Continuous Passive Motion

Continuous Passive Motion (CPM): refers to

passive motion that is performed by a
mechanical device that moves a joint slowly and
continuously through a controlled range of
motion.
Continuous Passive Motion Device for the
Knee.
Benefits of Continuous Passive Motion

– Preventing development of adhesion, contracture and

joint stiffness.
– Providing a stimulating effect on the healing of
tendons and ligaments.
– Minimizing the effect of immobilization.
– Increasing the synovial fluid of the joint so increase
rate of intra-articular healing.
• Indications

• After joint surgery, including anterior cruciate ligament

(ACL)
• After knee arthoroplasty
• After surgical repair of stable intra-articular or extra-
articular fractures
• After meniscectomy
• After osteochondral repair
• Contraindication

• Continuous passive motion is

contraindicated in cases for which the
device can cause unwanted translation of
opposing bones, overstressing the healing
process.
• Precautions

• The use of CPM in conjunction with

anticoagulation therapy may produce an intra-
compartmental haematoma.
• Skin irritation from the straps or carriage cover
may develop.
 Clinical Application of Continuous Passive
Motion
• General Principles:
• The CPM unit is often applied in the recovery room immediately
after surgery even when the patient is wearing brace or surgical
bandages.
• The arc of motion for the joint is determined. Often a low arc of 20 to
30 degrees is used initially and progressed to 10 to 15 degrees per
day.
• The rate of motion is usually 1 cycle per 45 seconds or per 2
minutes.
• The amount of time on the CPM machine ranges from 1 hour, three
time a day to continuous for 24 hours. After surgery use is for 6 to 8
hours a day.
• Physical therapy treatment is provided during the time the patient is
not on the CPM machine.
• Duration minimum for CPM is usually less than one week when a
satisfactory range of motion is reached.
The following protocol is provided as an example for a
post-ACL reconstructive surgery.

• Setup and Application:

• Measure the length of the patient’s thigh from the ischial

tuberosity to the joint line of the knee. Adjust the proximal
carriage so that the proximal end meets the bottom of the
buttocks.

• Determine the length of the lower leg by measuring from the

joint line of the knee to approximately ¼ inch beyond the
heel. Adjust the distal portion of the carriage accordingly.

• Place the lower extremity in the unit with the joint line of the
knee aligned to the articular hinge of the CPM unit.

• Adjust the foot in the footplate so that the tibia is placed in

the neutral position. Internal or external rotation of the tibia
can result in increased stress on the ACL.
• Set the Rom as prescribed by the surgeon. Usually started with a
limited ROM (0 to 60 degrees) and progress to the full ROM as
healing occurs.

• Set the speed of the treatment (e.g., cycle time of 4 minutes; 15

cycles per hour).

• Give the patient the hand held control and provide instruction on
how and when to use it, including increasing speed and ROM and
termination of the treatment.

• After termination of the treatment remove the machine and clean

the mechanical housings with soap specially if the unit become
soiled with blood or synovial fluid.
• Dispose of the carriage cover or wash it according to the
manufacture’s instructions.