Practice guideline for home setting and use of CPM devices for passive rehabilitation after orthopeadic surgery

 

Guideline for a correct use of CPM devices  at home

 

Practice and simple instructions for CPM device setting at home

 

 

 

Since some years, rental activities of CPM devices for patient dismissed are increased, who need to have an effective way to recover the mobility in the first weeks after surgery.

 

Generally, surgeons and physiotherapists recommend the use of CPM units at home, due to reasons which are linked to the time of the recovery.

 

Use of continuous passive motion (CPM) in the home setting may be considered medically necessary as an adjunct to physical therapy in the following situations:

 

- under conditions of low postoperative mobility or inability to comply with rehabilitation exercises following a total knee arthroplasty (TKA) or TKA revision;

- during the non-weight-bearing rehabilitation period following intra-articular cartilage repair procedures of the knee (e.g. microfracture,..);

- post articular cruciate ligament (or multi-ligament) reconstruction;

- post release ofadhesive capsulitis of the knee requiring manipulation under anesthesia;

 

Obviously CPM devices have (general) limitations and exclusions, which can be different from patient to patient, but normally applicable:

 

1) CPM therapy is recommended to be initiated within 72 hours of surgery (usually within 24-48) and is tipically utilized for a period of 7-10 days (not to exceed 21 days - (3 weeks)). Continued use beyond 21 days has not been shown to be effective and is therefore not considered to be medically necessary.

 

2) Continued use of CPM is not medically necessary after 95 degrees of knee flexion (measured by goniometry) is achieved;

 

3) CPM therapy is not considered medically necessary in individuals who are able to participate in an active physical therapy program;

 

4) CPM therapy is not considered medically necessary for the treatment of non-operatively treated degenerative joint diseases and / or chronic contractures;

 

 

Which are the critical points when a dismissed patient have to use a CPM device at home?

First of all the setting of the frame, and secondly the programming of the functions.

This two step have been solved by CPM manufacturers introducing practical guide, tutorial videos, pocket guides with images.

In this way, patient can follow the rehab session and participate actively in first person.

 

The only things to do? An electrical power unit is used to set the variable range of motion (ROM) and speed: even if the initial settings for ROM is based on patient's level of comfort, in next steps he has to set a different ROM. The ROM is increased by 3-5 deegres per day, as tolerated. The speed and ROM can be varied, depending on joint stability.
 

 

Actually Rimec is going to develop a new series of CPM devices, Fisiotek 3000, for passive rehabilitation of hip, knee and ankle.

Thinking to rental activities at home, we have thought to develop a device completely  "self-sufficient": about this point, symbols have been added to graphic in order to improve the easyness in programming.

Graphic symbols are useful for patients because they're self-explanatory and can be identified by everyone.

 

You want further information about the new graphic of Fisiotek 3000?

Visit our blog on Google Plus: Rimec S.r.l.

 

 

 

 

 

 

 

 



International Conference on Sports Rehabilitation and Traumatology - London, 20th and 21st April 2013

 XXII International Conference on Sports Rehabilitation ans Traumatology

 

presented by Isokinetic Medical Group

 

 

 

Rimec has been exhibitor at the XXII Conference presented by Isokinetic, in London, from 20th to 21st of April. The main theme of the congress was "Football Medicine Strategies for Muscle & Tendon Injuries", where have been discussed some of most important injuries of lower and upper joints, especially during sports activities.

The congress has taken place at The Queen Elizabeth II Conference Center (picture 1)

 

 

Picture 1

 

The congress has been also the opportunity, for some companies, to exhibit theirs products for rehabilitation purposes after joint injuries.

 

Rimec has exposed some of its equipment, as the new Fisiotek 3000, Fisiotek 2000 E and Fisiotek LT.  The attention of the public of reference has focused on Fisiotek 3000 (see pictures 2 and 3), which has be judged very interesting, thanks to its new programmables features, but especially for the weight: the quality of Fisiotek 3000 has improved (raw materials and components) up to the realization of a device with of weigh of only 9,5 kg, one of the heavier CPM devices on the market.

