Clinical utility and some myths

Neuromuscular bandage in the children hand

Elisabeth Ortuño Cano Pediatric Physiotherapist

ICF- CY

Health Condition (disorder/disease)

Activities Body

funcion&structure Participation

Enviromental Factors

Personal Factors

Evidence

•  Absence of randomized controlled trials or systematic reviews

•  Differences in skin and tensions

•  No placebo effect, but... What about parents placebo?

NB in children versus adults

•  Effects attributed to bandaje: No evidence

•  Neuromuscular bandage as material for mechanical restraint and alignement. Forget about the technique.

•  Hypothesis: NB produces changes in activity in cases of minor motor and cognitive impairments.

•  AHA as tool for assessment

Truths and Myths

Real effect?

•  How we can measure it? Do we have tools?

•  Could neuromuscular bandaje influence hand configuration before reaching the object?

Differences between several materials

NB DMO DS(neoprene)

Evidence - + ++

Versatility +++ ++ ++

Difficulty in manufacturing or using + ++ +++

Child & family’s acceptance +++ ++ ++

Cost ++ - +

Advantages of NB

•  It is possible to change and try different placements in the same session (tension, direction, positioning...)

•  It is a comfortable material for the child (neoprene)

•  It allows to test different possibilities before making a hand splint

•  Usually NB is better received than splints as first aid choice

Combination with DMO and Dynamic Splints

•  NB DMO DS

•  NB/DMO/DS: Structural involvement (night splints, serial casting...) + activity needs, depending on the priority of correction/assistance

Questions

•  Is the continued use of a material that replaces/changes propioceptive information the better option? Could its effect cause “fatigue” to propioceptive system?

•  Does its effect expire?

•  Gain/Cost

I don’t have a conclusion, it’s just my experience...

...And many questions

@eliockinesio Elikinesio@hotmail.com