CTM Therapy® has proved its effectiveness in cold therapy in clinical studies. CTM Therapy® is now being used by many leading orthopaedic and trauma hospitals as well as rehabilitation centres. the postoperative clinical pathway has benefited significantly from our treatment concept as a result.
Two important studies – from Ghent University (Belgium) and Ulm University Hospital (Germany) – are now providing tangible, practice-based data on the effectiveness of CTM Therapy® in the postoperative care of total knee replacement and trauma patients.
S. Cornette, A. Van Ostade, N. Mahieu und T. Willems
Ghent University, Belgium
“We observed a significant reduction in pain among patients treated with CTM Therapy®. These patients also reported better functionality after four days – most probably because of the reduction in pain. The patient can also be left by themselves and does not need to be continuously monitored: the system works independently. The length of stay was also shorter for patients using CTM Therapy®. This is an extremely important aspect in reducing costs.”
Dr. Tine Willems
Department of Physical Therapy and Motor Rehabilitation
Faculty of Medicine and Health Sciences at Ghent University (Belgium)
As part of the study, 21 patients were given CTM Therapy® and 21 patients treated with traditional cooling elements. CTM Therapy® was applied over a period of two hours and at temperatures between 12 – 18 °C on the outstretched knee. The cooling element was wrapped in a sheet and placed on the patient’s outstretched knee without any additional pressure. The temperature of the freezer was -18 °C.
Recorded before and after the cryotherapy (days 1 – 4). Scores on the visual analogue scale (VAS) – patient questionnaire to record pain levels; the pain was also measured using the KOOS (knee injury and osteoarthritis outcome score) questionnaire.
Calculated on day 4 using the KOOS questionnaire
Length of stay
Calculated by subtracting the admission date from the discharge date
At the beginning of the study (first day post-op), both groups measured similarly severe pain levels. From day 3, patients being treated with CTM Therapy® reported significantly less pain (both before and after the cryotherapy treatment) than patients being treated with the traditional cooling elements (see figures 1A and 1B).
Patients being treated with CTM Therapy® showed signs of a reduction in pain earlier than the patients being treated with traditional cooling elements. In order to further validate the pain levels determined by VAS scores, the KOOS questionnaire was also used to determine the pain levels. Patients being treated with CTM Therapy® reported a significantly higher KOOS score (i.e. a greater reduction in pain) on day 4 of the cryotherapy treatment than patients being treated with traditional cooling elements.
The KOOS value for functionality of activities of daily living (ADL) on day 4 was better among patients being treated with CTM Therapy®, probably due to the greater reduction in pain. (see figure 2)
Length of stay
Patients in the CTM Therapy® group spent an average of 1.5 fewer days in hospital than patients being treated with traditional cooling elements (figure 3). One outlier in each group appeared unsuitable for the analysis and was therefore excluded from this statistic (cooling elements: 40 days; CTM Therapy®: 44 days).
Ulm University Hospital, Germany
In the study, 62 trauma patients received a four-hour CTM Therapy® treatment session on the day of their operation (immediately after the surgery) followed by a treatment regimen comprising two two-hour sessions (mornings, afternoons) on two consecutive days (days 1 and 2).
A numerical rating scale (NRS) was used to measure pain levels, both before and after the cryotherapy
Range of motion (ROM)
Goniometer for passive flexion and extension before and after the cryotherapy
Measurement of the circumference of the thigh, knee and lower leg before and after the cryotherapy
Oral assessment of temperature and comfort during the CTM Therapy®
A significant reduction in pain was observed after the cryotherapy on days 1 and 2 (in the morning and afternoon) (figure 4). The values were calculated using the NRS score. A declining trend in the daily pain levels before the CTM Therapy® was also observed. This would suggest that the treatment has a lasting and prolonged effect on pain and that its effect is not restricted to the period immediately after application. The CTM Therapy® also led to a significant reduction in pain before the start of the second night in hospital (figure 5)
Range of motion
A significant improvement in the range of motion after the CTM Therapy® was noted on days 1 and 2 (figure 6)
Although the swelling increased over the course of the measuring period, there was generally a significant reduction in swelling after the CTM Therapy®. In particular, a significant reduction in the swelling of the thighs was observed on all days (in the morning and afternoon) (figure 7A).
All of the measurements for the knee, with the exception of the morning on day 2, were significant (figure 7B). A significant reduction in the swelling of the lower leg was also noted for all of the measurements with the exception of the day of the surgery (figure 7C)