1 Theory and Application Therapeutic Taping2012

8/10/2019 1 Theory and Application Therapeutic Taping2012

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Dr. Dyanna Haley-Rezac , PT, DPT, OCS, CSCS, CKTP, CGFI- MP2

Dr. Scott Rezac , PT, DPT, OCS, CSCS, CKTP, CGFI-MP2, CEAS

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Dyanna Haley-Rezac

PT DPT OCS CSCS CKTP CGFI-MP2

DPT - Slippery Rock University BS - Exercise Physiology WVU OCS - Orthopedic Certified Specialist (APTA)

CSCS - Certified Strength and Conditioning Specialist (NSCA) CKTP - Certified Kinesio Taping Practitoner (KTA) CGFI-MP2 – Certified Golf Fit Instructor Level 2 – Medical

Professional (TPI)Manual Fellow in Training for AAOMPT Regis University Co-Owner Rezac & Associates Physical Therapy

Affiliate Faculty for Regis University APTA Certified Clinical Instructor (CI)Member APTA, AAOMPT, NSCA, CO Professional Development Co-Chair & Mentoring Committee APTA CO SE District Secretary

Scott & Dyanna Rezac - Intro to Therapeutic Taping2





Participants will be able to select appropriate patients fortaping interventions relative to indications and

contraindications.

Participants will be able to select and apply appropriatetaping techniques based on patient presentation and functional limitations.

Participants will be able to assess efficacy of tapingapplication objectively.

Participants will be able to discuss current evidence withregard to utilizing taping techniques.

Participants with be able to objectively document techniques

applied for billing and reimbursement.


Course Objectives



Non-Elastic - Rigid

Athletic Tape

Cramer®/Mueller®/Johnson & Johnson®/Power Tape®

Immobilization Joint Protection / Support

Control Movement

Re-injury Prevention

Utilized prewrap to prevent skin irritation

Now also in cool colors for both the tape andprewrap, but not the same as the newerElastic (Kinesio®/Balance Tex®) Tape

Invented in 1920s by J&J, but hit height ofpopularity in 80s


Types of Taping

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Theories

Rigid Tape (Athletic Tape) Theories

Prevention of re-injury through immobilization

Provide rest to injured tissues

Mechanical Support

Unloading

Similar to bracing

Useful for acute injuries on field to allow

athlete to complete game / competition


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Types of Taping Non-Elastic - Semi-Rigid

McConnell Institute® and Mulligan Techniques (Leukotape® / EnduraTape® / DonJoy®) Tape Some Flexibility

Neuro Re-ed Facilitation – with direction of muscle fibers

Inhibition - across muscle belly

Joint position – patellar relocation, navicular lift

Improve muscle torque

Support for improved tolerance to joint loading Unloading painful structure by shortening tissue

Utilizes Cover Roll or Hypafix®

Introduced by Jenny McConnell in 1986 and BrianMulligan in 1989, most popular in the 90s


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Semi-Rigid Tape Theories Jenny McConnell

Neuromuscular re-education through facilitation (along muscle)or inhibition (across muscle)

Relocation of joint for optimal biomechanical alignment

Mechanical Support

Unloading of painful structures

Brian Mulligan Mobilization with Movement (MWM) – utilizes tape to carry-

over manual techniques – joint mobilization, soft tissue unload,positional correction

Neuromuscular Re-education, biomechanical alignment, unload


Theories

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Types of Taping

Elastic Proprioceptive Tape Kinesio® Tex/ Balance Tex® / Sports Tex®

/ Kinesiology®/ Spider® Tape Very Flexible

Neuro Re-ed muscle facilitation inhibition

Lymphatic Drainage Unloading Proprioceptive Input

Joint Support Invented in the 70s by Dr. Kenso Kase

(Chiropractor), not popular in US until2000s



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Kinesio® Taping Theories

Muscle Function

Facilitate muscle contraction via muscle spindles

Inhibit / relax muscles via GTOs

Increase ROM - Inhibition of hypertonic muscles

Decrease Pain - Activation of weak muscles for AROM Proprioceptive feedback / re-ed

Reduce over-extension or over-contraction of muscle

Skin FunctionStimulation of nocioceptors, mechnoreceptors and

thermoreceptors influencing CNS response Pain Function

Gate Control Theory – increased mechanoreceptor stimulation Inflammation Reduction – decreased nocioceptor stimulation Unloading / Inhibition of painful structures


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Why these are THEORIES

No research to support:

Joint realignment via radiography or MRI

EMG activation/de-activation of muscle fibers

(muscle spindles, GTOs)

Effect on nocioceptors, mechanoreceptors or

thermoreceptors Reproduction of Joint Position Sense (RJPS) /

Proprioception


Theories

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Evidence Based Practice

What the research DOES support:

