Kinesio Taping


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Kinesio Taping

  1. 1. Kinesio Taping : An Introduction on Technique and Results Chris Keating SPT Thomas Jefferson University
  2. 2. Overview <ul><li>Introduction to Kinesio Taping </li></ul><ul><ul><li>Properties </li></ul></ul><ul><ul><li>Theoretical Benefits </li></ul></ul><ul><ul><li>Types of Application </li></ul></ul><ul><ul><li>Application Guidelines </li></ul></ul><ul><li>Current Evidence </li></ul><ul><ul><li>Shoulder Pain </li></ul></ul><ul><ul><li>Lower Trunk ROM </li></ul></ul><ul><ul><li>Lateral Patella Dislocation </li></ul></ul><ul><ul><li>Acute Pediatrics Population </li></ul></ul><ul><li>Clinical Implications </li></ul><ul><li>Application of Kinesio Tape </li></ul><ul><ul><li>RTC Impingement Taping </li></ul></ul><ul><ul><li>Quadriceps Facilitation Taping </li></ul></ul>
  3. 3. Kinesio Tape Properties
  4. 4. Properties of Kinesio Tape <ul><li>Mimics skin qualities </li></ul><ul><li>Tape is replicating hands on the patient </li></ul><ul><ul><li>Sensiomotor stimulation </li></ul></ul><ul><li>Allows longitudinal stretch of 30-40% of its resting length </li></ul><ul><li>Effective for 3-5 days of constant use </li></ul><ul><li>Latex free and heat activated adhesive </li></ul><ul><li>Acrylic adhesive applied in wave fashion to allow for moisture escape </li></ul>
  5. 5. Theoretical Benefits
  6. 6. Theoretical Benefits <ul><li>Analgesic Affect </li></ul><ul><ul><li>Mechanoreceptors </li></ul></ul><ul><ul><li>Create space for areas of pain and inflammation </li></ul></ul><ul><ul><li>Assist or limit motion through sensory stimulus </li></ul></ul><ul><li>Lymphatic Drainage </li></ul><ul><ul><li>Increase lymph drainage from the area via increased subcutaneous space </li></ul></ul>
  7. 7. Theoretical Benefits <ul><li>Correct Malalignment </li></ul><ul><ul><li>Positional stimulus </li></ul></ul><ul><ul><li>Align fascia tissues </li></ul></ul><ul><li>Scar Tissue </li></ul><ul><ul><li>Breaks adhesions </li></ul></ul><ul><ul><li>Reduce irritation </li></ul></ul>
  8. 8. Types of Application
  9. 9. Types of Application <ul><li>Y </li></ul><ul><li>I </li></ul><ul><li>X </li></ul><ul><li>Fan </li></ul><ul><li>Web </li></ul><ul><li>Donut </li></ul>
  10. 10. Types of Application: Y <ul><li>Used to surround muscle </li></ul><ul><li>Either to facilitate or inhibit muscle stimuli </li></ul><ul><li>Should be 2 inches longer than target muscle </li></ul>Teres Minor Y
  11. 11. Type of Application: I <ul><li>Used for more acute injuries in place of Y </li></ul><ul><li>Primary purpose for edema and pain </li></ul><ul><ul><li>Greater surface area </li></ul></ul><ul><li>Used for alignment correction </li></ul>Tricep I strips
  12. 12. Type of Application: X and Donut <ul><li>X </li></ul><ul><ul><li>Used when origin and insertion change depending on movement (Rhomboids) </li></ul></ul><ul><li>Donut </li></ul><ul><ul><li>Specifically used for edema </li></ul></ul><ul><ul><li>Use overlapping strips and the center is cut out over area of focus </li></ul></ul>
  13. 13. Types of Application: Fan/Web <ul><li>Chief use for edema </li></ul><ul><li>Web different because ends remain intact </li></ul>
