Knee CPM machines – no long-term ROM or functional changes

This is the second or third study I’ve seen about how CPM machines don’t have evidence to show their effectiveness – in this one, they don’t provide long-term effects and don’t affect functional performance.  Why do a post about this one since I’m in an outpatient clinic?  In the future I may be at a hospital where they use them.  Additionally, we had a patient discharged from the hospital with an order for outpatient PT, and they wrote that we were to provide the person one and that person expected that is all we were to do.  Apparently this is a common issue with CPM – patients think that the machine will get them better and they don’t need to do any work (ours did eventually come back and work with us).  I struggled with how to say that we don’t provide them (which was a big sticking point in the conversation, because the order says that we do so we should have them and give the patient one, even though we don’t and we can’t), there is limited evidence for them, and that patients would be better served if they actively worked on their rehab with us.  Didn’t do that as well as I would have liked, but this is the place to learn and I think PT’s encounter people like that throughout their careers.  Anyway, here is the article info.

Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy, after total knee arthroplasty
Lenssen TAF, van Steyn MJA, Crijns YHF, Waltjé EMH, Roox GM, Geesink RJT, Brandt PA, De Bie RA  BMC Musculoskeletal Disorders 2008, 9:60 [29 April 2008]


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