CPM Machine

[Carollyn14]

I absolutely loved my CPM. I'm 6 months post op now. I'm a nurse on an ortho floor and I'm always seeing patients suffer from severe stiffness because we dont use CPMs where I work and I think it's an absolute shame. These people that do so called studies on whether CPMs are useful need to have a dang knee replacement and find out the hard way. I'd say the majority of us have benefited from using a CPM. My flexion was 130 at 6 weeks. The CPM controlled my post op pain and prevented DVT along with taking Xarelto. It was awesome. What sold me on my CPM the most was when I was still in the hospital on post op day 1. I was on the CPM when P/T came by to walk me. I walked great with some minimal stiffness. She put me back to bed without the CPM for about 4 hours and came back to walk me. I was SO STIFF that I cold barely walk!! So has long as Stayed in the CPM, I was less stiff and less swollen. I don't care what these studies are saying, I believe hospitals stop using them to save money, bottom line!! At the patients expense of being miserable. Im sure theyre not for everyone but man, try it before you judge!!!!!

 

[skigirl]

I could not disagree more. I hated the stupid thing---I got a lot more from just walking around. I hated being strapped in---and it hurt my back. also the stupid things walk---and if you don't have a footboard, they walk right off the bed. My doc, a knee specialist, says that after 90 degrees, they are useless. I was 90 degrees on day one.

I now have a rom of 150 and I did not spend a single moment strapped down in bed with a silly machine.

 

[sleenie]

I was told I would use one at the hospital and likely at the rehab center and if needed will have one at home. I don't think it was designd for muscle strength but more for just keeing the knees from geting stiff. I can understand that because mine get stiff not from just sitting. Time will tell.

 

[kneeper]

My doc, a knee specialist, says that after 90 degrees, they are useless. I was 90 degrees on day one.

That's an interesting point.
I think the main thing is to move the knee. Maybe the cpm is used because it makes sure people do that.

 

[referee54]

It is very interesting reading of all of the different protocols that each OS has. As I have stated, my OS did not believe in them and I was to gain ROM on my own. My father's OS used them for both of my dad's TKR's---and my father told me jut the other day how much he loathed the CPM!

 

[suzzee2000]

I do need to find out how long I will be using it. Has anyone else been told they will be using this machine at home? Thoughts on the usage of it?

My opinion is ......I love using the cpm....My OS ordered it and I have had it since March 10th. The company will be picking it up on the 5th of April. I think it helped like some others have said just getting loosened up....

 

[leejaa]

It seems there are opposing views. My OS does not use them and I see no need- I definitely would not like to be strapped into anything - claustrophobic. My OS, the hospital PT and home PT stressed the importance of ankle slides and I did my ankle slides and ankle pumps and other exercises in small amts and slowly but often and that really helped with motion. If it works for some people and makes them feel good that is great but I am glad I did not have to use it - I know I would not have.

 

[Tobywan]

My surgeon actually told me to use one time and if I didn't like it I didn't have to use it. I loved it. Was in hospital 3 days and used it about 5 hours a day. Every time I was hooked up to it I fell asleep. On the second night I got the night nurse to hook me up to it around 11pm and told her I would call her when I wanted out. I fell asleep and was woken up by the tech getting blood at 5am. She asked how long I was in it. When told she left the room and got the night nurse who came in mortified that she hadn't gotten me out it. I told I didn't mind and wanted to stay in it for the rest of the night. I stayed in it until PT came at 9am and promptly walked 300ft. So for me I loved it.

 

[Racewalker45]

I have a CPM at home and use it 2 hours at a time, for a total of 6 hours a day. I increase the degree of flexion by 5-10 degrees daily. Right now I am at 75 degrees. I actually like the machine, it seems to help my range of motion. My OS wants me to use it for 21 days.

 

[new knee in June]

Love the C.P.M...It took care of all the "Mantra's" at once. Elevating ( toes above nose )
I use to ice on it ( sometimes over night ) & gentle stretching. I would fall asleep in it I think
My R.O.M ( 145 ) would of turned out well without it. But, I found it very comfortable
When It wasn't going, I still used it for elevating
Diana

 

[Celle]

Since the use, or not, of a CPM makes no difference in the long run, I think the long and short of it is this:

• If your surgeon recommends it and you feel it is helpful, use it.
• If your surgeon recommends it and you hate it, don't use it.
• If your surgeon does not recommend it and you don't use it, your recovery will not be impeded.

