Chen B, Zimmerman J R, Soulen L, DeLisa J A
Department of Physical Medicine and Rehabilitation, UMDNJ-New Jersey Medical School, University Hospital, Newark 07103, USA.
Am J Phys Med Rehabil. 2000 Sep-Oct;79(5):421-6. doi: 10.1097/00002060-200009000-00003.
Continuous passive motion (CPM) has been shown to increase significantly the amount of knee flexion for patients with total knee arthroplasty in the acute care hospital. Whether there is any additional benefit to using CPM for these patients who are transferred to a rehabilitation hospital is not known. There have been no prospective, randomized, controlled studies in this area.
Fifty-one such patients on an inpatient rehabilitation service were randomly assigned to two groups. Group 1 (n = 23) received CPM for 5 consecutive hours per day plus physical therapy, whereas group 2 (n = 28) received only physical therapy. Knee flexion was measured by a blinded physical therapist on admission, on the third and seventh days of hospitalization, and at the time of discharge.
The results indicated no significant difference in passive range of motion between group 1 and group 2. Patients in group 1 achieved an average increase in passive range of motion of 16 degrees, whereas those in group 2 achieved an average of 19 degrees (P = 0.33).
Although power analysis indicated the need for differences in results for 32 patients per group to achieve significance, the difference between the two groups suggested neither statistical nor clinical significance. We concluded that the use of CPM in the rehabilitation hospital is likely of no added benefit to patients admitted after single total-knee replacement.
在急症医院，持续被动运动（CPM）已被证明能显著增加全膝关节置换术患者的膝关节屈曲度。对于转至康复医院的这些患者，使用CPM是否有额外益处尚不清楚。该领域尚无前瞻性、随机对照研究。
51名接受住院康复治疗的此类患者被随机分为两组。第1组（n = 23）每天接受5小时的CPM治疗加物理治疗，而第2组（n = 28）仅接受物理治疗。由一名不知情的物理治疗师在入院时、住院第3天和第7天以及出院时测量膝关节屈曲度。
结果表明第1组和第2组在被动活动范围上无显著差异。第1组患者的被动活动范围平均增加16度，而第2组患者平均增加19度（P = 0.33）。
尽管功效分析表明每组需要32名患者的结果存在差异才能达到显著性，但两组之间的差异在统计学和临床上均无意义。我们得出结论，在康复医院对单膝全膝关节置换术后入院的患者使用CPM可能没有额外益处。
