Kinesiology Taping Techniques for the Upper Extremity

1 12/9/14 1 Kinesiology Taping Techniques for the Upper Extremity Kristin Valdes, OTD,OT, CHT Marybeth Laplant, PT, CHT Mary Loughlin, OTR/L,CHT,CKTP Evidence? n Despite its popularity and widespread clinical use, there is relatively little evidence to support the effectiveness of elastic therapeutic tape/Kinesiotape, let alone for specific neck and Upper Extremity conditions n A scoping review of the use of elastic therapeutic tape for neck or Upper Extremity conditions n Journal of Hand Therapy n 2014 n Taylor et al. Reviewed n Of the 14 studies that were included in this scoping review, seven articles were randomized controlled trials (RCTs), four were single-group repeated measure studies, two were quasi-experimental studies, & one was a case report n Looked at the impact on Taping on n Pain n Motion n Strength n Patient Preference Pain n Six out of eight studies that examined changes in pain for carpal tunnel syndrome, biceps tendonitis, medial epicondylitis, rotator cuff pain, neck pain and shoulder pain found statistically significant differences in favor of elastic therapeutic tape n n No long term follow-up measurements obtained n elastic therapeutic tape may be able to provide an immediate short-term reduction in pain 12/9/14 2 Impact on range of motion n Four of these studies involved changes in shoulder range of motion and two studies examined cervical range of motion.

2 Of these, three studies found statistical significance for increased range of motion. Impact on strength n Three studies (one with a healthy athlete population, and two with athletes with Upper limb conditions) examined changes in strength. Two measured grip strength, and one lower trapezius muscle strength following immediate application of elastic therapeutic tape. All found no statistically significant difference between groups. Patient preference n Only one study examined patients' preference of elastic therapeutic tape compared to an alternative intervention (in this case, bandaging for lymphedema management). They found statistically significant results to support the argument that elastic therapeutic tape was preferred by participants (p < ). Reasons included longer wearing times, less difficult usage, increased comfort and convenience.

3 Benefits of Taping n Another benefit that was found as part of this scoping review was that elastic therapeutic tape is a treatment modality that has few side-effects. No adverse events were reported in any of these studies as a result of the use of elastic therapeutic tape. n The findings of this scoping review suggest that elastic therapeutic tape may play a role in reducing short-term neck and Upper Extremity pain and that it may be a more convenient and comfortable alternative to existing conservative treatments. 12/9/14 3 Kaneko, S & Takaski, H JOSPT 2011 n Forearm Pain, Diagnosed as Intersection Syndrome, Managed by Taping : A Case Series 514 | july 2011 | volume 41 | number 7 | journal of orthopaedic & sports physical therapy[ CASE REPORT ]1 Staff Occupational Therapist, Shinoro Orthopedic, Hokkaido, Japan; PhD candidate, Sapporo Medical University, The Graduate School of Health Sciences, Department of Occupational Therapy, Hokkaido, Japan.

4 3 PhD candidate, The University of Queensland, School of Health and Rehabilitation Science, Division of Physiotherapy, Queensland, Australia. The patients reported in this study were seen and treated at the Shinoro Orthopedic. All patients provided informed consent to be included in this case series and their anonymity was guaranteed. The opinions or assertions contained herein are the private views of the authors. The authors affirm that we have no financial affiliation (including research funding) or involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript. Address correspondence to Hiroshi Takasaki, Division of Physiotherapy, School of Health and Rehabilitation Science, The University of Queensland, Brisbane, Queensland 4072, Australia.

5 E-mail: syndrome, an overuse injury affecting the forearm, has been reported in sporting activity involving the Upper limb, such as rowing, canoeing, racket sports, weight lifting, and People who have intersection syndrome report pain, crepitus, and/or swelling in the dorsal forearm, 4 to 8 cm proximal to Lister s tubercle,4 where the muscle bellies of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) cross the underlying extensorcarpi radialis longus (ECRL) and exten-sor carpi radialis brevis (ECRB).5 The pathophysiological basis for intersection !STUDY DESIGN: Case series. !BACKGROUND: Intersection syndrome is an overuse injury of the forearm. Taping has been de-scribed for the management of soft tissue injuries, yet there has been no report for the management of intersection syndrome using this method.

