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Special Topics
Bracing and Taping
| Question | Answer |
|---|---|
| Bandaging Purposes | -Acute/ emergency situations: support/ stabilize, restrict motion, control swelling/ bleeding -Wound care: protection, absorb exudate, debridement -Other purposes: residual limb shaping, muscle assist |
| Bandaging Materials: Muslin | -Rolled non-elastic cotton |
| All Cotton Elastic (ACE) bandage | -Advantages: Muscle assist, compression because of elasticity, reusable -Disadvantage: limited joint support |
| Gauze | -Open weave cotton -Rolled or as pads -Some pads are non-adhesive |
| Stockinet | -Tube of loosely or tight knit cotton -Hold dressings in place -Plaster cast lining -Improve swelling |
| Bandaging Techniques; Triangular | -Folded square cloth, used for UE, temporary sling |
| Circular | -Overlapping circular turns -Typically used to anchor bandage |
| Spiral | -Overlapping diagonal turns -Less apt to occlude circulation -Covers larger area than circular type |
| Spica | -Series of spinal turns applied in alternate directions in the shape of the number eight that is typically across a joint -Provides more stability -Used on extremity joints Turns typically used in combination |
| Knee & Elbow | -Anchor distal to joint -Wrap distally to proximal w/ lessening pressure as you wrap -Covers all skin with spiral turns as it lies -Finish by anchoring proximal to the jt. about 1/2 way up segment -4 in. bandage for adults and smaller for children |
| Hand & Wrist | -Anchor at the base of fingers -Wrap distal to proximal lessening pressure -Cover all skin w/ spiral turns -Anchor just distal to forearm muscle belly -2 in. bandage for adults and smaller for children |
| Foot & Ankle | -Position in neutral -Anchor at base of toes -Wrap distal to proximal lessening as you go -Cover all skin -Anchor just distal to gastroc muscle belly -4 in. bandage for adults and smaller for children |
| After bandaging | -Assess function and benefit |
| How would you ensure proper circulation | -Nail bed recovery -Pulses -Observation -Ask |
| Hip bandaging may be used for | -Above knee amputees -Thigh muscle strains |
| Hip bandaging | -Anchor below level of injury w/ circular turn -Wrap: prox. w/ spiral turn around thigh, then wrap pelvis/ iliac crests w/ spica and return to thigh alternately -Anchor on pelvis circular turn -Bandage: 6 in. adults & 4 in children -Double bandage |
| Thigh muscle strain: Hamstrings | -Hamstrings -Hip position: Extended -Wrapping force: Posterior between LEs |
| Thigh muscle strain: Hip Flexors | -Hip Flexors -Hip position: Flexed -Wrapping force: Anterior between LEs |
| Thigh muscle strain: Hip Adductors (Groin) | -Hip adductors (groin) -Hip position: Slight adduction/ flexion -Wrapping force: Medial |
| Thigh muscle strain: Hip abductors (rare) | -Hip abductors (rare) -Hip position: Abducted -Wrapping force: Lateral |
| Taping purposes | -Injury prevention -Joint support/ protection -Biomechanical: repositioning, proprioceptive input, muscular activation |
| Taping materials | -General adhesive taping: athletic taping -Specialty adhesive taping: Leukotape/Endura tape/ Kinesio-tex taping (KKT) |
| Athletic taping | -Provides support with physical activities |
| Athletic taping: What is the most common sprain and specific ligament? | -Lateral sprain -Anterior Talofib ligament |
| Athletic taping: Lateral sprain: Stirrups applied from ____ to ____ and creating _____ | -from Medial to Lateral and creating Eversion -Heel locks and figure 8 turns are applied in pairs and in both directions |
| Medial Sprain: applied from ___ to___ and creating ____ | -Similar to lateral ankle sprain taping -Exception- stirrups are applied from Lateral to Medial and creating Inversion |
| Athletic taping vs KTT and no taping | -Improved avg. EV muscle activity with IV perturbation with a hx of ankle sprains |
