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Results for “Motion Therapy, Continuous Passive”

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At least 55 records · Page 3Linked to original sources
PubMed1998

[Long-term peridural anesthesia and minimally invasive therapy of arthrofibrosis of the knee joint].

We report on our experiences with continuous epidural anesthesia after arthrolysis of the knee joint. The restoration of knee motion is the main goal of our treatment regimen which includes daily passive full mobilisation of the knee joint with a continuous epidural catheter after arthroscopic lysis and a functional after treatment with full weight bearing. From December 1992 to November 1996 32 arthroscopic lysis have been performed at the Surgical Department of Triemli Hospital in Zürich, Switzerland. The indications for prior knee surgery included 22 ACL reconstructions, 4 sustained fractures about the knee and 6 miscellaneous etiologies. Arthroscopic lysis was performed for any failure in improving knee motion despite intensive physical therapy. According to Gassen et al. [4] we found one (3.1%) very severe, 5 (15.6%) severe, 12 (37.5%) moderate and 14 (43.8%) minor cases of arthrofibrosis. After 8 months on average, a second lysis had to be performed in six cases. All had an ACL reconstruction as prior surgery, in four out of these six patients only physiotherapeutic after treatment was performed after the first lysis, 2 patients developed a symptomatic patella baja. At the end of the treatment after 10 months on average, 16 (50%) cases showed a very good, 7 (22%) a good, 5 (16%) a satisfactory and 4 (12%) a poor result concerning range of motion. We think that a daily passive full mobilisation under regional anesthesia with a continuous epidural catheter is the key to hold the intraoperatively reached range of motion especially for moderate to very severe cases of arthrofibrosis.

Adult↗
PubMed2003

Pigmented villonodular synovitis of the knee with lesions of the bursae.

Five patients with pigmented villonodular synovitis of the knee associated with lesions of the posterior periarticular bursae were treated by posterior exploration, excision of the bursal tissue, and routine anterior synovectomy of the knee. It was hypothesized that complete excision of the posterior periarticular bursae would reduce the high recurrence rate of pigmented villonodular synovitis of the knee. To completely excise the periarticular lesions, two posterior oblique skin incisions were used. In all patients, periarticular lesions were seen clearly on computed tomography scans after air arthrography and on magnetic resonance imaging scans. The patients were followed up for 6.9 years on average (range, 3.3-8.1 years) after surgery. One of five patients required reoperation because of recurrence. Two of five patients required manual mobilization after release of the intraarticular adhesion. However, in the remaining three patients, who started continuous passive motion exercise immediately after surgery, full range of motion was restored within 3 months after the operation. Complete excision of the periarticular lesions is recommended to reduce the high recurrence rate, and continuous passive motion exercise immediately after surgery also is recommended to prevent reduction of range of motion.

Adult↗
PubMed2003

Simultaneous bilateral tibial tubercle avulsion fracture in a basketball player.

A 16-year-old male basketball player had sustained an injury upon landing after a forceful jump. Plain radiography demonstrated bilateral tibial tubercle avulsion fracture involving partially proximal physis. Open reduction and internal fixation were performed at once. Continuous passive motion was started immediately after operation, and the patient was ambulated with hinged knee extension braces. After 27 months follow-up his knees completely regained normal range of motion except a 3 degrees extension loss in the left knee. He resumed all daily functional activities (Lysholm functional score of 99), but he slightly lost his level of activity (Tegner activity level from 7 to 6). No angular deformity at all on the frontal plane was determined upon radiological examination. Tibial slope angles were symmetrical and within the normal range. There were visible small bone fragments inside the left patellar tendon.

Adolescent↗
PubMed1991

Continuous passive motion versus immobilization. The effect on posttraumatic joint stiffness.

