The effects of continuous passive motion on the temporomandibular joint after surgery Part II. Appliance improvement, normal subject evaluation, pilot clinical trial

Background and Purpose. This randomized clinical trial was conducted to compare the effectiveness of 3 in-hospital rehabilitation programs with and without continuous passive motion (CPM) for range of motion (ROM) in knee flexion and knee extension, functional ability, and length of stay after primary total knee arthroplasty (TKA). Subjects. Eighty-one subjects who underwent TKA for a diagnosis of osteoarthritis were recruited. Methods. All subjects were randomly assigned to 1 of 3 groups immediately after TKA: a control group, which received conventional physical therapy intervention only; experimental group 1, which received conventional physical therapy and 35 minutes of CPM applications daily; and experimental group 2, which received conventional physical therapy and 2 hours of CPM applications daily. All subjects were evaluated once before TKA and at discharge. The primary outcome measure was active ROM in knee flexion at discharge. Active ROM in knee extension, Timed “Up & Go” Test results, Western Ontario and McMaster Universities Osteoarthritis Index questionnaire scores, and length of stay were the secondary outcome measures. Results. The characteristics of and outcome measurements for the subjects in the 3 groups were similar at baseline. No significant difference among the 3 groups was demonstrated in primary or secondary outcomes at discharge. Discussion and Conclusion. The results of this study do not support the addition of CPM applications to conventional physical therapy in rehabilitation programs after primary TKA, as applied in this clinical trial, because they did not further reduce knee impairments or disability or reduce the length of the hospital stay. [Denis M, Moffet H, Caron F, et al. Effectiveness of continuous passive motion and conventional physical therapy after total knee arthroplasty: a randomized clinical trial.

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Design and Development of Continuous Passive Motion (CPM) for Fingers and Wrist Grounded-Exoskeleton Rehabilitation System

Applied Sciences ◽

10.3390/app11020815 ◽

2021 ◽

Vol 11 (2) ◽

pp. 815

Author(s):

Husam Almusawi ◽

Géza Husi

Keyword(s):

Experimental Testing ◽

Hand Movement ◽

Evaluation Process ◽

Continuous Passive Motion ◽

Wrist Flexion ◽

Design And Development ◽

Passive Motion ◽

Assistive Robots ◽

Flexion Extension ◽

Design Characteristics

Impairments of fingers, wrist, and hand forearm result in significant hand movement deficiencies and daily task performance. Most of the existing rehabilitation assistive robots mainly focus on either the wrist training or fingers, and they are limiting the natural motion; many mechanical parts associated with the patient’s arms, heavy and expensive. This paper presented the design and development of a new, cost-efficient Finger and wrist rehabilitation mechatronics system (FWRMS) suitable for either hand right or left. The proposed machine aimed to present a solution to guide individuals with severe difficulties in their everyday routines for people suffering from a stroke or other motor diseases by actuating seven joints motions and providing them repeatable Continuous Passive Motion (CPM). FWRMS approach uses a combination of; grounded-exoskeleton structure to provide the desired displacement to the hand’s four fingers flexion/extension (F/E) driven by an indirect feed drive mechanism by adopting a leading screw and nut transmission; and an end-effector structure to provide angular velocity to the wrist flexion/ extension (F/E), wrist radial/ulnar deviation (R/U), and forearm supination/pronation (S/P) driven by a rotational motion mechanism. We employed a single dual-sided actuator to power both mechanisms. Additionally, this article presents the implementation of a portable embedded controller. Moreover, this paper addressed preliminary experimental testing and evaluation process. The conducted test results of the FWRMS robot achieved the required design characteristics and executed the motion needed for the continuous passive motion rehabilitation and provide stable trajectories guidance by following the natural range of motion (ROM) and a functional workspace of the targeted joints comfortably for all trainable movements by FWRMS.

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