Abstract：
OBJECTIVE: This study evaluated the efficacy of continuous passive motion (CPM) versus conventional physical therapy (CPT) in the early postoperative period following retrograde femoral nailing (RFILN). Based on the principles of operation of CPM, we hypothesized that it would improve knee function and decrease pain after open reduction and internal fixation with a retrograde femoral interlocking nail.
METHODS: Eighty-eight patients over the age of 18 years who met the inclusion criteria got randomized into one of two groups. The experimental group had CPM, while the control group had CPT. Postoperative knee functions assessed were the degree of knee stiffness, the total arc of motion, and knee pain. Knee stiffness, defined as the range of motion ≤ 90° assessed one week, two weeks, and six weeks postoperatively, while knee pain was measured using the visual analog scale (VAS) on days one, two, three, four, five, six and seven postoperatively.
RESULTS: The CPM group had a significantly lower incidence of knee stiffness at one week, two weeks, and six weeks postoperatively than the CPT group (all p < 0.0001). The VAS scores of the CPM group on days one, two, three, four, five, six and seven were significantly lower than those of the CPT group (p < 0.006 for day one and p < 0.001 for the remaining days). Similarly, the total arc of motion gained postoperatively was significantly greater in the CPM group than in the CPT (all p < 0.001).
CONCLUSIONS: The continuous passive motion effectively reduced the number of patients with knee stiffness and knee pain. It increased the total arc of motion in the early postoperative period compared to CPT. Therefore, we recommend CPM for patients undergoing retrograde femoral nailing use in the early postoperative period.
METHODS: Eighty-eight patients over the age of 18 years who met the inclusion criteria got randomized into one of two groups. The experimental group had CPM, while the control group had CPT. Postoperative knee functions assessed were the degree of knee stiffness, the total arc of motion, and knee pain. Knee stiffness, defined as the range of motion ≤ 90° assessed one week, two weeks, and six weeks postoperatively, while knee pain was measured using the visual analog scale (VAS) on days one, two, three, four, five, six and seven postoperatively.
RESULTS: The CPM group had a significantly lower incidence of knee stiffness at one week, two weeks, and six weeks postoperatively than the CPT group (all p < 0.0001). The VAS scores of the CPM group on days one, two, three, four, five, six and seven were significantly lower than those of the CPT group (p < 0.006 for day one and p < 0.001 for the remaining days). Similarly, the total arc of motion gained postoperatively was significantly greater in the CPM group than in the CPT (all p < 0.001).
CONCLUSIONS: The continuous passive motion effectively reduced the number of patients with knee stiffness and knee pain. It increased the total arc of motion in the early postoperative period compared to CPT. Therefore, we recommend CPM for patients undergoing retrograde femoral nailing use in the early postoperative period.
摘要：
目的：本研究评估了连续被动运动（CPM）与常规物理治疗（CPT）在逆行股骨钉（RFILN）术后早期的疗效。根据CPM的操作原理，我们假设逆行股骨带锁髓内钉切开复位内固定后,膝关节功能改善,疼痛减轻.
方法：88例符合纳入标准的18岁以上患者随机分为两组。实验组有CPM,对照组行CPT。术后膝关节功能评估为膝关节僵硬度，总的运动弧线，膝盖疼痛。膝部刚度,定义为一周评估的运动范围≤90°，两周,术后六周，而在第一天使用视觉模拟量表（VAS）测量膝关节疼痛，两个,三,四,五,术后6和7。
结果：CPM组在一周时膝关节僵硬的发生率显着降低，两周,术后6周高于CPT组(均p<0.0001)。第一天CPM组的VAS评分，两个,三,四,五,6和7显著低于CPT组(第1天p<0.006,其余天数p<0.001).同样，CPM组术后总活动度明显大于CPT组(均p<0.001).
结论：持续被动运动有效减少了膝关节僵硬和膝关节疼痛的患者人数。与CPT相比，它增加了术后早期的总运动弧度。因此,我们推荐CPM用于术后早期逆行股骨钉的患者.
方法：88例符合纳入标准的18岁以上患者随机分为两组。实验组有CPM,对照组行CPT。术后膝关节功能评估为膝关节僵硬度，总的运动弧线，膝盖疼痛。膝部刚度,定义为一周评估的运动范围≤90°，两周,术后六周，而在第一天使用视觉模拟量表（VAS）测量膝关节疼痛，两个,三,四,五,术后6和7。
结果：CPM组在一周时膝关节僵硬的发生率显着降低，两周,术后6周高于CPT组(均p<0.0001)。第一天CPM组的VAS评分，两个,三,四,五,6和7显著低于CPT组(第1天p<0.006,其余天数p<0.001).同样，CPM组术后总活动度明显大于CPT组(均p<0.001).
结论：持续被动运动有效减少了膝关节僵硬和膝关节疼痛的患者人数。与CPT相比，它增加了术后早期的总运动弧度。因此,我们推荐CPM用于术后早期逆行股骨钉的患者.