 

 

                            Picture 2                                                                           Picture 3

 

 

The public has evaluated this point as particulary useful for transportation and flexibility during the use: Fisiotek 3000 represent an excellent support for professional utilisation, where is required to customize and adapt the service provided with reference to the customer's needs.

 

The public of reference came from different countries all over the world: this annual meeting gather various nationalities and job roles, like surgeons, orthopaedic doctor, physiotherapists, physicians.

 

For the next year, the XXIII International Isokinetic Conference will take place in Milan, from 22nd to 24th March 2014, with the thème " Football Medicine Strategies for Joint & Ligament Injuries": we invite our customers to come and enjoy Fisiotek series.

If you want to discover this event, we invite you to watch the video of our sponsorship on YouTube, enjoy!

 

 

Passive rehabilitation of upper limbs: Fisiotek HP2 - completeness and effectiveness in an unique device

Fisiotek HP2: your partner for passive rehabilitation of upper joints

Fisiotek HP2 has met, since its creation, good appreciations by the health care and health professional's world. For reasons that are connected to quality, Fisiotek HP2 has demonstrated, during years, an excellent reliability and precision in the final results.

A creation of Rimec, Fisiotek HP2 has been studied with the aim to cover a wide range of needs in passive rehabilitation, especially because it cover all the major upper joint as shoulder, elbow and wrist (Picture 2).

Only one device for physical therapy: it has been designed in order to provide a complete solution for whom that treat different patologies (surgical's one or not surgical) for the upper limbs: this is only thanks to the wide choice of accessories that are available (as optional) for this device. 

Flexibility: it gives the possibility to operate both with patient in seated than in supine position. This is an excellent point of beginning, because it provide more confortable position for the patient. This possibility is enriched by the wheeled carriage, which allow to move the device everywhere.

Wide range of movement: being able to treat all the major upper joints, Fisiotek HP2 cover the complete physiological range through differents movements for each articulation (Picture 1):

- Shoulder: elevation - adduction/abduction - rotation (internal/external)

- Elbow: flexion/extension - pronation/supination

- Wrist: deviation - flexion/extension

Picture 1

Customization: this CPM device boast the opportunity to treat differents patient, even if they don't have to follow the same rehab session. Thanks to the Memory Card system, Fisiotek HP2 offer data memorization of all the parameters set; for this reason, it's possible to have one card for each patient.

Precision and reliability: HP2 mobilizer offers excellent stability thanks to the weight.

It's precise, because it uses a pointer laser for the correct correspondence with the rotation centers of the joints, and extremely reliable over time, because it not requires periodical maintenance or checks.

Fisiotek HP2 is available for customers who have physiotherapy centers, rehab clinics, physical therapy structures, and for all the professionals in Rehab field who need a perfect combination between quality, durability and reliability.

Picture 2

Picture 3



The Kirschner methodology: utilisation in Orthopedic First Aid

The Kirschner's methodology: application and advantages for the Orthopedic First Aid

 

Kirschner's methodology is an orthopedic technique used in surgery when is necessary to treat a fracture. It has been introduced by the surgeon Martin Kirschner, in 1909.

A Kirschner wire (also called a K-wire) is a thin, rigid wire that can be used to stabilize bone fragments. The wires are available from 0,8 mm to 4 mm, depending on the bone's size.
These wires can be drilled through the bone to hold the fragments in place.
They are placed percutaneously (through the skin), thus avoiding an operation in some cases.
In other cases, the K-wires are used after an operation to hold bone fragments in place.

The value is due to Mr. Kirschner, who has developped this precise technique for that aim, idealising both the metallic whire with differents dimeters, and the necessary equipment for the introduction in the bone.

The equipment consist in a drill for the introduction of the wire, the wire's guide, a traction's clamp, a traction's cord, some weights and a system of rods and pulleys in order to assure the hanging of the limb.

 

 

The K. method has the aim, tractioning the bone along its major axis, to win the tipical displacements of fractures and facilitate the reduction of them in favour of their healings.



In practice, the procedure consist in a previous retention of the reduction of the fracture (picture 1):

 

Picture 1



 

The bone's fragment has to be positioned in its original place, along the fracture's line.

