Table 2. Summary of two-way ANOVA for fatigue and taping conditions on normal hand (left hand).

Variable and source df MS F _2

Mean force of pinch in wrist flexion *p < .05

Fatigue 1 9994.305 12.607* .808

Taping 1 9990.031 0.035 .012

Fatigue _ Taping 1 9990.321 4.029 .012

Variability of pinch force in wrist flexion

Fatigue 1 9990.011 0.453 .131

Taping 1 9990.005 0.357 .106

Fatigue _ Taping 1 9990.012 11.354* .791

MPF for FCU in wrist flexion

Fatigue 1 3864.021 53.114* .947

Taping 1 9556.309 2.056 .407

Fatigue _ Taping 1 9925.319 0.177 .056

MPF for FCU in ulnar deviation

Fatigue 1 2507.481 12.172* .802

Taping 1 1351.867 91.795 .374

Fatigue _ Taping 1 9989.015 94.546 .602

MPF for FCU in radial deviation

Fatigue 1 1247.838 40.112* .930

Taping 1 9277.431 0.514 .146

Fatigue _ Taping 1 9983.215 3.151 .512

Conclusion:The carpal tunnel is clinically significant not only because of the importance of the struc-tures within it, but also because of the frequent incidence of carpal tunnel syndrome and its resulting clinical problems. In this syndrome, compression of the median nerve can restrict motor function as well as sensation along the median nerve distribution of the hand. Less frequently, constriction of the tunnel traps the tendons running through it, and restricts, and may even prevent, flexion the fingers.

In testing of wrist flexion toward the radial side, when subject’s flexor carpi radialis weakness caused decreases the strength of wrist flexion, and pronation strength may be diminished, causing an ulnar deviation of the hand. Wrist flexion toward the ulnar side, when subject’s flexor carpi ulnar weakness caused decrease in the strength of wrist flexion, and may result in a radial deviation of the hand. Flexion of the wrist, when subject’s palmaris longus weakness resulted in decrease in the ability to cup the palm of the hand. (Kendall & McCreary, 1983)

MANAGEMENT OF SCAR TISSUEKim Rock StockheimerUniversity of Wisconsin, LaCrosse Wisconsin

Collagen is a protein that is mainly found in the second layer of your skin, called the dermis

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Summary Techniques for taping pitted skin and adhered scars . Emphasis of Presenta-tion: Scar management

When you suffer a cut, scrape, injury or surgical opening that goes beyond the superficial layer (epidermis), and down to the second layer (dermis), exposure of the collagen occurs, which is then al-lowed to come to the skin’s surface. Scars mainly consist of collagen.

Although it is possible to soften, or even get rid of an old scar, your best move is to stop scars from forming. It is easier to prevent a scar than to reduce it once it forms. The key to preventing scars is to break up the collagen and not allow it to bond to your skin’s top layer.

Preventing ScarsCover the wound so the wound stays moist to prevent scab formation.(Scabbing presents a barrier to healing) *The scab can create a barrier like ring and the wound has an increased depth that it has to go for healing. Be very careful with moisture as too much moisture around the wound can cause maceration, which is skin break down. Applying light pressure through com-pressive dressings or pads on the wound as it is healing keeps collagen from pop-ping up above the skin when a wound is healing.

Normal Skin consists of; Epidermis which is the outermost layer of the skinDermis lies just deep to the epidermis.Underneath the skin is the subcutaneous tissue and muscle

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Kinesio Taping Scars

Caution: When Kinesio Taping Scars, do not apply Kinesio Tape on a scar until it is

well healed. This would be when the scar is in its middle to later remodeling stage of

healing. (Around 2-4 weeks after the wound is closed). Applying tape too early could

cause extensive damage to the tissue. This could slow down wound healing. Be extra

careful with patients with diabetes, venous insufficiency, and peripheral neuropathy. It

is recommended that gentle manual techniques be provided as soon as the wound is

closed prior to starting Kinesio Taping methods.

Scar taping assists in the softening of scar tissue and reducing adhesions and pit-

ting. It helps to make the scar soft, flat and pliable and ultimately reduces the risk of

contractures. Low load-prolong duration stress on scar tissue, Helps to soften and

remodel scar tissue. Applied stress to the scar helps to lay down collagen fibers in a

more parallel pattern. Stress can be provided in the form of pressure or stretch.

Mechanical pressure with a corresponding stretch applied to a scar will eventu-

ally remodel the hypertrophic scar. If mechanical pressure is applied directly to the

scar as soon as the development of hypertrophic scar is clinically evident, whorl like

and nodular formations will change resulting in the reorientation of collagen fibers

to elongated parallel patterns. Future contracture and hypertrophy is prevented or

diminished. Thus, you can accelerate the natural healing process.

Scar taping with directional pull is used to assist in the softening of scar tissue and to reduce adhesions. Posi-tion patient in maximal muscular, fascial/skin elongation of the area of the scar. Lay down an “I” tape with 25-50% stretch. Rub the tape after application to adhere the tape. Place cross strips with pulling the base strip in the desired direction with 25-5-% stretch in tape.

Scar on knee after reconstructive surgery on the Anterior Cruciate Ligament.

Remember to start gently with scar tissue. You can gradually increase the tension to 50% only if the integrity of the skin can toler-ate it. If the skin is too fragile, use only a gentle manual technique.

Scar taping for pitting scars: Such as after open reduction with external fixation or surgical scars is used to assist in the softening of scar tissue and reduction of pitting.

Adhered point on a long scar. Start anchor away from adhered point and then stretch the tape toward the scar with 25% tension then apply tape. You can add a second piece if needed.

