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Abstract：
BACKGROUND: The use of continuous passive motion therapy (CPM) has led to promising results in the early phase of rehabilitation after surgical treatment of rotator cuff tears and arthrolysis of the elbow. However, its use has not been proven in other pathologies of the upper extremity. Therefore, the aim of the underlying study was to evaluate the use of CPM therapy after plate osteosynthesis of proximal humeral fractures.
METHODS: 95 patients with isolated proximal humerus fractures were enrolled in a prospective, randomized study. Patients were assigned to a treatment group with (n = 48, CPM) or without CPM therapy (n = 47, CG). Four patients (2 of each cohort) violated the study protocol and were excluded. CPM therapy was used for 6 weeks after surgery 2-3 times daily. Functional (range of motion) and patient reported outcomes (PROM, Constant Score [CSS], QuickDASH, subjective shoulder value [SSV], pain on visual analogue scale [VAS]) were evaluated at 6 weeks, 3 and 12months. 60 patients completed the 1-year follow-up.
RESULTS: The average patient age was 65.3 years (min: 27, max: 88, SD: ± 14.7). Seventy-two patients were female (79%). There was no difference regarding injury severity (2/3/4 part-fracture: 6/32/7 vs. 9/26/11, p = 0.867) and sex (p = 0.08). However, patients in the CPM group were significantly younger (CPM: 67 [min: 34, max: 82], CG: 74 [min: 27, max: 88], p = 0.032). After 6 weeks we observed a better range of motion for forward flexion (CPM: 90° [min: 50°, max: 180°] vs. CG: 80° [min: 20°, max: 170°] p = 0.035) and abduction (CPM: 80° [min: 40°, max: 180°] vs. CG: 70° [min: 20°, max: 180°], p = 0.048) in the CPM group. There was no difference regarding the further planes of motion or the assessed PROMs at 6 weeks. At 3 and 12 months the results between the treatment groups equalized with no further significant differences.
CONCLUSIONS: The treatment with CPM increases the range of motion after plate osteosynthesis of proximal humerus fractures in the first 6 weeks after surgery. This effect is not sustained after 3 and 12months. The evaluated PROMs are not being influenced by CPM therapy. Hence the results of this prospective randomized study suggest that CPM can be a beneficial asset in the early period of rehabilitation after proximal humerus plate osteosynthesis.
BACKGROUND: The study protocol was registered in the US National Institutes of Health\'s database ( http://www.
RESULTS: gov ) registry under NCT05952622.
METHODS: 95 patients with isolated proximal humerus fractures were enrolled in a prospective, randomized study. Patients were assigned to a treatment group with (n = 48, CPM) or without CPM therapy (n = 47, CG). Four patients (2 of each cohort) violated the study protocol and were excluded. CPM therapy was used for 6 weeks after surgery 2-3 times daily. Functional (range of motion) and patient reported outcomes (PROM, Constant Score [CSS], QuickDASH, subjective shoulder value [SSV], pain on visual analogue scale [VAS]) were evaluated at 6 weeks, 3 and 12months. 60 patients completed the 1-year follow-up.
RESULTS: The average patient age was 65.3 years (min: 27, max: 88, SD: ± 14.7). Seventy-two patients were female (79%). There was no difference regarding injury severity (2/3/4 part-fracture: 6/32/7 vs. 9/26/11, p = 0.867) and sex (p = 0.08). However, patients in the CPM group were significantly younger (CPM: 67 [min: 34, max: 82], CG: 74 [min: 27, max: 88], p = 0.032). After 6 weeks we observed a better range of motion for forward flexion (CPM: 90° [min: 50°, max: 180°] vs. CG: 80° [min: 20°, max: 170°] p = 0.035) and abduction (CPM: 80° [min: 40°, max: 180°] vs. CG: 70° [min: 20°, max: 180°], p = 0.048) in the CPM group. There was no difference regarding the further planes of motion or the assessed PROMs at 6 weeks. At 3 and 12 months the results between the treatment groups equalized with no further significant differences.
CONCLUSIONS: The treatment with CPM increases the range of motion after plate osteosynthesis of proximal humerus fractures in the first 6 weeks after surgery. This effect is not sustained after 3 and 12months. The evaluated PROMs are not being influenced by CPM therapy. Hence the results of this prospective randomized study suggest that CPM can be a beneficial asset in the early period of rehabilitation after proximal humerus plate osteosynthesis.
