Kinesiology and Elastic Therapeutic taping (ETT)

in Paediatrics

Claire McInally October 2015

Background to K-tape l  Invented in Japan 1979 by

Dr Kenzo Kase and Nitto Denko

l  First major international exposure in 1988 – Soel Olympics

l  Introduced to Europe 1998 l  Introduced to VHK 2008 l  Esther de Ru course 2014

What it is?

Kinesiology… “The Study of the

Mechanics of Body Movements”

l  Aim is to use the bodies natural healing processes

l  Main points are the skin, fascia and muscles

l  Testing by the principle of kinesiology (hence the name)

Material l  Thin porous fabric l  Elasticity, comparable

to the skin and muscles.

l  Water repellent

l  Can use for no. of days (most reaction 3-5 days if chronic problem 7 days)

l  Hypoallergenic

Differences in taping methods Mechanical Taping Sensory Taping

Functional immobilisation Full range of motion

Protects joints and muscles

To support the muscle activity and natural healing processes of the body

Can reduce circulation No reduction to circulation

Original Theoretical models l  Skin (convolutions)

causing friction between layers-increased circulation

l  Skin lifting: making space between dermis and epidermis (decompression)

l  Proprioceptive awareness

l  Origin-insertion direction results in either facilitation or inhibition of underlying muscles

New theoretical models

l  Fascia model-whole body patterns-www.anatomytrains.com

l  Tensegrity model-type of structure based on

balance between tension and compression components.

Indications l  Muscle tendon disorders l  Orthopaedic disorders l  Neurological disorders l  Blood flow problems l  Breathing problems l  Lymph and circulation disorders l  Pain l  Sports injuries l  Nerve entrapment

Contra-indications

l  Skin problems l  Sunburn l  Swelling without detailed history l  Open wounds l  Severe trauma l  Allergic reaction to tape l  No result after 2/3 applications l  Individuals with systemic illness/Infection

Careful with Children l  Skin thinner than adults l  Neck l  Auxilla l  Parts of stomach l  Groin l  Great care taken with babies 0-6 months l  Epilepsy l  Consider what organs underneath l  CRPS etc.

K-taping Applications l  Lymphatic technique l  Scar technique l  Muscle technique – 0% stretch on tape l  Ligament/tendon technique – 25%-100% stretch l  Mechanical/Correctional technique – Base fixed –

tails 25-100% stretch l  Assist l  cross/Trigger point technique

Kinesiotape in Physiotherapy l  Decrease Pain l  Reduce Inflammation l  Provide mechanical support l  Facilitates lymphatic drainage l  Inhibit Muscle (detonisation – insertion to origin) l  Facilitate Muscle (tonisation - origin to insertion) l  Mental benefits

General tips

l  Skin clean dry l  Base and Tails l  Always round corners l  Rub tape after you have applied l  Remove immediately if any reactions l  Tape must be smooth no “pleats” l  No evidence re. colour but differences noted l  Apply 20 -30 mins prior to sport

Magic Word!!

l RECOIL

l Think what is your goal!!

Common Tapings Utilised l  Lumbar – Mechanical low back pain l  Shoulder –instability and ACJ pain l  Knee – AKP, quads weakness/strain, MCL/LCL

strains,OSD l  Ankle – Achilles tendonopathy, Sever’s

Back pain

SIJ pain

Shoulder instability

AKP

Sever’s/OSD/SIJ

Calf problems

Transverse arch taping

l  Improves balance l  Halux valgus l  In toeing l  Pain l  Talipes

Transverse arch

Babies!!

l  Need monitored l  Not keen on neck due to artery l  No preterm babies l  Skin colour tape only l  Small thin strips only l  Must know the child l  Talipes-transverse arch or lateral strip l  In conjunction with Ponsetti

Other ideas l  S-tape just under chin for excessive drooling l  Scars-perpendicular small bits down line of scar

(vary technique depending on how old scar is) l  Tape vs. splint/lycra- tape can be used as a test l  Trunk e.g. low tone/hypermobile l  Correction tape e.g. Posture/intoeing l  Assited e.g. Improve heel strike/wrist extension l  Lymph technique

Scars

Correction tape l  CP patients l  Remember recoil l  Shoulder instability l  Hip IR l  Scapula l  Elbow hypermobility l  Used for short period only e.g. treatment session

then muscle technique

Trunk

l  Diaphragm e.g. hyper mobile, low trunk tone l  Rectus abdominis/erector spinae l  Obliques l  Transverse abdominal combi-tape l  Diastasis recti

Assist technique

l  40 percent stretch l  Remember recoil l  Dorisflexion l  Wrist extension l  Knee hyper-extension

Lymph/haematoma

l  Stimulating the skin l  Acute injury-ankle sprain l  haematomas l  Lymph tape after surgery-elbow l  Careful of groin area l  Decreases pain and healing l  Research

l  Just Try! l  Do not fret about systems/organs etc l  If it doesn’t work try again! l  Case studies

Research

l  Most research done on healthy adults l  Requires research in Paediatrics l  Same brand same colour of tape used l  Mainly systematic reviews out there l  Hard due to outcome measures, reliability etc l  People finding taping working but not

reporting it

Research

l  Journey of Physiotherapy Vol 60 Issue 1-Current Evidence does not support the use of kinesio-taping in clinical practice: a systemic review

l  Esther wrote letter of complaint (September issue)

l  Results not correct l  French copy has different conclusion

Continued… l  Increases proprioception: Ø  Akio Mori, Masaki: Activation of cerebral Cortex

(2005) Ø  Yuh-Hwan Liu et al: Ultrasonic imaging UE (2007) Ø  Tibaud et al Skin Stimulation and muscle fatigue

(2011) Ø  Callaghan MJ (2012) knee tape and MRI Ø  Gait and posture(33) 2011 Ø  Evidence “rock tape” optimises athletes

performance

Research/Case Studies and Clinical Reasoning

l  Increased Research l  http://www.kinesiotaping.co.uk l  Limitations/Bias l  Clinical Reasoning

l  Thank you l  Any questions….