Management of intraarticular fractures is often complicated by joint stiffness long after bony healing has occurred. The following experiments provide biomechanical evidence for the effectiveness of CPM in maintaining joint function in stabilized articular injuries. The ankles of ten adolescent New Zealand white rabbits were penetrated by Steinmann pins to create an intraarticular injury. One limb of each animal was immobilized, and the contralateral limb was placed in a continuous passive motion (CPM) machine for three weeks. Joint stiffness of each ankle was quantified with an arthrograph before injury and after three weeks of treatment. Hindlimb volumes were recorded before injury and monitored at weekly intervals using a water-displacement method. Joint stiffness increased 2.6 times the preinjury levels in limbs that were immobilized for three weeks. There was no statistically significant increase in joint stiffness in ankles treated with CPM compared to preinjury values. The posttraumatic difference between the CPM-treated and immobilized limbs was highly significant; limb swelling was not affected by CPM.

Animals↗
PubMed1993

Rehabilitation of the temporomandibular joint through the application of motion.

This paper presents a method of joint rehabilitation utilizing the principals of active motion and CPM (continuous passive motion) and joint unloading. Most true intra-articular disorders appear to be a progression of both chemical and mechanical alterations. The physiological sound principals of joint mobilization are used both as post surgical rehabilitation and as definitive therapy. When used as nonsurgical therapy, the benefits appear to be as a result of a reversal, lessening, or a favorable adaptive response of the chemical and mechanical alterations.

Adult↗
PubMedDate not supplied

Management of the completely stiff pediatric knee.

The purpose of this study was to ascertain whether aggressive surgical treatment of ankylosed knees, followed by immediate continuous passive motion (CPM), can restore acceptable function in children. A retrospective analysis was performed on five children operated on for severely contracted knees. In all cases, extensive intraarticular pathology was present, and lysis of adhesions, tendon lengthenings, and capsular releases were performed in each case. Cruciate ligament release, drilling of subchondral bone, and patellectomy or meniscectomy or both also were performed in certain cases. Surgery was followed by immediate CPM for 6 weeks. Knee motion improved significantly from a preoperative mean of 7 degrees (range, 0-20 degrees) to 63 degrees (range, 15-90 degrees) at final follow-up, and all patients were satisfied with the result. The mean follow-up interval was 4.6 years. The regenerative properties of articular cartilage as well as the physis in the skeletally immature may permit a radically different approach from that accepted in adults. Such an approach can spare the native joint and restore acceptable function.

Adolescent↗
PubMed1991

ACL reconstruction: in vivo measurement of patellar tendon graft elongation.

The implantation of a free autogenous patellar tendon graft is the surgical technique that currently offers the best results in anterior cruciate ligament reconstruction. However, numerous aspects regarding both technique and postoperative rehabilitation can still be improved. The aim of this study was to measure the elongation of the patellar tendon in vivo in the operating room after reconstructive surgery, subjecting the knee to normal strain such as passive mobilization or anterior displacement of the tibia. Three volunteers were studied. Our results were different from those reported in a previous study conducted in vivo on a normal anterior cruciate ligament (ACL). In spite of the isometric position of the tendon, passive mobilization provoked a progressive increase in the elongation of the graft within each cycle of flexion-extension and between one cycle and the next. This also occurred during the Lachman test. These findings suggest that the graft undergoes a process of tensile adjustment when it is first put under strain. Continued elongation once this process appears stabilized raises doubts as to the reliability of isometric measuring devices.

Adult↗
PubMed2001

Remodelling following condylar fractures in children.

PURPOSE: In this study, 18 children with 21 subcondylar fractures sustained during their growth period (age at trauma from 4-11 years, mean 7.7 years) have been followed-up. MATERIAL AND METHODS: All patients were treated by custom-made arch bars and intermaxillary fixation for 12-17 days, then kept on a liquid diet for 15 days without fixation. The mean follow-up was 4.7 years. The conservative treatment has been evaluated with clinical, radiographic, and functional parameters. RESULTS: Remodelling of the condylar head was good in 17, whilst moderate remodelling occurred in the other four condyles. In four patients, a slight deflection (less than 2 mm) to the side of the fracture on wide mouth opening was seen. There was no malocclusion or ankylosis. CONCLUSION: Conservative treatment of condylar fractures during growth resulted in good function and good remodelling of the condyle. Functional treatment after intermaxillary fixation for 12-17 days proved to be quite acceptable.

