An exploratory study of the effect of a course of wrist and thumb kinesioTM taping on range of motion, quality of movement and function in children with a diagnosis of cerebral palsy, hemiplegia
Citation:
Michelle Spirtos, 'An exploratory study of the effect of a course of wrist and thumb kinesioTM taping on range of motion, quality of movement and function in children with a diagnosis of cerebral palsy, hemiplegia', [thesis], Trinity College (Dublin, Ireland). School of Medicine. Discipline of Occupational Therapy, 2008Download Item:
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Abstract:
This study aimed to examine the effect of a 6 week course of kinesio™ taping, applied to the thumb and the wrist, on range of motion, quality of movement, functional skills and performance of daily activities, in a population of children with a diagnosis of cerebral palsy (CP), hemiplegia. It gathered the parent perceptions of both the taping programme and of the perceived benefits of the taping to their child. The prevalence of CP is estimated to be between 1.4 and 2.4 per 1,000 live births (Rodgers, 2005) and hemiplegia is the second largest classification within this group (Fendrizzi et al, 2003). The typical presentation of the upper limb in hemiplegia is elbow flexion, forearm pronation, wrist and digit flexion and thumb adduction. Children can present with difficulties in grasp, release, inhand manipulation and performance limitations in tasks requiring bilateral integration. These children are regularly in receipt of occupational therapy and physical therapy and the therapy techniques utilised include neurodevelopmental therapy, splinting and constraint induced movement therapy. There is a significant lack of evidence to support or refute the effectiveness of these treatment Interventions (Boyd, Morris & Graham, 2001; Steultjens et al, 2004) and there is almost no data relating to the Irish population. Kinesio™ tape and the kinesio™ taping technique was introduced by Dr Kenso Kase to the field of sports injuries in 1975 in Japan (Coopee, 2002). It has been slowly gaining international recognition in the treatment of both sports and hand injuries and it has an entire chapter devoted to its application in the fifth edition of Rehabilitation of the Hand and Upper Extremity (Coopee, 2002). Its use within the paediatric population is more recent and there is only one published pilot study to date, which examines its effectiveness in the treatment of the upper limb in neurological impairment. At the commencement of this study, kinesio™ taping was not part of routine intervention for children in Ireland. A repeated measures design was employed with each child acting as their own control.
Evaluations were completed at six week intervals; at base line, pre taping, post taping and follow up. The total number to complete the study was fourteen. Goniometric Measurement, The Melbourne Assessment of Unilateral Upper Limb Function, The Assisting Hand Assessment and the Pediatric Evaluation of Disability Inventory, Self-care Domain and Caregiver Assistance Scale, Self-care Domain were administered to m easure change. Two parental questionnaires were utilised to gather information from the parents regarding their perceptions of the taping programme and any perceived benefits to their child. Analysis of the data was completed using descriptive and nonparametric inferential statistics. The total study group was examined for statistically significant change and each child was individually considered as a single case. A statistically significant change was found in active wrist extension, radial and palmar abduction at both post taping and follow up. This indicates that the tape was effective in positively influencing the degrees of active motion achieved at the wrist and the thumb. There was not a statistically significant gain in either of the tests used to measure quality of movement or upper limb function. There are two factors which may have influenced this result. The change achieved in motion at a body systems level may not have resulted in a change at the activity level. The tests may not have been sensitive enough to pick up gains from the six week taping intervention. The PEDI Self-care Domain did show a statistically significant gain at both post taping and follow up. The difference in gain scores for the measure of caregiver assistance required was statistically significant at follow up but not at post taping. Overall, the parents were positive about the taping programme and improvement was reported in dressing, feeding, play and school/home work. The degree of improvement varied from slight improvement to substantial improvement, with the greatest perceived change in school/homework, followed by play. Thirteen out of fourteen parents reported post taping that they would consider incorporating kinesio™ taping into their child’s programme.
When the data for the children was analysed individually and as groups, by age, sex, side of involvement and severity, no clear picture emerged regarding the characteristics of the child who would best benefit from the taping programme. Therefore, no statements regarding this can be made. Overall, the study supports the inclusion of kinesio™ taping in the intervention programmes being provided to children with CP, hemiplegia. Further research is recommended which combines taping with focused occupational therapy intervention and the use of kinesio™ taping with children with bilateral involvement.
Author: Spirtos, Michelle
Advisor:
O'Mahony, PaulQualification name:
Master in Science (M.Sc.)Publisher:
Trinity College (Dublin, Ireland). School of Medicine. Discipline of Occupational TherapyNote:
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