Nadler S F, Malanga G A, Zimmerman J R
Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, New Jersey School of Medicine, Newark.
Am J Phys Med Rehabil. 1993 Jun;72(3):162-5. doi: 10.1097/00002060-199306000-00011.
Continuous passive motion (CPM) has been commonly used in the postoperative rehabilitation of patients after total knee arthroplasty. In the acute care hospital, most studies have found CPM to be useful in improving range of motion and reducing length of stay. The benefit of CPM in the rehabilitation hospital has not been studied. The charts of 61 patients who had undergone total knee arthroplasty and subsequently were admitted to the East facility of the Kessler Institute for Rehabilitation were reviewed. Patients were separated into two groups: Group 1 received CPM for 3 to 4 hours/day and physical therapy for 2 hours/day. Group 2 received only physical therapy. There was no significant difference in passive range of motion or length of stay between Group 1 and Group 2. An analysis of the 16 patients who underwent bilateral replacement was undertaken. Patients in Group 1 (n = 7) achieved an average increase in passive range of motion of 20.1 degrees, whereas those in Group 2 (n = 9) achieved an increase of 12.7 degrees (P = 0.18). Power analysis demonstrated the need for 50 patients per subgroup to achieve significance. The lack of statistical significance in this subgroup may be a reflection of the small study population (n = 16). The following conclusions can be drawn concerning the use of CPM in the rehabilitation setting: (1) CPM was of no added benefit to those patients admitted after single knee replacement, and (2) CPM may be beneficial to those patients admitted after bilateral knee replacement.
持续被动运动（CPM）已普遍用于全膝关节置换术后患者的康复治疗。在急症医院，大多数研究发现CPM有助于改善关节活动范围并缩短住院时间。CPM在康复医院中的益处尚未得到研究。我们回顾了61例接受全膝关节置换术并随后入住凯斯勒康复研究所东区的患者的病历。患者被分为两组：第1组每天接受3至4小时的CPM治疗和2小时的物理治疗。第2组仅接受物理治疗。第1组和第2组在被动关节活动范围或住院时间方面没有显著差异。对16例行双侧置换的患者进行了分析。第1组（n = 7）患者的被动关节活动范围平均增加了20.1度，而第2组（n = 9）患者增加了12.7度（P = 0.18）。功效分析表明每个亚组需要50例患者才能达到显著性。该亚组缺乏统计学显著性可能反映了研究人群较小（n = 16）。关于在康复环境中使用CPM可得出以下结论：（1）CPM对单膝关节置换术后入院的患者没有额外益处，（2）CPM可能对双侧膝关节置换术后入院的患者有益。
