Trzeciak Tomasz, Richter Magdalena, Ruszkowski Krzysztof
Katedra i Klinika Ortopedii i Traumatologii, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu.
Chir Narzadow Ruchu Ortop Pol. 2011 Nov-Dec;76(6):345-9.
Continuous passive motion (CPM) is frequently used method in the early post-operative rehabilitation in patients after knee surgery. Aim of this study was to evaluate the effectiveness of CPM after primary total knee arthroplasty. Efficacy was assesed in terms of clinical score and functional recovery. 93 patients (101 knee joints) undergoing total knee replacement were assigned into two groups. The experimental group received continuous passive motion and active exercises. A control group received conventional physical therapy only. CPM was initiated in the first day after surgery, for 120 minutes, starting with 0-40 degrees range of motion, increased as tolerated (mean 10 degrees per day) and maintained during the hospital stay. Outcome measures were those included in Knee Society Score (KSS). Functional recovery was evaluated using WOMAC. All subjects were evaluated once before the surgery and on 10th day postoperatively. Mean clinical score (KSS) at the day 10 was 70 +/- 15 points in the experimental group and 74 +/- 12 in a control group. There were no statistical difference between the two groups for any outcome measures. CPM group mean range of motion was 83 degrees +/- 14 degrees and a group without CPM 77 degrees +/- 21 degrees. KSS functional score was 66 +/- 9 points in the experimental group compared to 62 +/- 7 points in a control group. Subjective estimation of pain level, joint stiffness and function showed no statistical difference between the two groups regarding total and subscale scores. Mean total score was 24 +/- 19 points in the CPM group and 22 +/- 17 in a group without CPM. These findings show that CPM had no significant advantage in terms of improving clinical measurements. However, there was beneficial effect on subjective assessment of pain level, joint stiffness and functional ability.
持续被动运动（CPM）是膝关节手术后患者早期术后康复中常用的方法。本研究的目的是评估初次全膝关节置换术后CPM的有效性。从临床评分和功能恢复方面评估疗效。93例（101个膝关节）接受全膝关节置换的患者被分为两组。实验组接受持续被动运动和主动锻炼。对照组仅接受传统物理治疗。CPM在术后第一天开始，持续120分钟，起始活动范围为0 - 40度，根据耐受情况增加（平均每天增加10度），并在住院期间维持。结果指标包括膝关节协会评分（KSS）中的项目。使用WOMAC评估功能恢复情况。所有受试者在手术前和术后第10天各评估一次。实验组术后第10天的平均临床评分（KSS）为70±15分，对照组为74±12分。两组在任何结果指标上均无统计学差异。CPM组的平均活动范围为83度±14度，未使用CPM的组为77度±21度。实验组的KSS功能评分为66±9分，对照组为62±7分。两组在疼痛程度、关节僵硬和功能的主观评估方面，总分及各子量表得分均无统计学差异。CPM组的平均总分是24±19分，未使用CPM的组为22±17分。这些结果表明，CPM在改善临床测量指标方面没有显著优势。然而，在疼痛程度、关节僵硬和功能能力的主观评估方面有有益效果。