Decrease in pain rating scales Gonzalez-Iglesias, 2011 Kaya, 2011

Gonzalez-Iglesias, 2009 Garcia-Muro, 2009 Jotkowitz, 2009 Warden, 2008 Aminaka, 2008 Janacaitis, 2006 Frazier, 2006 Griffin, 2006 Brandon 2005

Vicenzio 2003Scott & Dyanna Rezac - Intro to Therapeutic Taping12

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Improvement in disability scores

Gonzalez-Iglesias, 2011

Kaneko, 2011 Kaya, 2011

Jotkowitz, 2009

Hughes, 2008

Michael, 2008

O’Sullivan, 2008

Kilbreath, 2006






Evidence Based Practice What the research DOES support:

Improvement in functional tasks Maguire, 2010 Gonzalez-Iglesias, 2009 Garcia-Muro, 2009 McConnell, 2009 Hsu, 2009 Abian-Vicen, 2009 Jotkowitz, 2009

Callaghan, 2008 Baltaci, 2008 Callagan, 2008 Meana, 2008 Aminaka, 2008

Michael, 2008 O’Sullivan, 2008 Thelen, 2008 Vicenzino, 2007 Yoshida, 2007 Aspergren, 2007 Kilbreath, 2007 Moiler, 2006 Jancaitis, 2006 Halseth, 2004 Vicenzion, 2005









Decreased incidence of re-injury Fleet, 2009

Eagleton, 2009

Refshauge, 2009

Franettovich, 2009

Hughes, 2009

Baltaci, 2009

Meana, 2008 Griffon, 2006

Osterhues, 2004

Crossley, 2000







Decreased inflammation / edema

Tsai, 2009

Bialoszzewski, 2009 Osterhues, 2004







Psychological Benefit

Abian-Vicen, 2009

Hughes, 2009 Paterson, 2009

Moiler, 2006

Jancaitis, 2006

Hunt, 2006

Crossley, 2006

Simoneau, 2006







Does not make them worse

All of the above!


S thi b tt th l




Something better than any laser,wrap, or electric massager.…TheTape. it is a special hot-pinkathletic tape that came from Japan

and seemed to have specialpowers. Every morning before thestage, they would tape us all up,different parts of our

bodies...George's back, Chechu'sknees. Sometimes we'd be sowrapped up in hot-pink tape thatwe'd look like dolls, a bunch of

broken dolls. But the next day thepain disappeared--it was gone." byLance Armstrong. Every SecondCounts




Elastic Proprioceptive Taping

New adjunct for clinician tool box




Application of Elastic Tape

Skin free of oils / lotions and dry

Spray adherent can be used, no prewrap or cover roll

Clip or shave thick or “furry” hair

Can apply as many of the individual techniques as needed – recommendtaping for pain and function

Lightly rub to activate heat sensitive adhesive

Using a hair dryer after showering can help maintain elasticity andprevent uncomfortable wet tape

No tension at beginning and end of tape

Round ends of tape to prevent rolling May be used in many people with tape allergy, still need to test

Can be worn for 3-7 days, elastic properties prevent loosening




Other considerations

Age

Use caution with elderly, frail skin (consider test trip)

Pediatric delicate skin (consider test strip)

Don’t apply over non-closed incisions or wounds or abrasions/rashes

Elastic tape more tolerable in persons with tape allergy, generally if theycan tolerate a band-aid, they can wear (test skin)

Can adjust wearing schedule to less time on for sensitivity

Tape should NEVER increase pain or dysfunction

Apply one technique at a time and test

Tape for pain AND function components as appropriate


Application of Elastic Tape



Application of Elastic Tape Facilitation- Moderate/50% to Maximum/100%

Inhibition- Minimal /<25%

Edema- No Stretch

Space Correction/Unloading- Maximum/100% Stretch




Solid Strip

Split Strip

Diamond Cut Outs


Elastic Tape Strip Types



pplication of Tape

The Rezac Principles

Should not produce or increase pain




pplication

of Tape

The Rezac Principles

Use the least amount oftape necessary to

accomplish goal.






ElasticTaping

While rigid taping still has it’s use for immobilization withsignificant instability, all techniques presented in thiscourse utilize elastic tape.

Credit is given for each technique to the originator of thetechnique. If not noted, the technique has, to theknowledge of the instructor, never been presented byanother person or organization.




Rules for Taping

There are no “rules” only guidelines

All of these types of taping utilize very specific step-by-stepinstructions regarding position of muscle / joint, strips of tapeand direction of pull – but NONE of them has substantial

evidence to show THEIR technique is any better than anyother one

Utilize your knowledge of biomechanics and anatomy andtape for what you want to accomplish

Use to carry-over manual techniques (JTM, STM, PNF)

Then check to see if it accomplished your goal (objectivemeasures)




Questions Comments

Rotten Tomatoes?


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1 Theory and Application Therapeutic Taping2012