关节活动技术理论ppt课件.ppt

* * * Range of Motion CPM 益处 Benefits of CPM 避免黏连和挛缩，防止关节僵硬 adhesions and contractures joint stiffness 刺激肌腱和韧带，促进愈合 stimulating tendons and ligaments 增加活动关节伤口愈合 Enhances healing of the moving joint 增加关节滑液润滑作用，从而促进软骨内愈合与再生速率 Increases synovial fluid lubrication of the joint， increases intra-articular cartilage healing and regeneration 避免固定造成软组织衰退 Prevents the degrading effects of immobilization 更快地关节活动恢复 Provides a quicker return of ROM 减少术后疼痛 Decreases postoperative pain Range of Motion CONTINUOUS PASSIVE MOTION Focus on Evidence 减少术后并发症 早期出院 长期的功能影响 Some studies have identified detrimental effects, such as the need for greater analgesic intervention and increased post- operative blood drainage, when using CPM in contrast to claims that CPM decreases postoperative pain and post- operative complications. Cost-effectiveness of the CPM equipment, patient compliance, utilization and supervision of equipment by trained personnel, length of hospital stay, speed of recovery, and determination of appropriate patient populations become issues to consider when making the choice of whether or not to utilize CPM devices. Range of Motion CONTINUOUS PASSIVE MOTION CPM一般原则 General Guidelines for CPM 1. The device may be applied to the involved extremity immediately after surgery while the patient is still under anesthesia or as soon as possible if bulky dressings prevent early motion. 术后尽快使用，辅料厚重。 2. Often a low arc of 20°to 30 °is used initially and progressed 10 °to 15 °per day as tolerated. The portion of the range used initially is based on the range available and patient tolerance. 初始20°~30°，每天增加10°~15°，患者能忍受为度。 3. The rate of motion is determined; usually 1 cycle/45 sec or 2 min is well tolerated. 运动的速率通常为45s或2min为1个循环。 Range of Motion CONTINUOUS PASSIVE MOTION General Guidelines for CPM continuous