Intermittent Compression Flashcards
What is intermittent compression?
mechanical pressure that encourages venous and lymphatic return from UE/LE
What makes up the intermittent compression?
nylon sleeve specific to a body part connected to series of hoses
How does IC work?
Compression is a result of air flow or cold water pumping through the device
Types of Compression
Circumferential
Sequential
R/O compartment syndrome or fracture
Circumferential
equal compression to all parts of the covered extremity
most effective in acute phase-assists in preventing inflammation-combined with elevation
Sequential
compression that increases from distal to proximal through sequential filling of different pressure chambers
How does IC assist with subacute/chronic inflammation?
provides a pumping mechanism to rid wastes and deliver nutrients to injured area
- decrease edema
- decrease ecchymosis
Controlled Cold Therapy vs IC unit
Controlled Cold: continuous compression/prevents edema
IC: remove edema once accumulated
What are the physiological effects of compression?
decreased capillary hydrostatic pressure by increasing reabsorption of interstitial fluids by lymphatic system
creating a second pressure gradient from distal (high pressure) & proximal (low pressure) causing fluid mvmt from distal to proximal
How does it help decrease pain?
decreased by reducing mechanical pressure on pain receptors from edema formation
Indications
Post injury inflammation-more effective in subacute/chronic phases
Post surgical inflammation-CCU more effective acutely due to constant compression
Prevention of DVT
Venous stasis ulcers
lymphedema
Contradictions
DVT Compartment syndrome Fractures Congestive heart failure PVD Dermatitis
Set-up
Determine if contraindications exist
check skin condition
remove jewelry
Cover extremity with stockinette or similar material for sanitary reasons
Select sleeve appropriate size and place injured extremity in sleeve–elevate
Connect sleeve to compression unit
What should BP be above what to be effective?
DBP—initial treatment UE=40-60mmHG
initial treatment LE= 60-100mmHG
can increase to up to 20mmHG below SBP
Duty cycle should be:
3:1 usually 45sec on 15 sec off
tx time=20-30 min for musculoskeletal injuries
set temp b/w 50-60 F
What effect does constant light stress applied to injured tissue have?
promotes more natural alignment of collagen fibers and prevents cross linkages
CMP may assist in what in regards to ROM?
gaining ROM early in rehab but no long term effects when compared to normal ROM exercises
- manual ROM and PROM with progression to AROM probably more effective
- may assist pt apprehension to ROM early in rehab since pt can predetermine ROM
Some evidence suggests using CPM can decrease what?
need of manipulation following TKA
Continuous Passive Motion (CPM)
Electrical motorized devices that move jt through a preset partial PROM at a preset controlled speed
Goal of CPM
prevent or decrease negative effects of immobilization
improve tissue healing, prevent contractures, delay atrophy
3 types of design of CPM
free linkage
Anatomic
Nonanatomic
Most common uses-post surgically
acute/subacute phase following ACL reconstruction/ TKA/ Osteochondral defects or chondromalacia
Shoulder surgeries
Hand surgeries
Foot/ankle surgeries
What effect does CPM have on joint nutrition
may assist in joint nutrition during immobilization–circulates synovial fluids
may be more effective than active motion during early rehab for such injuries
What effect does CPM have on edema reduction
assist venous and lymphatic return
What effect does CPM have on pain reduction
gentle mvmt activates sensory afferents to contol pain through gate control—not very effective
CPM ligament healing
promotes more natural alignment of collagen fibers
ACL is extrasynovial so doesn’t receive knee joint nutrition from synovial fluid–so it depends on internal blood supply
Indications for CPM
TKA, ACL recon, Osteochondral repair, Chondromalacia, Tendon lacerations
Contraindications for CPM
Unstable fractures
Conditions where CPM causes unwanted motion
Uncontrolled infection
Prep of treatment (LE)
Measure length of thigh from ischial tuberosity to knee jt line
place extremity in unit and make sure the articular hinge of CPM unit is in line w/pt knee jt line
tibia should be in neutral (NO IR/ER-stress ACL)