You can add tape in 2 directions if needed. There are times when it is appropriate to apply a second tape at a different direction. Make sure to apply with 25% tension.

Directional side pull. At times the whole scar is adhered in one direction. A side taping may be appropriate with 25% tension.

Scar Taping with Directional Pull:

Taping of scar induration to soften it. Cut 1/4 inch wide strips about 2 inches long. Start the an-chor away from adhered point and then stretch the tape toward the scar with 25% tension, then apply tape. Alternate directions that the tape is applied.

Taping of scar induration with a directional pull. Taping of scar induration to soften it. Cut 1/4 inch wide strips about 2 inches long.

Scar taping: Position the patient in maxi-mal muscular and fascial/skin elongation of the area of the scar. Apply a base “I” tape with 25-50% stretch. Rub the tape after application to adhere the tape.

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Approved Kinesio Taping SeminarsKT1 Fundamental Concepts, Screening/Muscle Test, & Muscle Applications (Recommended to take course in consecutive days with KT2)The KT1 course is designed to introduce practitioners to the Kinesio Taping Method. Over the course of this 8 hour class, the instructor will discuss the fundamental concepts of the Kinesio TapingMethod and the unique properties and use of Kinesio Tex Tape. During lab sessions, attendees will have ample time to practice screening and muscle testing created for the enhancement of your KT skills and muscle applications for both the upper and lower body. Upon completion of this course, attendees will be able to discuss and apply the Kinesio Taping Method to relax overuse syndromes, stimulate weak muscles, and decrease pain and swelling.

KT2 Advanced Concepts & Corrective Techniques (Upon completion qualifies for KTA Level 2 Membership) The KT2 course builds on material learned in KT1. During this 8 hour class, the instructor will introduce the six Corrective Techniques (Mechanical, Functional, Space, Fascia, Ligament/Tendon, and Lymphatic) and discuss their application in a variety of clinical conditions. During lab sessions, attendees will have ample time to practice applying these techniques to a variety of upper and lower body conditions. Upon completion of this course, attendees will be able to discuss and apply the KT Method to orthopedic & neurological conditions.

KT3 Course Kinesio Taping Certification Course (Upon completion, qualifies for KTA Level 3 Membership) The Kinesio Taping Certification Course combines KT1 and KT2 coursework with extra lab time for attendees to practice their skills on a variety of clinical applications. KT3 will allow the instructor to cater towards specific practitioner protocols, clinical applications, and pracittioner population. Upon completion of this course and preresiquite seminar, attendees will be eligible for Certified Kinesio Taping Practitioner (CKTP) status.This KT3 course is intended to allow for the Kinesio Taping Instructor to design courses to address specific professions (pediatrics, hand therapy, sports medicine, chiropractic, etc.) or clinical conditions (stroke, scoliosis, lymphedema, etc.).

Note: Health professionals who have successfully completed the required Fundamental and Advanced Kinesio Taping (KT1, KT2, & KT3) courses are eligible to take the Certified Kinesio Taping Practitioner (CKTP) exam. Upon passing this exam with a score of 80% or better, practitioners will be granted the CKTP title along with all the associated rights and benefits.

THE KINESIO TAPING® ASSOCIATION IS PROUD TO PRESENT A STRUCTURING OF A NEW DATABASE AND TEACHING SYSTEM HERE IN THE US AND ITS TERRITORIES, THE KINESIO TAPING ASSOCIATION HAS CREATED A NEW TEACHING PROTOCOL THAT WILL ALLOW US TO PROPERLY CHANNEL OUR EFFORTS TOWARDS THE PROPER STANDARDIzED TEACHINGS NEEDED TO BETTER TRAIN KINESIO TAPING PRACTITIONERS NOT ONLY ON A NATIONAL BASIS, BUT ALSO AN INTERNATIONAL BASIS.

Through the use of contracts and discussion all approved courses will require the instructor to follow all necessary teaching protocols set forth by The Kinesio Taping Association International, the parent company of Kinesio Taping Association USA. KTA, at this time, is also working on the accreditation steps needed to certify the standing of Certified Kinesio Taping Practitioner (CKTP) through the National Commission of Certifying Agencies (NCCA). This certification process is a necessary step in solidifying the importance of incorporating the KT Method into everyday practice. The issue of accreditation for certification organizations is one that will allow us to utilize our certification as a valued commodity, not only with our practitioners, but also with our company as a whole. Certification does not necessarily ensure that the CKTP will see an increase in compensation or professional recognition, the suggestion is that this will be a key step in creating relationships with the medical community and lead to possible insurance reimbursements on a consistent basis. With the structuring of a new database and teaching system here in the US and its territories, The Kinesio Taping Association has created a new implementation plan that will allow us to properly channel our efforts towards the proper standardized teachings.

With an emphasis over the last three years on discussion and research, KTA strongly believes these necessary protocols, programs, and levels of certification, will effectively introduce our new teaching format within the US markets. All materials needed for approved courses will be provided by the KTA.

Adhered volar wrist scar with flexor tendons adhered, reducing range of motion of fingers and wrists. Finger extension and finger flexion are limited.

Taping of volar scars (alternate applications):

This taping is used to encourage gliding motion of the scar in a distal direction. Attach the tape to the finger with 25-50% tension

To encourage gliding motion of the scar in a proximal direction, attach the tape pulling proximal. Apply tape with 25-50% tension.

Adhered dorsal wrist scar. The scar tissue adhered to the tendons limits finger extension and flexion. Taping of the dorsal adhered scar. This taping is to encourage gliding motion of the scar in the proximal direction; attach the tape with 25-50% tension.

To encourage gliding motion of the scar in a distal direction,attach the tape to the finger with 25-50% tension.

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