Desenvolvimento de aparelho de movimentação passiva contínua portátil para a mão / Development of the equipment continuous passive motion portable for the hand

RESUMEN

The rehabilitation technique called Continuous Passive Motion (CPM) is an execellent means to diminish pain, prevent adhesion formation, and reduce oedema around joints and other limb segments and skeletal tissues during the healing process that follows injuries and surgical procedures. It prescnts a great potential for application in the postoperative rehabilitation of the hand. The purpose of the present investigation was to develop a portable CPM device for the hand, based on other countries pre-existing models, but employing national low cost technology. The device was developed in phases, according to the systems devised, as follows 1) motion system, which consists of an electric motor, gear box and motion arm; 2) forearm fixation system, which consists of two plastic splints. for the right and left hands, respectively; 3) finger fixation system, which consists of a bent attachment rod and different parts for fixation onto the tip of the fingers; 4) electrical supply and control system, which consists of a rechargeable battery, an on/off switch and a speed control knob. The device was devised to carry out either en bloc flexion and extension of the fingers or separate flexion and extension of metacarpophalangeal and proximal and distal interphalangeal joints of individual fingers or all together. Once developed the device was tested on both the right and left hands of 15 normal adults and it was observed that it is able to completely extend the three joints of each finger, although flexion is limited in the last degrees, particularly at the distal interphalangeal joint, despite any adjustment carried out. The device was also tested on a patient oí staged flexor apparatus reconstruction, from the third postoperative day onward, on a daily 8-hour regimen, for ten consecutive days. The patient, who otherwise presented little oedema and normal healing of the wounds. devoid of complications, reported no pain or discomfort. The performance of the device was satisfactory on both normal and operated subjects, the on complaint being the excessive weight (1 270 gf). The author concluded that the mechanic characteristics of adaptability, motion and reliability of the device permit its use in hand rehabilitation following injuries and operations, and that the development of a CPM device for hand rehabilitation with national low cost technology is viable