Home-based continuous passive motion versus conventional physical therapy: a randomized follow-up trial after release of degenerative elbow stiffness

Background/Objective: Continuous Passive Motion (CPM) has been used in rehabilitation for several decades. However, there is a lack of randomized controlled trials (RCTs) comparing CPM with conventional physical therapy (PT) for rehabilitation after the release of elbow contracture. Although some studies suggest that CPM may improve postoperative range of motion, its effectiveness compared to PT in functional recovery remains unclear. This study aims to evaluate the effectiveness of home-based immersive CPM training for rehabilitation following elbow contracture release, compared to manual physical therapy, and to determine its role in promoting functional recovery of the elbow. Methods: This single-blind, single-center RCT retrospectively analyzed 40 patients with moderate to severe elbow osteoarthritis who underwent standardized arthroscopic release around September 1, 2023. The patients were divided into two groups: 20 received home-based immersive CPM rehabilitation, while 20 underwent conventional PT, with comparisons made across baseline characteristics, surgical techniques, and rehabilitation protocols. Results: The average follow-up time was 3 months. The CPM group showed greater improvements in ROM, increasing by 83.03% (from 69.25$^\circ$ pre-op to 126.75$^\circ$), compared to a 61.29% increase in the PT group (from 69.75$^\circ$ to 112.50$^\circ$). MEPS scores in the CPM group rose by 30.41% (from 74.00 to 96.50), while the PT group saw a 24.83% improvement (from 72.50 to 90.50). Additionally, the CPM group had significantly lower rehabilitation costs (500 RMB/month vs. 6000-9000 RMB for PT). Conclusion: Home-based immersive CPM rehabilitation proved more effective and cost-efficient than conventional PT, showing greater improvements in ROM, superior pain management, and better functional recovery following elbow surgery.