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What is a CPM machine?
A Continuous Passive Motion (CPM) machine is a motorized apparatus designed to passively mobilize a joint within a predetermined range of motion. Typically utilized post-surgery, it aims to alleviate joint stiffness and enhance flexibility. While commonly associated with knee replacement procedures, CPM machines are also applicable for elbow, hip, and shoulder surgeries.
Traditionally, CPM Machines have been standard in hospitals and as at-home recovery aids. However, recent research has raised doubts regarding their efficacy.
Read on to explore the latest findings and considerations for integrating CPM into your post-surgery recovery regimen.
Do CPM machines offer benefits?
Concerns about joint stiffness post-surgery may lead to restricted motion and the formation of scar tissue. CPM machines facilitate joint movement without requiring muscular effort, theoretically counteracting the negative effects of prolonged immobility. Nevertheless, the effectiveness of CPM remains contentious, with several studies reporting no significant improvement in range of motion among post-operative patients.
The American Physical Therapy Association now advises against CPM machine usage following total knee replacement surgeries, based on recent evidence indicating negligible benefits.
While some studies suggest potential advantages in specific scenarios, inconsistent positive outcomes and limited sample sizes characterize much of the research. Consequently, many healthcare professionals are no longer advocating for CPM machine use, favoring alternative recovery methods.
Applications of CPM machines
CPM machines are predominantly utilized post-knee surgeries but can also address hip, shoulder, and elbow joint procedures. Additionally, they have been explored for managing chronic non-specific back pain.
Post-knee surgery CPM utilization
Despite occasional use post-knee reconstructive surgeries, studies have indicated limited efficacy. For instance, research on CPM application following intra-articular knee fracture repair showed no discernible benefits.
Yet, there are exceptions. A study on ACL reconstructive surgery patients under 20 found reduced scar tissue interventions among those receiving CPM treatment. Moreover, early CPM implementation with swift motion range progression has shown promise for optimal recovery.
CPM applications beyond knees
CPM machines may be recommended after hip surgeries, as evidenced by improved hip flexion following arthroscopic interventions for hip impingement.
Similarly, for shoulder surgeries like adhesive capsulitis treatment, both CPM and traditional physiotherapy have demonstrated recovery enhancements. Notably, CPM users reported superior pain alleviation and functional improvement.
Regarding elbow surgeries, CPM's efficacy is uncertain, with studies suggesting redundancy and limited effectiveness.
Addressing chronic non-specific back pain, CPM usage for three weeks has shown pain reduction benefits.
Using a CPM machine
Before initiating CPM therapy, consult with your healthcare provider to determine its suitability and explore alternative treatments, given recent research questioning its efficacy.
Your healthcare provider and device instructions should guide proper CPM utilization. Typically, the device is used while lying down, with remote control adjusting motion parameters.
CPM duration varies depending on surgery type and extent, typically lasting four hours daily for four weeks post-hip surgery and about three weeks post-knee replacement.
Precautions and costs
Despite lingering recommendations for CPM use in some cases, its efficacy is under scrutiny. The American Physical Therapy Association advises against CPM after knee surgery unless formal physical therapy isn't viable, citing limited benefits versus the added costs and risks of prolonged bed rest.
Obesity has been associated with less favorable CPM outcomes, warranting caution. If experiencing discomfort or concerns during CPM use, discontinue and seek medical advice promptly.
CPM machines entail considerable costs, with options for rental or purchase, typically covered by health insurance, including Medicare.
In conclusion, while historically prevalent in post-surgery recovery, CPM machines' efficacy is increasingly debated, prompting careful consideration and consultation with healthcare professionals regarding their use.