| Athletic taping vs KTT, placebo, and no taping | -Decreased vertical jump and heel raise performance with chronic ankle instability (CAI) |
| Athletic support: Loss of support with activity | -50% loss after 15 minutes of standard vigorous exercise including jumping, pivoting, and running -20% loss after 20 minutes start/stop running on uneven ground and jumping |
| Ankle taping: CAI | -Talar stability: position pt. in neutral to 10 degrees DF/ tape assists with posterior glide of talus -High ankle strain: tape assists with posterior glide of distal fibula and approximation of distal tibfib joint |
| Knee taping- McConnell | -Developed by Jenny McConnell, PT -Used for patellofemoral P! syndrome; aka anterior knee P! or patellar maltracking |
| Patella typically deviates abnormally in a ____ direction | -Lateral |
| Knee taping purposes | -Proprioception- especially with poor initial proprioception -Biomechanics: improved medial and lateral placement, improved inferior shift to increase contact area -Improved knee extensor torque |
| Arch taping | -Purpose: controls excessive pronation -Types: Low dye- most familiar/ recognized; Augmented low dye-rare; Tear drop-rare |
| Arch taping indications | -Plantar fasciitis -1st MTP OA -PFPS -Tibiofemoral lateral compartment OA -Hip impingement/OA -Those with contributing pronation -Benefits: Positional changes in the entire LE |
| Augmented low dye benefits | -More effective than Low Dye @ maintain med longit arch -Increase peak & mean max pressure on the lat mid foot with walkin & joggin Decrease mean max pressures on med forefoot & peak pressure on med rearfoot durin walkin -Controls excessive pronation |
| Augmented low-dye benefits in runners | -Delayed onset of gluteus medius, vastus medialis, and vastus lateralis -Increased lateral midfoot plantar pressure |
| Shoulder taping | -Shoulder complex: Supraspinatus/Biceps tendon tendonitis/-osis -Indication: lowest tolerant pts when gravity is irritating their condition, better option than sling |
| Shoulder taping cont... | -Impaired scapular companion motions with impingement -Indication: impingement with poor scapular control -Assist with LT activity -Promotes: Scapular upward rotation and _____retraction? Improved posture |
| Spinal taping | -Purposes: cervical/ thoracic spine- bilateral scapular positioning -Indication; C-DJD or stenosis/ thoracic P, functional instability, osteoporosis/ vertebral bofy fx -Promote Flex bias in upper and middle c-spine -Promote Ext bias in lower c&t spine |
| Spinal taping cont... | -Lumbar spine for ext bias -Meta-analysis on spinal P! and disability- taping lacked firm support and not clinically relevant |
| Kinesio-tex Taping | -Developed by Dr. Kenzo Kase, DC -Unidirectional elasticity -Latex free -Hypoallergenic- last 3-5 days -Water resistant version available |
| KTT claims to... | -Alter muscle function -Reduce pain -Reposition subluxed joints by relieving muscle tension -Promote circulation by “lifting” skin -Limited research to substantiate claims as of Summer 2012 but growing |
| KTT vs manipulation with MND after 1 wk | -Similar improvements in P! , disability, and ROM (except for rot) -Only clinically meaningful changes with P! for both interventions -No control group |
| KTT evidence | -No change with thoracic myofascial trigger points compared to placebo -Did not facilitate muscle performance at the knee |
| KTT evidence: CAI vs athletic tape | -Similar or greater performance |
| KTT evidence: CAI vs athletic and no taping | -No significant effect on EV mm activity |
| KTT evidence: CAI vs placebo and no taping | -No significant differences for dynamic balance -Faster and equal difference in the hopping and single limb hurdle |
| KTT evidence: CAI vs athletic, placebo, and no taping | -Better vertical jump and heel raise performance |
Created by:
alovedaytn
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