BACKGROUND: The study protocol was registered in the US National Institutes of Health\'s database ( http://www.
RESULTS: gov ) registry under NCT05952622.
摘要：
背景：使用连续被动运动疗法（CPM）在手术治疗肩袖撕裂和肘关节松解术后的早期康复阶段取得了有希望的结果。然而,它的使用尚未在上肢的其他病理中得到证实。因此,基础研究的目的是评估肱骨近端骨折钢板接骨后CPM治疗的应用.
方法：95例孤立性肱骨近端骨折患者纳入前瞻性研究，随机研究。患者被分配到接受（n=48，CPM）或不接受CPM治疗（n=47，CG）的治疗组。4名患者(每组2名)违反研究方案并被排除。手术后使用CPM治疗6周，每天2-3次。功能（活动范围）和患者报告的结果（PROM，恒定分数[CSS]，QuickDASH,主观肩值[SSV]，疼痛视觉模拟评分[VAS])在6周时进行评估，3和12个月。60例患者完成1年随访。
结果：患者平均年龄为65.3岁（min：27，max：88，SD：±14.7）。72例患者为女性（79%）。损伤严重程度没有差异（2/3/4部分骨折：6/32/7与9/26/11，p=0.867）和性别（p=0.08）。然而,CPM组患者明显年轻（CPM：67[min：34，max：82]，CG:74[min:27,max:88],p=0.032)。6周后，我们观察到向前屈曲的运动范围更好（CPM：90°[min：50°，max:180°]vs.CG:80°[min:20°,max:170°]p=0.035)和外展(CPM:80°[min:40°,max:180°]vs.CG:70°[min:20°,max:180°],CPM组p=0.048)。在第6周时，进一步的运动平面或评估的PROM没有差异。在3个月和12个月时，治疗组之间的结果相等，没有进一步的显着差异。
结论：CPM治疗增加了肱骨近端骨折术后前6周的钢板固定后的活动范围。这种效果在3个月和12个月后不会持续。评估的PROM不受CPM治疗的影响。因此，这项前瞻性随机研究的结果表明，在肱骨近端钢板接骨术后的早期康复中，CPM可能是一项有益的资产。
背景：研究方案已在美国国立卫生研究院的数据库中注册（http://www.
结果：gov）NCT05952622下的注册表。
方法：95例孤立性肱骨近端骨折患者纳入前瞻性研究，随机研究。患者被分配到接受（n=48，CPM）或不接受CPM治疗（n=47，CG）的治疗组。4名患者(每组2名)违反研究方案并被排除。手术后使用CPM治疗6周，每天2-3次。功能（活动范围）和患者报告的结果（PROM，恒定分数[CSS]，QuickDASH,主观肩值[SSV]，疼痛视觉模拟评分[VAS])在6周时进行评估，3和12个月。60例患者完成1年随访。
结果：患者平均年龄为65.3岁（min：27，max：88，SD：±14.7）。72例患者为女性（79%）。损伤严重程度没有差异（2/3/4部分骨折：6/32/7与9/26/11，p=0.867）和性别（p=0.08）。然而,CPM组患者明显年轻（CPM：67[min：34，max：82]，CG:74[min:27,max:88],p=0.032)。6周后，我们观察到向前屈曲的运动范围更好（CPM：90°[min：50°，max:180°]vs.CG:80°[min:20°,max:170°]p=0.035)和外展(CPM:80°[min:40°,max:180°]vs.CG:70°[min:20°,max:180°],CPM组p=0.048)。在第6周时，进一步的运动平面或评估的PROM没有差异。在3个月和12个月时，治疗组之间的结果相等，没有进一步的显着差异。
结论：CPM治疗增加了肱骨近端骨折术后前6周的钢板固定后的活动范围。这种效果在3个月和12个月后不会持续。评估的PROM不受CPM治疗的影响。因此，这项前瞻性随机研究的结果表明，在肱骨近端钢板接骨术后的早期康复中，CPM可能是一项有益的资产。
背景：研究方案已在美国国立卫生研究院的数据库中注册（http://www.
结果：gov）NCT05952622下的注册表。