  14. 14. Type of Application Stretch <ul><li>Muscle should be elongated prior to application </li></ul><ul><li>KT requires none to partial stretch </li></ul><ul><li>Stretch results in skin convolutions whether they are visible or not they are present </li></ul><ul><li>Would rather have too little than too much stretch </li></ul><ul><li>This is not athletic taping, do not take up full stretch* </li></ul>
  15. 15. Types of Application Stretch <ul><li>Full- 100% </li></ul><ul><li>Severe- 75% </li></ul><ul><li>Moderate- 50% </li></ul><ul><li>Light- 15-25% </li></ul><ul><li>None- 0% </li></ul><ul><li>Percentage stretch refer to percentage of available stretch </li></ul>
  16. 16. Type of Application Direction <ul><li>Insertion to Origin </li></ul><ul><ul><li>Used to inhibit overused or stretched muscles </li></ul></ul><ul><ul><li>Light stretch required to achieve this goal </li></ul></ul><ul><li>Origin to Insertion </li></ul><ul><ul><li>Used to facilitate weak or under performing muscles </li></ul></ul><ul><ul><li>Light to moderate stretch required </li></ul></ul>
  17. 17. Application Guidelines
  18. 18. Application Guidelines <ul><li>Shave hair if interfering with adhesive </li></ul><ul><li>No oils or lotions on skin </li></ul><ul><li>If wet, pat dry </li></ul><ul><li>Do not use hair dryer on tape </li></ul><ul><li>Use alcohol to prep skin if needed </li></ul>
  19. 19. Application Guidelines <ul><li>Measure appropriate length- allowing for desired stretch </li></ul><ul><li>Remove tape carefully in order not to touch or increase application difficulty </li></ul><ul><li>Rub tape after application to activate adhesive </li></ul><ul><li>Allow 20 mins for adhesive to take effect </li></ul><ul><li>If KT doesn’t reduce pain than D/C treatment after 20 mins </li></ul>
  20. 20. Evidence Based Practice
  21. 21. Shoulder Pain Thelen et al. <ul><li>Purpose </li></ul><ul><ul><li>To compare the short-term effect of a therapeutic KT application on reducing pain and disability in subjects with RTC tendonitis/impingement versus sham KT taping </li></ul></ul><ul><li>Population </li></ul><ul><ul><li>18-24yo College Students; (n = 27) </li></ul></ul><ul><ul><li>+ Hawkins-Kennedy, + Empty Can, + Pain Before 150 ° elevation in any plane </li></ul></ul><ul><ul><li>- Fracture, - GH Disloction/Subluxation, - Cervical Involvement, - Shoulder Surgery < 12 months </li></ul></ul>
  22. 22. <ul><li>Intervention </li></ul><ul><ul><li>15-25% Stretch Y-Strip for Supraspinatus </li></ul></ul><ul><ul><li>15-25% Stretch Y-Strip for Deltoid </li></ul></ul><ul><ul><li>50-75% Stretch Y or I-Strip Coracoid Process -> Posterior Deltoid </li></ul></ul><ul><li>Outcome </li></ul><ul><ul><li>Only significant difference between groups found on day 1 with treatment group achieving greater abduction (19 °) </li></ul></ul><ul><ul><li>Both groups over 6 days demonstrated improvements in all outcome measures </li></ul></ul><ul><ul><li>Attrition was high 7/27, due to scheduling conflicts </li></ul></ul>
  23. 23. Lower Trunk ROM Yoshida et al. <ul><li>Purpose </li></ul><ul><ul><li>To determine the effects of KT on lower trunk flexion, extension and lateral flexion </li></ul></ul><ul><li>Population </li></ul><ul><ul><li>30 healthy subjects (15f, 15m) </li></ul></ul><ul><ul><li>Average age (26,20) </li></ul></ul><ul><ul><li>Volunteered </li></ul></ul><ul><ul><li>Were excluded if had LBP within 6 months of trial </li></ul></ul>
