Publication Date

Spring 4-2017

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Colleen O’Leary-Kelley

Second Advisor

Betty King

Third Advisor

January Tenorio

Keywords

Manipulation under anesthesia, Continuous passive motion, Total knee arthroplasty, Total knee replacement, Orthopedic nursing

Abstract

Since the early 1980s, continuous passive motion has been used as adjunct therapy in patients’ rehabilitation following total knee arthroplasty. Although existing literature challenged the benefits of continuous passive motion claiming it had no added short-term or long-term benefits after knee arthroplasty (Boese et al., 2014; Chen et al., 2012; Herbold et al., 2014; Leach et al., 2006; Maniar et al., 2012), the existing literature is difficult to generalize and apply to the veteran population at San Francisco Veterans Affairs Medical Center. This study was undertaken to determine the efficacy of continuous passive motion in helping veteran patients at San Francisco Veterans Affairs Medical Center achieve post-operative range of motion goals following total knee arthroplasty. Using a retrospective design an extensive chart review was conducted. Analysis of Variance (ANOVA) with time as a repeated measure independent variable, continuous passive motion as a between-subjects independent variable, and extension/flexion as dependent variables was conducted. For extension, time was statistically significant (p < .001) but mean extension did not differ between continuous passive motion and no continuous passive motion (p = .976). Similarly, for flexion, time was statistically significant (p < .001) but mean flexion did not differ between continuous passive motion and no continuous passive motion (p = .128). Therefore, this research is consistent with current literature, which claims that continuous passive motion does not have short-term benefits, particularly in the area of range of motion.

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