• Serkan Bakırhan, Bayram Ünver, and Vasfi Karatosun.
• İzmir University School of Health, Department of Physiotherapy and Rehabilitation, İzmir, Turkey.
• Acta Orthop Traumato. 2015 Jan 1; 49 (5): 497-502.

ObjectiveThe aim of this study was to compare the effects of two different continuous passive motion (CPM) application protocols (low- and high-angle) on the early phase functional activities of total knee arthroplasty inpatients.MethodsThe study included 170 patients who underwent primary TKA. While 84 of the TKA patients underwent low-angle CPM application, 86 of the patients underwent high-angle CPM application. The patients' functional activities were compared using the Iowa Level of Assistance Scale (ILAS), gait speeds using the Iowa Ambulation Velocity Scale (IAVS), knee scores using the Hospital for Special Surgery (HSS) Knee Score, and the duration of hospital stays with the Visual Analog Scale (VAS) preoperatively and on postoperative Day 2, Day 6, and at discharge.ResultsIt was found that patients in the high-angle group had lower pain levels than did the patients in the low-angle group postsurgery (p<0.05). Patients in the high-angle group achieved their functional activities more independently on postoperative Day 2, Day 6, and at discharge than did the patients in the low-angle group (p<0.05). However, gait speed of patients in the former group was lower than that of the patients in the latter group (p<0.05).ConclusionAlthough low-angle CPM application produced better results in terms of gait speed following TKA, the high-angle CPM application was superior in terms of independence levels of functional activities in the early postsurgery period. This result suggests that the appropriate use of rehabilitation methods such as CPM applications may guide clinicians to increase patients' level of independence.

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