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Nursing Literature - Essay Example

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There is a clinical debate about the merits of continuous passive motion (CPM) following total knee arthroplasty (TKA). This argument has been held over a 25 year period. There is even controversy in the current body of research as benefits and detriments are evaluated…
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Nursing Literature
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"Nursing Literature"

Download file to see previous pages According to Davis et.al. (2003) there is no difference in the use of CPM post operatively or not. This study used randomized patients studied in three different group through a six month period. They looked at length of stay, pain control and flexion of the knee. The results of the research should that there was no difference in range of motion, pain, or utilization of services between patients that had just physical therapy and patients who also have CPM. This was supported by a study done by Denis et.al.(2006). This group performed a randomized control trial that was very similar and weighted the use of CPM in different intervals ranging from 35 minutes per day to continuous ROM. These were compared to patients who had active physical therapy. The results showed that there was no difference between the results of each of the combinations of therapy.
Controversy comes when Wells et.al. (2008) did a meta-analysis of 14 studies. This analysis showed that in 14 randomized control trials the results were that CPM and PT increased active knee flexion and reduced hospital stay as well as pain and increased range of motion. Again, however, in the study done by Bruun-Olsen et.al (2009) in a randomized control trial done with active exercises versus CPM, results were very similar to other studies noted for this paper. There were not statistical differences noted between the control group and the trial group. Lenssen et.al. (2008) essentially agrees in his comparison of CPM during the 1st rehab phase to active physical therapy without CPM. This study shows only slight improvement with the use of CPM and is supported by Grilla (2008) who finds no support for CPM as improving any outcomes.
In conclusion, of the six studies that were reviewed, only one supported the use of CPM for increased motion, reduced length of stay or reduced pain. One, which was a meta-analysis did support it but is vague in its content. From these six studies alone, there is no evidence based answer. There is reason to further research the use of CPM in post of knee replacement.







References
Bruun-Olsen, V., Heiberg, K. & Mengshoel, A. (2009). Continuous passive motion as an adjunct to active exercises in early rehabilitation following total knee arthroplasty. Disability and Rehabilitiation. 31(4). 277-283. Retrieved from Academic ...Download file to see next pagesRead More
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