Definition Continuous passive motion (CPM) is a modality of postoperative treatment intended to assist recovery following joint surgery or injuries

of upper or lower extremities. CPM equipment covers a range of mechanical devices designed to move the patient's joint or extremity without the use of the patient's muscles through a prescribed range of motion over extended periods of time. These devices were first introduced in the 1980s by Dr. Robert Salter, an orthopedic surgeon. Purpose CPM is used to reduce the adverse effects of trauma or immobilization following surgery. In physiological terms, synovial fluid is diffused without hindering tissue repair; the joint receivesnutrition, the flow of venous blood is increased, and the cartilage is prevented from deteriorating. From a clinical perspective, joint swelling (edema) is decreased, range of motion (ROM) is maintained, tissue repair is accelerated, and the patient experiences less pain. CPM devices are used as alternatives and adjuncts to conventional physical therapy following surgery or injury. CPM devices may also be used in bedridden surgical patients to reduce the incidence of deep vein thrombosis, to treat abnormal muscle shortening that occurs due to prolonged immobilization, and in patients with burns or joint sepsis. Continuous passive motion (CPM) device is a motorized device that moves a joint through a prescribed range of motion for an extended period of time. The use of CPM devices are based on the theory that passive motion early in the healing process can provide movement of the synovial fluid and thus promote lubrication of the joint, stimulate the healing of articular tissues, prevent adhesions and joint stiffness, and reduce edema, without interfering with the healing of incisions or wounds over the moving joint. The goal of CPM devices is to maintain or restore range of motion (ROM) to the joint. The benefits of CPM are recognized although quantifying its value has been difficult. There is some evidence that use of CPM improves short- and midterm ROM of joints, avoiding a potentially painful physical therapy regimen to regain lost ROM. However, there continues to be conflicting findings regarding its effectiveness. CPM is often used to improve range of motion without patient assistance following total knee replacement, ligament reconstruction, tendon repair, joint manipulation under anesthesia, arthroscopic debridement of adhesions, stabilized intra-articular fracture, and articular cartilage regeneration techniques. Generally, CPM is initiated within 24 to 48 hours following surgery. Physical therapy following joint surgery or trauma focuses on restoration of mobility and active exercises to restore strength. Once the patient is participating in active PT, CPM is no longer medically necessary.