My surgeon doesn't use them, and I had a good recovery.

 

[new knee in June]

:iagree::iagree:

 

[bottomshollow]

@Celle, I think you have summed up the CPM machine business very nicely and succinctly. If it's okay with you, I'd like to use this in the future when it's appropriate giving you full credit for it.

 

[Celle]

Sure Judy, @bottomshollow

You're welcome! Use it any time you think it's appropriate.

 

[cjf1222]

I am currently in the "rack"as we call it, now. Since I only had a partial, It's hard to say what using it with a TKR would be like. I like using it and agree it's nice to observe the passive ROM increase daily. My home PT, who has 25+ years of experience, said she has seen better earlier results using the rack. I really didn't want to use one but am glad I have been.

 

[new knee in June]

I was just re-reading this thread. I think if your surgeon uses one, you should use it.
I would not go against what my surgeon uses. He obviously knows what he is doing
Diana

 

[Josephine]

Well this professional can give professional advice backed up with literature and statistics which I will do my best to rediscover. There have been innumerable papers on this topic, some written by the pro camp and others by the anti camp. They all appear to come to the same conclusion. For knee joint replacements the stats show that use of a CPM does not demonstrate any improved results over non-use of a CPM. This is a repeated conclusion. So why 'some' surgeons still insist on their use is a mystery! Obviously they don't read their own peer-reviewed publications! But the same can be said for use of anti-embolism stockings.

For those members who gleefully post that they 'love their CPM and use it all the time' and others who say 'I hated it', I would just say this:
a)the use or non-use of a protocol in one patient is not a viable statistic.
b) how would that individual know if use of the machine influenced their recovery? How would non-users know if NOT using it influenced their recovery? Truth is, they do not and they cannot.

My own (professional) opinion is that these are one-sided opinions with no empirical value whatsoever. Even the nurse who observed patients on her ward being stiff and concluded the non-use of the CPM to be responsible is just her personal opinion.

So I typed "cpm in tkr" into Google and these were the first five items that came up - interesting, no?

https://www.ncbi.nlm.nih.gov/pubmed/22959052
"No statistically significant differences were found in any of the outcome variables that were compared in this matched case design. No significant difference was found in all functional scores as measured by the Functional Independence Measure scale.

https://www.ncbi.nlm.nih.gov/pubmed/22708322
There were no statistical difference between the two groups for any outcome measures.
However, there was beneficial effect on subjective assessment of pain level, joint stiffness and functional ability.

https://www.wheelessonline.com/ortho/physical_therapy_after_tkr
- use of CPM may result in faster recovery of motion immediately after surgery, but appears not to ultimately increase ROM at one year post surgery;

https://physicaltherapy.about.com/od/orthopedicsandpt/a/Continuous-Passive-Motion.htm
Recently, the use of CPM during the post-operative period after TKR surgery has been called into question. Many well-designed studies that examined the effects of CPM after TKR have failed to show an added benefit from CPM when compared to active and passive physical therapy knee ROM exercises.

https://www.ncbi.nlm.nih.gov/pubmed/21752575
(Department of Orthopadic Surgery, Lilavati Hospital and Research Centre, Mumbai, India.)
We concluded that CPM gives no benefit in immediate functional recovery post-TKA, and in fact, the postoperative knee swelling persisted longer. We have since then discontinued its use in our patients without any untoward effect.

 

[Tykey]

Thanks Jo, it's always nice to go back to some real facts, and to confirm that they are useless in the long run, although some slight benefits to comfort at the early stage

We just need to remember that we still need to do our own exercises. Just sitting there immobile isn't the alternative to a CPM.

 

[skigirl]

Good point Tykey-- I had 90 rom on the day of surgery, so I did heel slides and outpatient pt from day 4 on. I did not have appreciable stiffness, so never felt the lack of the cpm.

But, I did spend most of the first two weeks and at least half of the time in the last two weeks of the first month in bed with my knee propped up on three pillows. I personally think it is more important to deal with the swelling and try to get it down than to worry about the rom.

 

[Celle]

I agree

I personally think it is more important to deal with the swelling and try to get it down than to worry about the rom.

I agree. The knee can't bend if it is still swollen with fluid. Get rid of the swelling and you may well find that the ROM was there all the time.