6 The purpose of this case series was, therefore, to describe the efficacy of Taping for the management of intersection syndrome. !CASE DESCRIPTION: Five patients with inter-section syndrome were managed by Taping , in an effort to reduce crepitus induced by thumb move-ments. Nonstretch sports tape was applied, with an ulnarly directed tension force across the dorsal aspect of the forearm. Taping was performed daily for 3 weeks. Follow-up took place at 1, 2, 3, and 4 weeks, and at 1 year from the initial consultation. !OUTCOMES: All patients demonstrated com-plete elimination of crepitus with the application of tape. Crepitus induced by wrist movements, ten-derness over the dorsal forearm, and swelling were no longer present at 3-week follow-up. Disability identified by the disability/symptom subscale of the Disabilities of the Arm, Shoulder and Hand questionnaire decreased at 3-week follow-up, and this reduction was maintained at 4-week and 1-year follow-ups.

7 !DISCUSSION: Taping improved symptoms and function in this small case series. One possible explanation for this improvement may be the alteration of soft tissue alignment. !LEVEL OF EVIDENCE: Therapy, level 4. J Orthop Sports Phys Ther 2011;41(7):514-519, Epub 6 April 2011. !KEY WORDS: overuse syndrome , tape, thumb, wristSHOUTA KANEKO, OT, MSc1 HIROSHI TAKASAKI, PT, MSc2 Forearm Pain, Diagnosed as Intersection Syndrome, Managed by Taping : A Case Seriessyndrome is uncertain, but 2 potential mechanisms are considered. The first may be friction between the tendons of the APL and EPB, and those of the ECRL and ECRB; the second may be stenosis, due to entrapment within the second dorsal compartment that houses the ECRL and ,10,20 Aso et al1 argued in support of the former mechanism, due to the presence of pain on palpation and crepitus over the intersection of the APL and EPB, and the ECRL and ECRB, rather than the distal area of the second dorsal compartment, and due to thumb movements that accompany crepitus.

8 A key feature of intersection syndrome on magnetic resonance imaging (MRI) is peritendinous edema around the first and second extensor compartment ten-dons, which extends proximally from the intersection between the APL and EPB, and the ECRL and ,14 Current management of intersection syndrome comprises a combination of rest, nonsteroidal anti-inflammatory drugs, and ,16 One report in-dicated that 60% of patients responded to this form of management within 2 to 3 However, splinting the wrist in 15 to 20 of extension restricts wrist and thumb movements, possibly leading to difficulty with daily living and work Steroid injection is recom-mended for those failing to respond to .DQHNR LQGG 30 Journal of Orthopaedic & Sports Physical Therapy Downloaded from at on December 2, 2014.

9 For personal use only. No other uses without permission. Copyright 2011 Journal of Orthopaedic & Sports Physical Therapy . All rights Technique n The Taping direction for each patient was determined by assessing crepitus during thumb movements, while manual force was applied across the soft tissue of the dorsal aspect of the forearm. Taping Technique n Tape was then applied in an attempt to replicate and maintain the manually applied force across the muscle-tendon unit. The distal end of the tape was applied first to the muscle bellies of the APL and EPB. Tension was exerted with the free end of the tape as it was applied across the dorsal forearm, perpendicular to its long axis n A 2nd layer of tape was used to reinforce the 1st layer Application and Wearing of the Tape n The tape was removed at night, and each patient was instructed to maintain the Taping regimen for 3 weeks and allowed to continue work.

10 The patients were also advised to perform their normal daily activities. Following the 3-week intervention, all patients were advised to use the symptomatic limb during activities of daily living and to work without tape. They were instructed to reapply the tape if they had any return of symptoms 12/9/14 4 Outcomes All patients reported a complete elimination of crepitus with the application of tape. Crepitus induced by wrist movements, tenderness over the dorsal forearm, and swelling were no longer present at 3-week follow-up. Disability identified by the disability/symptom subscale of the Disabilities of the Arm, Shoulder and Hand questionnaire decreased at 3-week follow-up, and this reduction was maintained at 4-week and 1-year follow-ups. Scapular Taping n Lin et al showed Taping caused increased serratus anterior activity and decreased Upper trapezius activity while there was no effect on lower trapezius The Effects of Scapular Taping on Electromyographic Muscle Activityand Proprioception Feedback in Healthy ShouldersJiu-jenq Lin,1,2 Cheng-Ju Hung,1 Pey-Lin Yang11 School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3 F, 17, Xu-Zhou Road, Taipei 100, Taiwan,2 Department of Physical Medicine and Rehabilitation; Physical Therapy Center, National Taiwan University Hospital, Taipei 100, TaiwanReceived 2 August 2009; accepted 12 February 2010 Published online 6 July 2010 in Wiley Online Library ( ).