We studied the effects of passive motion on joint stiffness, muscle
mass, bone density, and regional swelling after an intra-articular injury.
Instrumentation was applied to the hindlimbs of thirty adolescent New
Zealand White rabbits to allow either passive motion or immobilization of
the ankle. The knee was immobilized by the locking together of Steinmann
pins that had been placed within the medullary canals of the tibia and
femur. An intra-articular injury was produced by drilling of the tibial pin
through the ankle joint into the talus and subsequent withdrawal of the pin
from the ankle joint. The rabbits were divided into five groups, and they
received four, eight, twelve, sixteen, or twenty-four hours of passive
motion each day during the three-week period of study. One ankle of each
rabbit was moved through an arc of 90 to 170 degrees of dorsiflexion at one
cycle per minute, while the contralateral ankle was immobilized in 100
degrees of dorsiflexion with an aluminum splint, which was fixed to the
aluminum block that was used to stabilize the knee joint. We found that
sixteen and twenty-four hours of passive motion prevented stiffness of the
joint. Passive motion for shorter periods was ineffective, even harmful,
and resulted in stiffness ratios that were as much as four times higher
than those of the control limbs (those treated with immobilization).
Swelling of the limb decreased only in the group that received twenty-four
hours of passive motion. Muscle mass increased by an average of 13 per cent
(range, 4 to 34 per cent), in comparison with that of the immobilized limbs
in every group that was treated with passive motion. Bone density was
maintained only in the limbs in which the ankle became stiff (ankles that
had been treated with passive motion for twelve hours or less). An inverse
relationship was noted between the duration of passive motion and the
radiographic density of the distal tibial metaphysis; this relationship was
statistically significant (p < 0.01). The limbs treated for twelve,
eight, or four hours each day showed progressively greater bone density in
comparison with those treated with immobilization or with sixteen or
twenty-four hours of passive motion.