Continuous Passive Motion

This strange-sounding post title is the name for a range of devices that move your body parts for you, i.e. passively. A continuous passive motion machine (CPM) may bend your arm, flex your back, or in my case bend your leg at the knee. Four months after I brought it home from the hospital I still have my CPM because it still helps me push my flexibility to higher levels. Generally one would not use a CPM so long but my injury is so severe and my scar tissue so aggressive that it has been a huge struggle for me to regain flexibility. The idea is to move the leg even when it is too weak to bear weight or otherwise be exercised. Movement is important to combat scar tissue and loss of range of motion. If you just go home and sit in a brace for 8 weeks then you will gain scar tissue and lose range of motion. The CPM is supposed to help, although some studies say it is not any better than a good physical therapist. I like it because it is done at home, can be used for long periods of time, and psychologically you feel like you are making progress. There are various machine designs but my model, a “Legasus” (ha ha ha) pushes the knee up from beneath. There is a controller with which I can increase the angle of flexion (bending) and extension (straightening), as well as the pace or speed of the up and down motion. In truth the machine does not really push me to zero extension or the highest flexion b/c believe it or not, scar tissue and tight muscles are stronger than the motor drive on the machine! Although it pulls my leg towards straight, my knee stays up in the air at about 15-20 degrees. And at the high end of flexion, when it reaches the limit of my true flexion, the machine slides down the bed away from my thigh. I try various tricks to combat the weakness of the machine, the most important of which is to be sure I am properly situated within the machine with my knee at the axis of flexion, my foot securely in the foot pouch and my hip aligned with the axis there. By slowing increasing the angle of flexion I slowly gain more range of motion. The main drawback of the machine is that when you are very weak you need help getting into the machine, as I did for the first month at home. After that I was strong enough to get my leg into the machine properly. Another drawback is that the machine is lined with faux fleece, which is soft but hot! The foot pocket completely covers your foot in fleece, which is great if it is cold but horribly hot if it is warm. I think they need to design winter and summer versions of the padding! The best thing about my CPM is that it appears to date to the late 1980s with its neon colors on the controller and the body of the machine. I found that in the first few weeks I could barely tolerate more than an hour at a time in the machine. Now I can sit in it for several hours if necessary. The problem is that since it fails to get me to zero extension, if I stay in it too long then my extension suffers. To combat this problem I put in an hour or so, then stop and stretch extension for a while before repeating in the machine. It helps to distract myself by sending emails, watching movies, talking on the phone or reading a book.