Chiarello C M, Gundersen L, O'Halloran T
Columbia University, Program in Physical Therapy, New York, NY 10032, USA.
J Orthop Sports Phys Ther. 1997 Feb;25(2):119-27. doi: 10.2519/jospt.1997.25.2.119.
There is insufficient information on continuous passive motion (CPM) parameters in total knee arthroplasty patients for optimal patient outcomes. We compared CPM duration and increments on active and passive range of motion (ROM) in patients who underwent a unilateral total knee arthroplasty due to degenerative joint disease. Forty-five total knee arthroplasty patients were randomly assigned to either a control group, a short CPM duration (3-5 hours per day) group with CPM ROM increased 5 degrees twice daily, a short CPM duration group with CPM ROM increased daily to patient tolerance, a long CPM duration (10-12 hours per day) group with CPM ROM increased 5 degrees twice daily, or a long CPM duration group with CPM ROM increased daily to patient tolerance. Active and passive flexion and extension were measured goniometrically on each postoperative day that the patient was treated by physical therapy. No statistically significant differences between groups were found for baseline and final postoperative ROM. The CPM groups did not maintain the parameters assigned and were combined, revealing an enhanced rate of change of flexion. Most patients opted for a CPM duration of between 4 and 8 hours per day and the patient-preferred CPM incremental increase in ROM was 6-7 degrees/day.
对于全膝关节置换术患者，为实现最佳治疗效果，关于持续被动运动（CPM）参数的信息尚不充分。我们比较了因退行性关节疾病接受单侧全膝关节置换术患者的CPM持续时间以及主动和被动活动范围（ROM）的增加情况。45例全膝关节置换术患者被随机分配至对照组、CPM持续时间短（每天3 - 5小时）且CPM ROM每日两次增加5度的组、CPM持续时间短且CPM ROM每日增加至患者耐受程度的组、CPM持续时间长（每天10 - 12小时）且CPM ROM每日两次增加5度的组，或CPM持续时间长且CPM ROM每日增加至患者耐受程度的组。在患者接受物理治疗的术后每一天，通过角度测量法测量主动和被动屈伸情况。各小组之间在基线和术后最终ROM方面未发现统计学上的显著差异。CPM组未维持所分配的参数，因此将其合并，结果显示屈曲变化率有所提高。大多数患者选择每天4至8小时的CPM持续时间，患者偏爱的CPM在ROM方面的增量为每天6 - 7度。
