背景:连续被动运动(CPM)通常用作术后康复治疗,伴随着物理治疗,用于术后膝关节康复。然而,两者在膝关节置换术后恢复方面的疗效比较尚不清楚。
目的:比较CPM联合与单纯物理治疗在膝关节置换术后康复中的疗效和安全性。
方法:PubMed,Embase,和WebofScience数据库用于检索和访问有关CPM与物理治疗相比疗效的临床研究。使用ReviewManager软件根据纳入标准进行研究发表偏倚评估和数据分析。
结果:本研究共纳入6篇557例患者。就运动范围(ROM)而言,CPM和物理治疗(PT)(WMD,-0.17;95%CI,-0.98-0.64;p=0.68)。在长期随访中,CPM和物理治疗(PT)(WMD,-0.28;95%CI,-1.47至-0.92;I2=65%,p=0.65)。此外,CPM产生的住院时间明显更高(大规模杀伤性武器,0.50;95%CI,-0.31至0.69;I2=3%,p<0.001)。相对于物理治疗,CPM产生显著更高的治疗成本并且引起更多的护理成本。
结论:与PT相比,联合CPM未能显著改善膝关节ROM和患者满意度。此外,CPM治疗显著增加了住院费用。
BACKGROUND: Continuous passive motion (CPM) is commonly used as a postoperative rehabilitation treatment, along with physical therapy, for postoperative knee rehabilitation. However, the comparison between the two in terms of efficacy in postoperative knee replacement recovery is unclear.
OBJECTIVE: To compare efficacy and safety of combined CPM versus physical therapy alone in postoperative rehabilitation after knee arthroplasty.
METHODS: PubMed, Embase, and Web of Science databases were used to retrieve and access clinical studies on the efficacy of CPM compared with physical therapy. Review Manager software was used for study publication bias assessment and data analysis based on inclusion criteria.
RESULTS: A total of 6 articles covering 557 patients were included in the study. In terms of range of motion (ROM), passive knee flexion was similar between CPM and physical therapy (PT) (WMD, - 0.17; 95% CI, - 0.98-0.64; p = 0.68). At long-term follow-up, passive knee extension was similar between CPM and physical therapy (PT) (WMD, - 0.28; 95% CI, - 1.47 to - 0.92; I2 = 65%, p =0.65). In addition, CPM generates significantly higher in length of stay (WMD, 0.50; 95% CI, - 0.31 to 0.69; I2 = 3%, p < 0.001). CPM generates significantly higher treatment costs and incurs more care costs relative to physical therapy.
CONCLUSIONS: Compared to PT, combined with CPM failed to significantly improve ROM of the knees and patient\'s satisfaction. In addition, CPM treatment significantly increased the cost of hospitalization.