Bone Remodeling↗
PubMed1998

[Joint empyema].

Bacterial joint infection is rare but may have an unfavourable functional aotcome. The different stages of purulent arthritis, depending on the pathophysiological developments, require different treatment measures. Clinical examination, analysis of joint tap and arthroscopy are crucial for diagnosis. Surgical management comprises: (1) open or arthroscopic débridement with intensive flush lavage; (2) postoperative drainage and flush lavage; (3) early and continuous active and passive motion. Recovery will be complete only if therapy is instituted as early as possible (within 3 days). Joint empyema must therefore be treated as a surgical emergency.

Adult↗
PubMedDate not supplied

Continuous passive motion as an alternative treatment for iatrogenic hallux limitus.

The use and effect of continuous passive motion (CPM) was evaluated for 10 patients suffering from iatrogenic hallux limitus. All patients had previous hallux valgus corrective surgery. After their initial evaluation, patients were instructed to begin CPM therapy at home for a minimum of 4 hr. a day and were instructed to increase range of motion (ROM) as tolerated. CPM was used for 4 weeks. ROM was measured on day 0, 28, 48, 90. There were significant increases in mean extension (p < 0.025) and mean flexion (p < 0.05). All patients reported a decrease in pain and stiffness of the first metatarsophalangeal joint. Seven of the 10 patients treated with CPM had increases in ROM. Three patients, all of whom had first metatarsal elevatus, required an additional surgical procedure. Patients suffering from iatrogenic hallux limitus with no associated first metatarsal elevatus can utilize CPM as a viable alternative to return to functional ROM.

Contracture↗
PubMed1997

Prospective outcome analysis of a protocol for the surgical and rehabilitative management of burns to the hands.

Treatment protocols for the management of burned hands are essential for integrating team efforts and achieving optimal functional results. Standard protocols are especially useful during mass casualty incidents, when the admission of multiple patients with large burns and/or associated injuries may reduce the priority usually accorded the hands. We prospectively evaluated a surgical and rehabilitative treatment protocol for burned hands during a mass casualty incident, after which 43 burn patients with 82 burned hands were admitted to one burn center. Soft-tissue management was individualized to achieve, if possible, wound closure within 14 days, and included the use of topical antimicrobials, cutaneous debridement and/or tangential excision, biologic dressings, and split-thickness autografts. Range of motion therapy was based on daily measurement of active motion of the metacarpophalangealjoints. Static splinting alternating with continuous passive motion every 4 hours was utilized for sedated patients. Continuous passive motion alternating with active ranging and night splinting was utilized for metacarpophalangeal flexion <70 degrees. Active ranging and progressive resistance was utilized for metacarpophalangeal flexion > or =70 degrees. Sixty-four hands required excision and grafting, with 89 percent having at least one autografting procedure completed by postburn day 16. Total active motion of the hands treated averaged 220.6 degrees on discharge and 229.9 degrees at 3 months after injury. Mean hand grip strength was 60.8 pounds at discharge and 66.0 pounds at 3 months after injury. Adherence to a standard hand burn protocol resulted in timely wound coverage and recovery of hand function for a large group of patients treated at a single burn facility after a mass casualty incident.

Accidents, Aviation↗
PubMed2006

Does passive leg activity influence oxygen saturation and activity in sedentary elderly adults?

This study aimed to investigate whether any physiological changes might have a clinically significant effect on function in sedentary, institutionalized, older adults treated by a passive training program. A total of 18 subjects (mean age 60.7 +/- 3.4) with intellectual disability (ID) participated. We measured SpO2 (arterial oxygen saturation) before, during, and after passive training, and used Barthel Index to measure daily living activities. The general trend indicated that inactive people with ID evidenced a continual increase in SpO2% levels and some functional gains during passive treatment, with superiority to manual passive treatment compared to mechanical active passive training. For current clinical practice, most sedentary patients who experience clinically significant deconditioning and desaturation can benefit from passive treatment.

Activities of Daily Living↗