Abstract:

BACKGROUND: At present, continuous passive motion therapeutic instrument for treatment of joint stiffness and contracture following total knee replacement has been widely applied in orthopedics field. The speed is seldom paid attention during continuous passive motion, and there are no relevant reports.
OBJECTIVE: To explore the effects of continuous passive motion speed on postoperative joint functional rehabilitation following knee replacement.
METHODS: A total of 60 patients undergoing artificial total knee replacement were selected at the Department of Orthopaedics, Minhang Central Hospital, Shanghai Ruijin Hospital Group from December 2007 to August 2009. The subjects were assigned to treatment and control groups (n = 30). The treatment group taken at the beginning of continuous passive motion machine maximum speed of 1/2 gradually from 2/3 of the transition to a maximum speed of treatment, the initial scope of activities for the 0°-45°, a day continuous use of 2 hours. Each treatment increased 5-15 minutes per 1°, range of activities every day for 10°, all patients prior to discharge to reach 90°. In the next day, the biggest point of view at day 1 of the end of treatment served as a starting point, and then a gradual increase. In the control group, velocity of continuous passive motion was determined in accordance with patient comfort. Continuous passive motion machine was used following artificial knee replacement to assess knee Hospital for Special Surgery (HSS) and activities of daily living Barthel index at 1 and 5 days following treatment. Affected limb underwent visual analogue scale (VAS) was detected at the same time at 1, 3 and 5 days following treatment.
RESULTS AND CONCLUSION: VAS of affected limb was significantly decreased in both groups following continuous passive motion treatment. At 1 and 3 days following treatment, VAS was significantly lower in the treatment group compared with the control group (P < 0.01). No significant difference was determined between both groups at day 5 (P > 0.05). HSS was significantly greater in the treatment group compared with the control group at day 5, whereas Barthel index was significantly lower in the treatment group than in the control group (P < 0.01). Efficacy rate of knee joint range of motion was significantly greater in the treatment group compared with the control group before discharge. Above-mentioned results indicated that slow start to increase progressively continuous passive motion campaigns will obtain early rapid analgesia compared with the choices according to the patients’ wills, resulting in improving the ability of daily activities and knee stability enhancement.