Clinically Proven
Studies & Clinical Evidence
Controlled movement of the joint soon after a surgery has been proven to speed up recovery and prevent stiffness. CPM therapy in particular is tried and tested in this regard.
Treatment Principle
Why CPM Therapy Works
CPM stands for Continuous Passive Motion. The principle has been established for decades in the rehabilitation of knee and shoulder joints and is now also available for hallux.
Controlled, passive movement of the joint immediately after the surgery distributes synovial fluid, promotes cartilage nutrition, and prevents adhesions. The joint remains mobile and healing is faster.
Schematic representation of passive joint mobilization — the principle of CPM therapy.
Reference Studies
The Scientific Basis
Clinical evidence regarding stiffness after immobilization, shorter recovery time with toe CPM and physical therapy after hallux surgeries, as well as the benefits of CPM therapy in general after joint interventions.
Akeson et al. (1987)
Stiffness After Immobilization
Already one week after immobilization, the lack of movement leads to shortening of the synovial membrane, adhesions of the synovial membrane, and long-term movement limitations.
One week
of immobilization is enough for the joint to stiffen
Akeson, W. H. et al. (1987). Effects of immobilization on joints. Clinical Orthopaedics and Related Research.
Connor et al. (1995)
Toe CPM Shortens Rehabilitation Time
Motorized toe CPM devices shorten the rehabilitation time after MTP-I surgery by up to 10 days compared to physical therapy alone. Range of motion increases earlier and patients return to normal load-bearing sooner.
10 days
quicker return to full mobility
Connor, G. F. et al. (1995). Continuous passive motion after MTP-I surgery. Foot & Ankle International.
Frigg et al. (2019)
Stiffness Persists Even with Minimally Invasive Surgery
Stiffness of the first MTP joint affects 7 to 38 percent of patients after hallux valgus surgery. This study was the first to compare the minimally invasive technique (MICA) with the open technique (scarf-Akin) in 98 patients over at least two years. The result: the stiffness rate was equally high in both groups, so the minimally invasive technique does not reduce the risk. The authors recommend prescribing physical therapy earlier than six weeks after surgery.
7 to 38 %
of patients develop stiffness, regardless of the surgical technique
Frigg A, Zaugg S, Maquieira G, Pellegrino A. Stiffness and Range of Motion After Minimally Invasive Chevron-Akin and Open Scarf-Akin Procedures. Foot & Ankle International 2019;40(5):515-525.
Schuh et al. (2008)
Advantage of Physical Therapy After Hallux Surgery
Targeted motion therapy after bunion surgery clearly improves big toe function and the physiological gait pattern, and increases peak pressure, range of motion, and the AOFAS score.
Up to 4 x higher weight-bearing of the big toe after 6 months
Schuh, R. et al. (2008). Effect of Physiotherapy on the Functional Improvement after Hallux Valgus Surgery. Z Orthop Unfall, 146, 630 to 635.
Schuh et al. (2009)
Advantage of Physical Therapy After Hallux Surgery
Physical therapy and gait training improve weight-bearing of the first ray during the stance phase. Within six months after surgery, the maximum force in the big toe increased significantly and patients resumed physiological weight-bearing of the foot.
6 months until weight-bearing of the first ray is restored
Schuh, R. et al. (2009). Importance of Physical Therapy to Restore Weight Bearing of the First Ray During the Stance Phase. Phys Ther, 89, 934 bis 945.
Michael et al. (2005)
Effectiveness of CPM in General
A motorized shoulder CPM device combined with physical therapy led to patients achieving full active mobility around 12 days earlier than with physical therapy alone, as well as faster pain reduction.
12 days
earlier to full active mobility
Michael, J. W. P. et al. (2005). Efficiency of a Postoperative Treatment after Rotator Cuff Repair with a Continuous Passive Motion Device (CPM). Z Orthop Unfall, 143, 438 to 445.
Garofalo et al. (2010)
Effectiveness of CPM in General
Four weeks of accompanying CPM use in the early rehabilitation phase after a shoulder surgery significantly improved both mobility and pain control compared to standard therapy alone.
Less pain
and more mobility in early rehabilitation
Garofalo, R. et al. (2010). Effects of one-month continuous passive motion after arthroscopic rotator cuff repair. Musculoskelet Surg, 94 (Suppl 1), pp 79 to 83.
All
Jaspers et al. 2018
Effectiveness of CPM in General
A continuous passive motion device significantly improves range of motion and reduces pain and swelling after cruciate ligament reconstruction. Knee flexion improved in the first to sixth postoperative weeks, swelling subsided between the fourth and sixth weeks.
Weeks 1 to 6
Better knee flexion and reduced swelling after cruciate ligament surgery
Continuous Passive Motion (CPM) does improve range of motion, pain and swelling after ACL reconstruction: a systematic review and meta-analysis.,“/pubmed/ 30321902″,“Jaspers T, Taeymans J, Hirschmüller A.“,“Z Orthop Unfall 2018 Oct
What These Studies Demonstrate
| ✓ Shorter recovery, faster return to physiological movement pattern | ✓ Prevention of joint stiffness and long-term adhesions |
| ✓ Promotion of joint mobility and synovial fluid distribution | ✓ Ensuring surgical success through early mobilization |
| ✓ Remobilization of already stiffened joints possible within 30 days | ✓ Reduction of pain through even, controlled movement |
Clinical Assessment
Patients report ease of use, clear instructions for use, noticeably increasing mobility and shortened recovery time. I recommend the device for broad clinical use in bunion correction postoperative treatment.
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