Intermittent Compression

Question 1

What is intermittent compression?

Answer 1

mechanical pressure that encourages venous and lymphatic return from UE/LE

Question 2

What makes up the intermittent compression?

Answer 2

nylon sleeve specific to a body part connected to series of hoses

Question 3

How does IC work?

Answer 3

Compression is a result of air flow or cold water pumping through the device

Question 4

Types of Compression

Answer 4

Circumferential
Sequential

R/O compartment syndrome or fracture

Question 5

Circumferential

Answer 5

equal compression to all parts of the covered extremity

most effective in acute phase-assists in preventing inflammation-combined with elevation

Question 6

Sequential

Answer 6

compression that increases from distal to proximal through sequential filling of different pressure chambers

Question 7

How does IC assist with subacute/chronic inflammation?

Answer 7

provides a pumping mechanism to rid wastes and deliver nutrients to injured area

• decrease edema
• decrease ecchymosis

Question 8

Controlled Cold Therapy vs IC unit

Answer 8

Controlled Cold: continuous compression/prevents edema

IC: remove edema once accumulated

Question 9

What are the physiological effects of compression?

Answer 9

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

Question 10

How does it help decrease pain?

Answer 10

decreased by reducing mechanical pressure on pain receptors from edema formation

Question 11

Indications

Answer 11

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

Question 12

Contradictions

Answer 12

DVT
Compartment syndrome
Fractures
Congestive heart failure
PVD
Dermatitis

Question 13

Set-up

Answer 13

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

Question 14

What should BP be above what to be effective?

Answer 14

DBP—initial treatment UE=40-60mmHG
initial treatment LE= 60-100mmHG

can increase to up to 20mmHG below SBP

Question 15

Duty cycle should be:

Answer 15

3:1 usually 45sec on 15 sec off
tx time=20-30 min for musculoskeletal injuries
set temp b/w 50-60 F

Question 16

What effect does constant light stress applied to injured tissue have?

Answer 16

promotes more natural alignment of collagen fibers and prevents cross linkages

Question 17

CMP may assist in what in regards to ROM?

Answer 17

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

Question 18

Some evidence suggests using CPM can decrease what?

Answer 18

need of manipulation following TKA

Question 19

Continuous Passive Motion (CPM)

Answer 19

Electrical motorized devices that move jt through a preset partial PROM at a preset controlled speed

Question 20

Goal of CPM

Answer 20

prevent or decrease negative effects of immobilization

improve tissue healing, prevent contractures, delay atrophy

Question 21

3 types of design of CPM

Answer 21

free linkage
Anatomic
Nonanatomic

Question 22

Most common uses-post surgically

Answer 22

acute/subacute phase following ACL reconstruction/ TKA/ Osteochondral defects or chondromalacia

Shoulder surgeries
Hand surgeries
Foot/ankle surgeries

Question 23

What effect does CPM have on joint nutrition

Answer 23

may assist in joint nutrition during immobilization–circulates synovial fluids
may be more effective than active motion during early rehab for such injuries

Question 24

What effect does CPM have on edema reduction

Answer 24

assist venous and lymphatic return

Question 25

What effect does CPM have on pain reduction

Answer 25

gentle mvmt activates sensory afferents to contol pain through gate control—not very effective

Question 26

CPM ligament healing

Answer 26

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

Question 27

Indications for CPM

Answer 27

TKA, ACL recon, Osteochondral repair, Chondromalacia, Tendon lacerations

Question 28

Contraindications for CPM

Answer 28

Unstable fractures
Conditions where CPM causes unwanted motion
Uncontrolled infection

Question 29

Prep of treatment (LE)

Answer 29

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)