Effectiveness of home based continuous passive motion compared with conventional physical therapy after arthroscopic release of degenerative elbow stiffness

Abstract

Continuous Passive Motion (CPM) has been widely used in rehabilitation, yet its effectiveness compared to conventional physical therapy (PT) following elbow contracture release remains unclear. This retrospective cohort study evaluated the effectiveness of home-based immersive CPM training versus manual PT in promoting functional recovery of the elbow. Clinical records of 40 patients with moderate to severe elbow osteoarthritis who underwent standardized arthroscopic release between 2020 and 2022 were reviewed. Among them, 20 patients received home-based CPM rehabilitation, and 20 underwent conventional PT. After a 3-month follow-up, the CPM group demonstrated superior improvements in range of motion (ROM), with an estimated increase of (95% CI, 7 to 20; p = 0.005), and a higher percentage increase in ROM (83.03% vs 61.29%, p = 0.01). The likelihood of attaining functional ROM was 35% greater in the CPM group (risk ratio 1.35; 95% CI, 1.02 to 1.78; p = 0.03), and Mayo Elbow Performance Score (MEPS) scores were significantly higher, with a 6-point difference (95% CI, 2 to 10; p = 0.02). Furthermore, CPM was more cost-efficient, with monthly rehabilitation costs of 500 RMB compared to 2850 RMB for PT. The primary outcome was ROM improvement, and secondary outcomes included MEPS scores, functional ROM attainment, and rehabilitation cost. As this was a retrospective study based on existing clinical records, trial registration was not required. This study was approved by the Medical Ethics Committee of Cangzhou Fifth Hospital (Approval No. QXRMYY202003). In conclusion, home-based immersive CPM rehabilitation was associated with greater ROM improvements, better pain management, and enhanced functional recovery compared to conventional PT in patients recovering from elbow surgery.