Efficacy of continuous passive motion compared to physiotherapy in rehabilitation after total knee replacement: a prospective randomized controlled non-inferiority trial.
Journal
International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation
ISSN: 1473-5660
Titre abrégé: Int J Rehabil Res
Pays: England
ID NLM: 7805421
Informations de publication
Date de publication:
09 Oct 2024
09 Oct 2024
Historique:
medline:
8
10
2024
pubmed:
8
10
2024
entrez:
8
10
2024
Statut:
aheadofprint
Résumé
Successful total knee replacement (TKR) heavily depends on postoperative rehabilitation. This study aims to investigate the efficacy of continuous passive motion (CPM) partially replacing group physiotherapy in an inpatient rehabilitation setting in order to contribute to the lack of physiotherapists in patients' care. Adult patients after TKR were included. A prospective randomized controlled two-center trial was conducted across inpatient rehabilitation facilities in Germany. Participants were randomly assigned to CPM or group physiotherapy. In addition, all participants received the same standard rehabilitation program. Primary outcome was the Staffelstein Score, and secondary outcome measures included Oxford Knee Score, range of motion (ROM), pain, and return to work. Non-inferiority margin for Staffelstein Score was set at ±5% of maximum scores based on previous collected data. Results indicate no significant differences between CPM and physiotherapy groups in the Staffelstein Score (CPM: 94 ± 10 points; group physiotherapy: 92 ± 10 points; P > 0.05), ROM, or pain management at discharge from rehabilitation facility. This study underscores the potential of CPM as a valuable component of TKR rehabilitation, providing comparable outcomes to traditional physiotherapy. However, individualized physiotherapy remains integral to optimizing long-term success. Future research should explore extended follow-up periods and diverse patient populations to further elucidate CPM's role in TKR rehabilitation.
Identifiants
pubmed: 39377759
doi: 10.1097/MRR.0000000000000646
pii: 00004356-990000000-00109
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Références
Brennan GP, Fritz JM, Houck LT, Hunter SJ. Outpatient rehabilitation care process factors and clinical outcomes among patients discharged home following unilateral total knee arthroplasty. J Arthroplasty 2015; 30:885–890.
Mistry JB, Elmallah RD, Bhave A, Chughtai M, Cherian JJ, McGinn T, et al. Rehabilitative guidelines after total knee arthroplasty: a review. J Knee Surg 2016; 29:201–217.
Bruun-Olsen V, Heiberg KE, Mengshoel AM. Continuous passive motion as an adjunct to active exercises in early rehabilitation following total knee arthroplasty – a randomized controlled trial. Disabil Rehabil 2009; 31:277–283.
Hong CM, Jid LQ, Yee Esther CW. Effectiveness of continuous passive motion in total knee replacement patients with slow rehabilitation under ERAS pathway. J Orthop Trauma Rehabil 2023; 30.
Richter M, Trzeciak T, Kaczmarek M. Effect of continuous passive motion on the early recovery outcomes after total knee arthroplasty. Int Orthop 2022; 46:549–553.
Wirries N, Ezechieli M, Stimpel K, Skutek M. Impact of continuous passive motion on rehabilitation following total knee arthroplasty. Physiother Res Int 2020; 25:e1869.
Jia Z, Zhang Y, Zhang W, Xu C, Liu W. Efficacy and safety of continuous passive motion and physical therapy in recovery from knee arthroplasty: a systematic review and meta-analysis. J Orthop Surg Res 2024; 19:68.
Lenssen TA, van Steyn MJ, Crijns YH, Waltje EM, Roox GM, Geesink RJ, et al. Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy, after total knee arthroplasty. BMC Musculoskelet Disord 2008; 9:60.
Chiarello CM, Gundersen L, O’Halloran T. The effect of continuous passive motion duration and increment on range of motion in total knee arthroplasty patients. J Orthop Sports Phys Ther 1997; 25:119–127.
Gerber LH. Exercise and arthritis. Bull Rheum Dis 1990; 39:1–9.
Harvey LA, Brosseau L, Herbert RD. Continuous passive motion following total knee arthroplasty in people with arthritis. Cochrane Database Syst Rev 2014; 2.
Salter RB. The biologic concept of continuous passive motion of synovial joints. The first 18 years of basic research and its clinical application. Clin Orthop Relat Res 1989; 242:12–25.
Chen B, Zimmerman JR, Soulen L, DeLisa JA. Continuous passive motion after total knee arthroplasty: a prospective study. Am J Phys Med Rehabil 2000; 79:421–426.
Herbold JA, Bonistall K, Blackburn M, Agolli J, Gaston S, Gross C, et al. Randomized controlled trial of the effectiveness of continuous passive motion after total knee replacement. Arch Phys Med Rehabil 2014; 95:1240–1245.
Bundesagentur-für-Arbeit. Berichte: Blickpunkt Arbeitsmarkt - Fachkräfteengpassanalyse 2023 Nürnberg Germany: Bundesargentur für Arbeit; 2023.
Deutsche Rentenversicherung Bund. Reha-Therapiestandards Hüft- und Knie TEP. 2020.
Middeldorf S, Casser HR. Verlaufs- und Ergebnisevaluation stationärer Rehabilitationsmaßnahmen nach alloarthroplastischem Hüft- und Kniegelenkersatz mit dem Staffelstein-Score. Orthopädische Praxis 2000; 36:230–238.
Naal FD, Impellizzeri FM, Sieverding M, Loibl M, von Knoch F, Mannion AF, et al. The 12-item Oxford Knee Score: cross-cultural adaptation into German and assessment of its psychometric properties in patients with osteoarthritis of the knee. Osteoarthritis Cartilage 2009; 17:49–52.
Khow YZ, Liow MHL, Goh GS, Chen JY, Lo NN, Yeo SJ. The oxford knee score minimal clinically important difference for revision total knee arthroplasty. Knee 2021; 32:211–217.
Potempa C, Rychlik RP. Zur Versorgung mit CPM-Bewegungsschienen nach Knie- bzw. Schulteroperationen. Monitor Versorgungsforschung 2018; 18:58–65.
Hyodo K, Masuda T, Aizawa J, Jinno T, Morita S. Hip, knee, and ankle kinematics during activities of daily living: a cross-sectional study. Braz J Phys Ther 2017; 21:159–166.