 

Then, we have to insert n° 2 Kirschner's wires (picture 3) inside the bone, in the orthogonal direction with rescpect to the fracture's line (picture 2):

 

 

Picture 2

Picture 3


 

                  

                                                                                     

 

 

Between the advantages of this technique:

 

1)  a mini-invasive surgery;

2) the absence of cutaneous incisions;

3) the main solution to avoid fracture's breakdown;

 

And between the disadvantages there are:

 

1) the compulsory retention of the plaster cast or of the orthopedic support up to the complete strenghthening of the bone;

2) the risk of a potential breakdown of the fracture;

 

In conslusion, the highlight of this orthopedic procedure is to be particulary useful in Orthopedic  First Aid, where is not required to operate through an intervention but it's compulsory to act promptly.

The peculiarity of the technique, as mentioned, foresee the use of plaster cast, a valid support together with Kirschner's wires in favour of fractures's care.

The main advantages of CPM methodology

The main advantages in the application of CPM methodology (Continuous Passive Motion) during the post-operative period

 

 

The application of CPM methodology (Continuous Passive Motion) in the first weeks after a intervention of orthopedic surgery, has to be considered important in order to assure to the patient a correct recovery of the joint mobility.

Passive mobilization has, between its first purposes, the aim to prevent the stiffness in order to grant an efficient return to the correct joint functionality.
If we are in front of an intervention of orthopedic surgery, this kind of therapy avoid the formation of scars, which can provide narrow-movementness.

This kind of therapy represent a valid alternative to manual mobilisation; the correspondence between articulations and mechnical joints of CPM devices, permit to produce to the patient a fluid, precise and direct movement, respecting the physiological degrees which have to be recovered (picture 1).

 

Picture 1

The application of this kind of physical therapy operate through a "wake-up" action to the joint; the CPM devices which are present on the market, have features able to increase progressively the physiological degrees which have to be recovered.

In addition, the CPM methodology permit to obtain anti-infiammatory effects, reducing the localized swelling.
The therapy through CPM mobilizers is usually introduced in rehabilitation protocols of knee, hip and ankle.

Even if some people believe that passive rehabilitation is not necessary to a correct recovery of the joint's mobility, passive mobilization is introduced in rehabilitative protocols as a compulsory step, very important to follow.

Since years, are born professional roles who rent these CPM devices at home, for patient who exit from hospital; the patient, in this way, can have his therapy without move to a physiotherapy center. It's always important to follow what is suggested by the physiotherapist or by the surgeon.

Fisiotek 3000 - the new CPM mobilizer for passive rehabilitation of hip and knee

The customization of the therapy in your hands...

Fisiotek 3000:

 your point of reference for passive rehabilitation

 

Fisiotek 3000 is the new CPM device from Rimec - all rights reserved

 

 

 

 



 





 

Rimec open the doors to a new line of CPM, Fisiotek 3000.

The new series of CPM devices will be composed by 5 models, with differents programming features.

 

What's new? Not only new points of design, but a completely new philosophy for what Passive rehabilitation is concerned.

The patient is now involved actively with the physiotherapist.

 

Thanks to the new mobile programming keyboard, the patient can be charged of responsibilities and can now take part, with the doctor, to the effective recovery of the mobility.

 

Concernig the planning, new raw materials have been used, like the aluminium and the alloy steel: as a result, Fisiotek 3000 weights only 9,5 kilos and the frame has changed with the aim to provide more easyness of use and excellent flexibility.

 

The new design of the programming consolle helps to program the device:

 

- new graphic symbols helps you to choose between the different features;

- the new cognitive display resume you, during the session, the most important parameters;

- the structure of the control panel has been created to be intuitive;

 

Something more? Of course.

 

The frame is fixed, if we have to change the limb to rehabilitate, we don't need to screw something (as the precursor Fisiotek 2000).

 

In addition, the footplate can be adjusted, in order to welcome the need os those patient who can not keeo the ankle in a erect position.

 

Do you want to discover Fisiotek 3000?

 

Visit www.rimec.it and check Rimec's promotional events.