  24. 24. <ul><li>Intervention </li></ul><ul><ul><li>Cross-over Study </li></ul></ul><ul><ul><li>15-25% stretch with Y-Strip </li></ul></ul><ul><ul><li>Place base above sacrum </li></ul></ul><ul><ul><li>Attach tails on each erector spinae group with light tension </li></ul></ul><ul><li>Outcomes </li></ul><ul><ul><li>Taping significantly increased flexion (17cm) over non-taping </li></ul></ul><ul><ul><li>No control group </li></ul></ul><ul><ul><li>Needs more detailed measurements </li></ul></ul>
  25. 25. Traumatic Patellar Dislocation Osterhues <ul><li>Purpose </li></ul><ul><ul><li>To demonstrate the use of KT for control of pain, restriction of quadriceps muscle contraction and altered sense of weight bearing stability in patella dislocation rehabilitation </li></ul></ul><ul><li>Population </li></ul><ul><ul><li>49 yo female PT who sustained a traumatic left knee patella lateral dislocation while cross country skiing </li></ul></ul>
  26. 26. <ul><li>Intervention </li></ul><ul><ul><li>10% Stretch Y-Strip from the insertion to origin </li></ul></ul><ul><ul><li>Base placed without tension </li></ul></ul><ul><ul><li>Tails across medial retinacular tissue and lateral quadriceps border with paper off tension </li></ul></ul><ul><ul><li>Treatment also included: </li></ul></ul><ul><ul><ul><li>IFC, ice with compression, static and dynamic balance training, stationary bike, ROM exercises, massage </li></ul></ul></ul><ul><li>Outcome </li></ul><ul><ul><li>Reduced pain with activity 4 weeks after injury with KT use function comparable to Atkin et al. (2000) study which put timetable at 6 months </li></ul></ul><ul><ul><li>Tests with NeuroCom Balance Master higher for taped condition than no taped, however both numbers outside (below) normal ranges </li></ul></ul>
  27. 27. KT effect on Peds Yasukawa et al <ul><li>Purpose </li></ul><ul><ul><li>To describe the functional arm and hand skills for children admitted into a rehab program subsequent use of KT </li></ul></ul><ul><li>Population </li></ul><ul><ul><li>15 Children (10f, 5m) Ages 4-16 </li></ul></ul><ul><ul><ul><li>4 SCI, 2 TBI, 3 Brain Tumor, 2 CVA, Seizure, CP, 2 Birth Defects </li></ul></ul></ul><ul><ul><li>+ muscle weakness or abnormal muscle tone </li></ul></ul><ul><ul><ul><li>Grades of 3 or more on Mod. Ashworth were excluded </li></ul></ul></ul><ul><ul><ul><li>Trace on MMT or sensory issues were also excluded </li></ul></ul></ul><ul><ul><li>No cognitive or motivation issues </li></ul></ul>
  28. 28. <ul><li>Intervention </li></ul><ul><ul><li>Wide variety of KT techniques, Individualized </li></ul></ul><ul><li>Outcome </li></ul><ul><ul><li>Melbourne Assessment </li></ul></ul><ul><ul><ul><li>16 pt questionnaire measuring upper limb function </li></ul></ul></ul><ul><ul><ul><li>Designed for CP population </li></ul></ul></ul><ul><ul><li>Scores significantly improve pre-test to post-test as well as 3 days after taping </li></ul></ul><ul><ul><li>Its hard to draw specific treatment from study </li></ul></ul><ul><ul><li>Overall function improved in group average immediately after taping limiting learning curve </li></ul></ul><ul><ul><ul><li>Increase of 5 on MA immediately after application </li></ul></ul></ul><ul><ul><ul><li>Increase of 10 on MA 3 days after application </li></ul></ul></ul>
  29. 29. Clinical Implications
