Clinically proven

Studies & Clinical Evidence

It has been proven that moving the joint early and in a controlled manner after surgery helps patients recover faster and prevents stiffness. Continuous Passive Motion (CPM) therapy—continuous passive movement—has proven particularly effective for this purpose.

Therapy principle

Why CPM therapy works

CPM stands for Continuous Passive Motion, i.e., continuous passive movement therapy. This principle has been established for decades in the rehabilitation of knee and shoulder joints and is now also available for the hallux.

Controlled, passive movement of the joint immediately after surgery distributes synovial fluid, promotes cartilage nutrition, and prevents adhesions. The joint remains mobile and healing progresses faster.

 

Icon mobilisation

Passive mobilisation of the joint—the principle of CPM therapy, shown schematically.

Reference studies

The scientific basis

Clinical evidence on stiffness after immobilisation, shortened recovery through toe CPM devices and physical therapy after hallux surgery, as well as the general benefits of CPM therapy after joint interventions.

Akeson et al. (1987)

Stiffness after immobilisation

After just one week of immobilisation, the synovial membrane shortens, adhesions form in the joint lining, and permanent restrictions in mobility can occur.

1 week

One week of immobilisation is enough to cause joint stiffness

Akeson, W. H. et al. (1987). Effects of immobilization on joints. Clinical Orthopaedics and Related Research.

Connor et al. (1995)

Toe CPM shortens rehabilitation

Motorised toe CPM devices shorten rehabilitation time after MTP-I joint surgery by up to 10 days compared with physiotherapy alone. Range of motion increases sooner, and patients return to normal weight bearing faster.

10 days

back to full mobility faster

Connor, G. F. et al. (1995). Continuous passive motion after MTP-I surgery. Foot & Ankle International.

Schuh et al. (2008)

Benefit of physical therapy after hallux surgery

Targeted movement therapy after bunion surgery significantly improves big-toe function and physiological gait pattern, increases peak pressure, range of motion, and the AOFAS score.

up to 4×

higher load bearing of the big toe after 6 months

Schuh, R. et al. (2008). Effect of Physiotherapy on the Functional Improvement after Hallux Valgus Surgery. Z Orthop Unfall, 146, 630 to 635.

Schuh et al. (2009)

Benefit of physical therapy after hallux surgery

Physical therapy and gait training improve loading of the first ray during the stance phase. Within six months after surgery, maximum force in the big toe increased significantly, and patients returned to physiological weight bearing.

6 months

until weight bearing of the first ray is restored

Schuh, R. et al. (2009). Importance of Physical Therapy to Restore Weight Bearing of the First Ray During the Stance Phase. Phys Ther, 89, 934 to 945.

Michael et al. (2005)

General CPM effectiveness

Using a motorised shoulder CPM device in addition to physiotherapy enabled patients to regain full active mobility around twelve days earlier than with physiotherapy alone, while also reducing pain sooner.

12 days

earlier to full active mobility

Michael, J. W. P. et al. (2005). Efficiency of a Postoperative Treatment after Rotator Cuff Repair with a Continuous Passive Motion Device (CPM). Z Orthop Ihre Grenzgeb, 143, 438 to 445.

Garofalo et al. (2010)

General CPM effectiveness

Four weeks of accompanying CPM use significantly improved both mobility and pain control in the early rehabilitation phase after shoulder surgery compared with standard therapy alone.

less pain

and more mobility in early rehab

Garofalo, R. et al. (2010). Effects of one-month continuous passive motion after arthroscopic rotator cuff repair. Musculoskelet Surg, 94 (Suppl 1), S79 to S83.
All

Jaspers et al. 2018

General CPM effectiveness

A Continuous Passive Motion (CPM) device significantly improves range of motion after ACL reconstruction and reduces pain and swelling. Knee flexion improved in postoperative weeks 1 to 6, and swelling decreased between weeks 4 and 6.

Week 1 to 6

better knee flexion and less swelling after ACL surgery

Continuous Passive Motion (CPM) does improve range of motion, pain and swelling after ACL reconstruction: a systematic review and meta-analysis.,“/pubmed/ 30321902″,“Jaspers T, Taeymans J, Hirschmüller A.“,“Z Orthop Unfall 2018 Oct

What these studies mean in practical terms

✓ Shorter recovery, faster return to a physiological movement pattern ✓ Prevention of joint stiffness and permanent adhesions
✓ Promotes joint mobility and distribution of synovial fluid ✓ Secures surgical success through early mobilisation
✓ Remobilisation of already stiffened joints possible within 30 days ✓ Pain relief through even, controlled movement

Clinical assessment

Patients report easy handling, clear instructions for use, noticeably increasing mobility, and a shorter recovery time. I recommend the device for broad clinical use in postoperative bunion correction treatment.
Learn more

Dr Gérard Farkas

Founder of Crossklinik (Basel), Member of the Executive Board | Specialist in Orthopaedic Surgery and Traumatology of the Musculoskeletal System, SEMS Sports Medicine