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Exercise Combined With Continuous Passive Motion or Slider Board Therapy Compared With Exercise Only: A Randomized Controlled Trial of Patients Following Total Knee Arthroplasty

LA Beaupré, MSc(PT), CPTA, MCPA, is Orthopaedic Research Coordinator, University of Alberta Hospitals, Orthopaedic Research, 8440–112 St, Edmonton, Alberta, Canada T6G 2B7 (lbeaupre{at}cha.ab.ca).
DM Davies, MSc(PT), CPTA, MCPA, is an orthopaedic research associate at University of Alberta Hospitals
CA Jones, PT, PhD, CPTA, MCPA, is an epidemiologist and a postdoctoral fellow, Faculty of Pharmacy, University of Alberta
JG Cinats, MD, FRCS(C), is Section Leader (Orthopaedics), Capital Health Regional Health Authority, and an orthopaedic surgeon at University of Alberta Hospitals

Address all correspondence to Ms Beaupré

Background and Purpose. The primary purpose of this randomized controlled trial was to determine which method of mobilization—(1) standardized exercises (SE) and continuous passive motion (CPM), (2) SE and slider board (SB) therapy, using an inexpensive, nontechnical device that requires minimal knee active range of motion (ROM), or (3) SE alone—achieved the maximum degree of knee ROM in the first 6 months following primary total knee arthroplasty (TKA). The secondary purpose was to compare health-related quality of life among these 3 groups. Subjects. The subjects were 120 patients (n=40/group) who received a TKA at a teaching hospital between June 1997 and July 1998 and who agreed to participate in the study. Methods. Subjects were examined preoperatively, at discharge, and at 3 and 6 months after surgery. The examination consisted of measurement of knee ROM and completion of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results. The 3 treatment groups were similar with respect to age, sex, and diagnosis at the start of the study. There were no differences in knee ROM or in WOMAC Osteoarthritis Index or SF-36 scores at any of the measurement intervals. The rate of postoperative complications also was not different among the groups. Discussion and Conclusion. When postoperative rehabilitation regimens that focus on early mobilization of the patient are used, adjunct ROM therapies (CPM and SB) that are added to daily SE sessions are not required. Six months after TKA, patients attain a satisfactory level of knee ROM and function.

Key Words: Continuous passive motion • Functional outcome • Randomized controlled trial • Rehabilitation • Total knee arthroplasty

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