  30. 30. Clinical Implications <ul><li>Level of evidence </li></ul><ul><ul><li>Weak- only one RCT found (via Medline, Cinahl, Cochrane, DARE, ACP) </li></ul></ul><ul><ul><li>Mainly case studies, presented were a sample of the most PT relevant </li></ul></ul><ul><li>What does the evidence support </li></ul><ul><ul><li>Increase in ROM </li></ul></ul><ul><ul><li>Increase in function </li></ul></ul>
  31. 31. Clinical Implications <ul><li>Why use it </li></ul><ul><ul><li>Tool in the toolbox </li></ul></ul><ul><ul><li>Treats patient for 72 consecutive hours </li></ul></ul><ul><ul><li>Feeling of treatment -> encourage movement </li></ul></ul><ul><ul><ul><li>Placebo or Treatment? </li></ul></ul></ul><ul><ul><li>Versatile </li></ul></ul><ul><li>Pros </li></ul><ul><ul><li>Some evidence proves theories </li></ul></ul><ul><ul><li>PTs provide treatment </li></ul></ul><ul><ul><li>Applicable to multiple pt populations </li></ul></ul><ul><ul><li>Constant treatment </li></ul></ul><ul><li>Cons </li></ul><ul><ul><li>Some evidence proves theories </li></ul></ul><ul><ul><li>Expensive </li></ul></ul><ul><ul><li>Requires practice </li></ul></ul><ul><ul><li>Skin reaction </li></ul></ul>
  32. 32. Clinical Implications <ul><li>Athletic Taping v Kinesio Taping </li></ul><ul><ul><li>Bragg article demonstrates AT decrease in support within an hour of use </li></ul></ul><ul><ul><li>Since KT does not focus on support its means of sensory stimulus to enforce movement may just be a better form of AT </li></ul></ul><ul><li>Clinical Opinion </li></ul><ul><ul><li>Kinesio Taping could be a useful tool for therapist who see patients only a handful of times during rehab </li></ul></ul><ul><ul><li>Little evidence supports its multiple theories, more research needed </li></ul></ul><ul><ul><li>May be a way to facilitate and encourage movement </li></ul></ul>
  33. 33. RTC Impingement Taping
  34. 34. Y-Strip Supraspinatus, 1st Y or I Strip, Anterior displacement, 3rd Y-Strip Deltoid, 2nd
  35. 35. Quadriceps Taping
  36. 36. Y-Strip 1st Y-Strip 2nd
  37. 37. References <ul><li>Clinical Theraputic Applications of the Kinesio Taping Method ; K. Kaze, J. Wallis, T. Kase; Tokyo, Japan, 2003 </li></ul><ul><li>The Clinical Efficacy of Kinesio Tape for Shoulder Pain: A Randomized, Double-Blinded, Clinical Trial ; M. Thelen, J. Dauber, P. Stoneman; Journal of Orthopaedic and Sports Physical Therapy, 38:7 2008 </li></ul><ul><li>Pilot Study: Investigating the Effects of Kinesio Taping in an Acute Pediatic Rehabilitation Setting ; A. Yasukawa, P. Patel, C Sisung; American Journal of Occupational Therapy, 60:1 2006 </li></ul><ul><li>The Use of Kinesio Taping in the Management of Traumatic Patella Dislocation. A Case Study ; D. Osterhues; Physiotherapy Theory and Practice; 20:4 2004 </li></ul><ul><li>The Effect of Kinesio-Taping on Lower Trunk Range of Motions ; A. Yoshida, L Kahanov; Research in Sports Medicine, 15 2007 </li></ul><ul><li>Characteristics of Patients with Primary Acute Lateral Patellar Dislocation and Their Recovery Within the First Six Months of Injury ; DM. Atkins, Dc Fithian, KS Marangi; The American Journal of Sports Medicine; 28:4 2000 </li></ul><ul><li>Failure and Fatigue Characteristics of Adhesive Athletic Tape; Bragg, R.W, Macmahon, J.M, Medicine and Science in Sports and Exercise 34:3 2002 </li></ul>