[The development of the multifunctional automatic rotating bed with process-monitoring].

We have developed a new rotating bed for the old and the paralised people. This rotating bed is composed of two bed heads at front and at end, bed boards, guardrails, an electric motor, a reducer, an induction locator and a set of electronic controls. With the preestablished program, the angle between the left/right bed board and the middle board is changed by rotating the left/right board around the rotation axis, and the gravity direction between the human body and the ground is changed by the rotation of the middle board as a whole, so that the middle bed board and the left and right ones will act respectively as supporters of weight of the person who is lying on his back or on his side. In this way, a person can turn over automatically, comfortably and naturally when he/she is asleep. This rotating bed meets the physiological needs of a sleeping person, and people with turning over problems can turn over in a comfortable and natural way by means of biotechnology. It can also improve the quality of sleep and help avoid decubitus. In addition, it can be used to promote the rehabilitation of those who are paralysed by reason of its passive exercising function.

Clinical evaluation of an automated turning bed.

PURPOSE: The purposes of this study were to assess client comfort and sleep quality, client physiologic response (skin and respiratory status), the effect on the need for caregiver assistance, and cost when using an automated turning bed. DESIGN: Nonexperimental, evaluative study. SAMPLE: Twenty-four adult home or long-term care resident subjects who had a degenerative disease, spinal cord injury, stroke, cerebral palsy, or back surgery. METHODS: Each subject agreed to use the automated turning bed for four weeks. Researchers completed a demographic survey and skin assessment, and assessed each subject for pressure ulcer risk and for the need of assistance of a care giver for turning before and after the four weeks of using the turning bed. Subjects rated the turning bed in terms of comfort and sleep quality. FINDINGS: Subjects rated the turning bed as more comfortable than their own bed and expressed satisfaction at the pain relief attained when on the turning bed. While using the turning bed, there was a significant improvement in sleep quality. No skin breakdown or deterioration in respiratory status occurred. Fewer subjects required the assistance of a caregiver for turning when on the turning bed. CONCLUSION: This automated turning bed shows great promise in meeting a need for patients with limited mobility whether they are homebound or in a residential community. IMPLICATIONS FOR NURSING RESEARCH: Future studies that further investigate use of the turning bed for postoperative back patients while still in the acute care setting are indicated. Replicative studies with a larger sample size are also indicated.

Continuous passive motion after total knee arthroplasty. Analysis of cost and benefits.

The authors report the results of a prospective study examining the benefits of daily continuous passive motion combined with physical therapy, compared with physical therapy alone, in 103 consecutive osteoarthritic patients undergoing primary total knee arthroplasty. The first 51 patients received continuous passive motion initiated in the recovery room and the next 52 patients did not receive continuous passive motion. Both groups underwent an identical physical therapy protocol starting on the first postoperative day. At discharge, there was a significant increase in active flexion in the continuous passive motion group. There were no significant differences regarding pain, wound healing, knee swelling, wound drainage, pulmonary embolism, or length of hospital stay between the 2 groups. At 2 years, there were no clinical differences in the motion or knee scores. Knee manipulation was done for < 50 degrees flexion after the tenth postoperative day. There were 5 manipulations in the noncontinuous passive motion group and none in the continuous passive motion group. The entire costs associated with the 5 manipulations was $48,274 or $937 per patient not receiving continuous passive motion. The average daily inpatient rental of the machine was $60 per day. Continuous passive motion is efficacious in increasing short-term flexion and decreasing the need for knee manipulation without increasing costs.

Early flexion routine. An alternative method of continuous passive motion.

One hundred knees that underwent primary total knee arthroplasties were divided into 2 groups: the first 50 consecutive knees were assigned retrospectively to Group I (control), and the following 50 knees were assigned prospectively to Group II (early flexion). All procedures were cementless meniscal-bearing total knee arthroplasties and were performed by the same surgeon. Maximum early flexion (Group II) resulted in decreased length of stay, decreased hospital costs, and increased range of motion at 1 year. In light of current government interest in hospital cost reduction, this method should be considered as an attractive alternative to continuous passive motion.

Continuous passive motion after arthroscopically assisted anterior cruciate ligament reconstruction: comparison of short- versus long-term use.

The use of continuous passive motion (CPM) following anterior cruciate ligament (ACL) reconstruction has become common. The duration of use of CPM for maximal therapeutic benefit is not known. This study compared 4-day CPM use with 14-day CPM use following arthroscopic ACL reconstruction using a bone-patellar tendon-bone autograft prospectively in 20 patients. The patients were randomly allocated to the CPM 4-day group [6 h daily CPM for 4 days in hospital followed by intermittent passive motion (IPM) at home] or to the CPM 14-day group (6 h daily CPM for 14 days). The objective parameters measured were girth measurements at four lower limb locations for joint swelling and muscle atrophy; range of motion of the knee, measured goniometrically; and KT-1000 arthrometry measurements for joint laxity. The measurements were made prior to surgery, and on days 2, 7, 14, and 42, postoperatively. There were no statistically significant differences (p greater than 0.05) at 42 days postoperatively between groups in all parameters measured with the exception of KT-1000 laxity at 42 days.