A client with a total knee replacement has a CPM (continuous passive motion device) applied during the postoperative period. Which statement made by the nurse indicates an understanding of the CPM machine?
A. “Use of the CPM will permit the client to ambulate during the therapy.”
B. “The CPM machine controls should be positioned distal to the site.”
C. “If the client complains of pain during the therapy, I will turn off the machine and call the doctor.”
D. “Use of the CPM machine will alleviate the need for physical therapy after the client is discharged.”
Correct Answer: B. “The CPM machine controls should be positioned distal to the site.”
The controller for the continuous-passive-motion device should be placed away from the client. Many clients complain of pain while having treatments with the CPM, so they might turn off the machine. The CPM flexes and extends the leg. Continuous passive motion (CPM) is a therapy in which a machine is used to move a joint without the patient having to exert any effort. A motorized device gently bends the joint back and forth to a set number of degrees, and the amount of movement and speed can be adjusted by the physical therapist. CPM machines are most commonly used on knee joints (after some types of knee surgery), but there are versions made for other joints as well.
Option A: The client is in the bed during CPM therapy. The use of CPM may begin in the recovery room after surgery or on the day after surgery. Use of the CPM machine may be continuous while you are in the hospital, other than at times when you are receiving other physical therapy or are getting out of bed to use the restroom.
Option C: The client will experience pain with the treatment. Recovering normal joint mobility after surgery can be a significant challenge. The stiffness of a joint can be a complication that limits outcomes and causes pain. Because of this, some surgeons use CPM to try to prevent scar tissue formation and improve range of motion.
Option D: Use of the CPM does not alleviate the need for physical therapy. It may be recommended after procedures like ACL reconstruction or frozen shoulder surgery, but CPM is most likely to be prescribed after knee replacement or knee cartilage repair surgery. It may also be used after surgery to remove knee tumors in children with osteosarcoma.