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Continuous Passive Motion
(CPM)
Chapter 15
Purpose
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Produce passive joint motion
Effects:
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Enhance nutrition
Increase metabolic activity
Stimulate tissue remodeling and regrowth of healing
tissues:
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Articular cartilage
Tendons
Ligaments
Specific to Body Area and Motion
Knee Flexion/Extension
Wrist Flexion/Extension
Wrist Radial/
Ulnar Deviation
Finger Flexion/Extension
GH Flexion/Extension
GH Internal/External Rotation
Types of CPM devices
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Free Linkage
Anatomic
Nonanatomic
Free Linkage Design
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Moves the limb through ROM by grasping it
proximal and distal to the joint
Adjustable to patient
Contraindicated for unstable joints
Anatomic Design
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Mimics natural motion of involved joint and the
proximal joints
Most suitable for knees
Nonanatomical Design
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Does not attempt to replicate natural joint motion
Compensatory movement occurs between limb
and CPM unit
Physiological Effects of CPM
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Encourages the remodeling of collagen along the lines of
force
Reduces:
 The negative effects of joint immobilization
 Functional shortening
 Cross linking of collagen
 Capsular adhesions
Enhances the tensile strength of
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Tendons
Allografts
Skin
Stimulate repair of articular cartilage
Physiological Effects
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Fluid pressures
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Extension:
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Flexion:
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Most joint volume
Low pressure
Least joint volume
High pressure
Changes in pressure creates a pumping effect
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Circulates synovial fluid
Assists in the removal of:
 Hemarthrosis
 Periarticular edema
 Blood from tissues surrounding joint
Range of Motion
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Total end range time (TERT)
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Delivers a low load, prolonged stress
Increases ROM as TERT increases
Helps patient overcome the apprehension of
moving joint after surgery
Decreases rate of atrophy
Limits functional shortening of muscle
No increase on cardiovascular system
Joint Nutrition
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Stimulates circulation of synovial fluids
Increases nutrient uptake
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Meniscus
Articular cartilage
Edema Reduction
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Not clearly understood
Varies according to:
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The body part
Condition being treated
The passive movement of the limb and the
elevation of the body part could assist in venous
and lymphatic return by milking the muscle
Pain Reduction
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Movement of joint activates the gate control pain
theory
Other effects such as decreased edema could also
decrease pain
Not used as an acute pain-control technique
Ligament Healing
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ACL does not receive the same nutritional
benefits from CPM as cartilage because of its
separate synovial lining
Effective in allograft-augmented medial collateral
ligament reconstruction
Contraindications
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Unwanted joint motion and overstressing
Unstable fractures
Spastic paralyses
Uncontrolled infection
Deep Vein Thrombosis
Clinical Applications
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A CPM technician will use the manufacturers
protocol to administer treatment following
surgery
Precaution:
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CPM devices should not
be used in the presence
of flammable gases
Treatment Duration
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Long term bouts: patient continuously attached
1-hour 3 times per day
6 to 8 hours a day post-surgery
In home treatments with home visits by physical
therapist