendons,
ligaments, and other soft tissue
Improved early range of motion
Potential edema reduction
Pain reduction via secondary mechanisms
(e.g., increased ROM)
 DOSAGE
Continuous passive motion may be applied in long- term bouts where the
patient is continuously attached to the unit, or the device may be applied in
1-hour treatment bouts three times a day. After surgery, use is for 6 to 8 hours
a day, although the duration preferred by patients is 4 to 8 hours.37 Patients
may also be in- structed in the use of CPM for in-home treatments, or a
home-care visit may be required.
 COUNTINOUS PASSIVE MOTION
IMPROVES SHOULDER JOINT INTEGRITY
FOLLOWING STROKE
 INTRODACTION
In a pilot study of patients with a first stroke and hemiparesis, we sought to
determine whether treatment of the upper limb with continuous passive
motion (CPM) that was device delivered would alter impairment, disability or
the associated adverse symptoms of shoulder joint instability, pain and tone.
 SUBJECTS
Two hundred and eighty consecutive patients were screened and 35 of
these with a first unilateral stroke, 13+6 days following the acute event,
provided informed consent and were randomly assigned to CPM treatment
or supervised group self-range exercise.
METHODS
 RESULTS

CPM-treated patients demonstrated positive trends towards improved

shoulder joint stability (p= 0.06, confidence interval - 0.03, 2.3) when
compared with patients performing therapist-supervised self-range of
motion. There were no significant differences in motor impairment, disability,
pain or tone.
 CONCLUSIONS
Device-delivered continuous passive range of motion may offer an
enhanced benefit for some adverse symptom reduction in the hemiplegic
arm after stroke over traditional self-range of motion exercise.
ANY QUESTION?