The estimates for risk of manipulation and adverse events are very imprecise and the estimate for the risk of adverse events does not distinguish between a clinical ly important increase and decrease in risk .
There was insufficient evidence to determine the effect of CPM on participants ' global assessment of treatment effectiveness .
CPM does not have clinical ly important effects on active knee flexion ROM , pain , function or quality of life to justify its routine use .
BACKGROUND Arthritis of the knee is a common problem causing pain and disability .
If severe , knee arthritis can be surgically managed with a total knee arthroplasty .
Rehabilitation following knee arthroplasty often includes continuous passive motion ( CPM ) .
CPM is applied by a machine that passively and repeatedly moves the knee through a specified range of motion ( ROM ) .
It is believed that CPM increases recovery of knee ROM and has other therapeutic benefits .
However , it is not clear whether CPM is effective .
OBJECTIVES To assess the benefits and harms of CPM and st and ard postoperative care versus similar postoperative care , with or without additional knee exercises , in people with knee arthroplasty .
This review is an up date of a 2003 and 2010 version of the same review .
Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy, after total knee arthroplasty
Background Adequate and intensive rehabilitation is an important requirement for successful total knee arthroplasty . Although research suggests that Continuous Passive Motion ( CPM ) should be implemented in the first rehabilitation phase after surgery , there is substantial debate about the duration of each session and the total period of CPM application . A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion . It also suggested , however , that future research should concentrate on the treatment period during which CPM should be administered . Methods In a r and omised controlled trial we investigated the effectiveness of prolonged  CPM  use in the home situation as an adjunct to st and ardised PT . Efficacy was assessed in terms of faster improvements in range of motion ( RoM ) and functional recovery , measured at the end of the active treatment period , 17 days after surgery . Sixty patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment were r and omised over two treatment groups . The experimental group received CPM + PT for 17 consecutive days after surgery , whereas the usual care group received the same treatment during the in-hospital phase ( i.e. about four days ) , followed by PT alone ( usual care ) in the first two weeks after hospital discharge . From 18 days to three months after surgery , both groups received st and ardised PT . The primary focus of rehabilitation was functional recovery ( e.g. ambulation ) and regaining RoM in the knee . Results Prolonged use of CPM slightly improved short-term RoM  in patients with limited RoM at the time of discharge after total knee arthroplasty when added to a semi-st and ard PT programme . Assessment at 6 weeks and three months after surgery found no long-term effects of this intervention Neither did we detect functional benefits of the improved RoM at any of the outcome assessment s. Conclusion Although results indicate that prolonged CPM use might have a small short-term effect on RoM , routine use of prolonged CPM in patients with limited RoM at hospital discharge should be reconsidered , since neither long-term effects nor transfer to better functional performance was detected . Trial Registration IS RCT
The estimates for risk of manipulation and adverse events are very imprecise and the estimate for the risk of adverse events does not distinguish between a clinical ly important increase and decrease in risk .
There was insufficient evidence to determine the effect of CPM on participants ' global assessment of treatment effectiveness .
CPM does not have clinical ly important effects on active knee flexion ROM , pain , function or quality of life to justify its routine use .
BACKGROUND Arthritis of the knee is a common problem causing pain and disability .
If severe , knee arthritis can be surgically managed with a total knee arthroplasty .
Rehabilitation following knee arthroplasty often includes continuous passive motion ( CPM ) .
CPM is applied by a machine that passively and repeatedly moves the knee through a specified range of motion ( ROM ) .
It is believed that CPM increases recovery of knee ROM and has other therapeutic benefits .
However , it is not clear whether CPM is effective .
OBJECTIVES To assess the benefits and harms of CPM and st and ard postoperative care versus similar postoperative care , with or without additional knee exercises , in people with knee arthroplasty .
This review is an up date of a 2003 and 2010 version of the same review .