Bracing and Taping
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| 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
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| Bandaging Materials: Muslin | -Rolled non-elastic cotton
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| All Cotton Elastic (ACE) bandage | -Advantages: Muscle assist, compression because of elasticity, reusable
-Disadvantage: limited joint support
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| Gauze | -Open weave cotton
-Rolled or as pads
-Some pads are non-adhesive
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| Stockinet | -Tube of loosely or tight knit cotton
-Hold dressings in place
-Plaster cast lining
-Improve swelling
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| Bandaging Techniques; Triangular | -Folded square cloth, used for UE, temporary sling
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| Circular | -Overlapping circular turns
-Typically used to anchor bandage
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| Spiral | -Overlapping diagonal turns
-Less apt to occlude circulation
-Covers larger area than circular type
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| 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
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| 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
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| 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
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| 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
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| After bandaging | -Assess function and benefit
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| How would you ensure proper circulation | -Nail bed recovery
-Pulses
-Observation
-Ask
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| Hip bandaging may be used for | -Above knee amputees
-Thigh muscle strains
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| 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
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| Thigh muscle strain: Hamstrings | -Hamstrings
-Hip position: Extended
-Wrapping force: Posterior between LEs
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| Thigh muscle strain: Hip Flexors | -Hip Flexors
-Hip position: Flexed
-Wrapping force: Anterior between LEs
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| Thigh muscle strain: Hip Adductors (Groin) | -Hip adductors (groin)
-Hip position: Slight adduction/ flexion
-Wrapping force: Medial
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| Thigh muscle strain: Hip abductors (rare) | -Hip abductors (rare)
-Hip position: Abducted
-Wrapping force: Lateral
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| Taping purposes | -Injury prevention
-Joint support/ protection
-Biomechanical: repositioning, proprioceptive input, muscular activation
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| Taping materials | -General adhesive taping: athletic taping
-Specialty adhesive taping: Leukotape/Endura tape/ Kinesio-tex taping (KKT)
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| Athletic taping | -Provides support with physical activities
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| Athletic taping: What is the most common sprain and specific ligament? | -Lateral sprain
-Anterior Talofib ligament
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| 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
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| Medial Sprain: applied from ___ to___ and creating ____ | -Similar to lateral ankle sprain taping
-Exception- stirrups are applied from Lateral to Medial and creating Inversion
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| Athletic taping vs KTT and no taping | -Improved avg. EV muscle activity with IV perturbation with a hx of ankle sprains
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| Athletic taping vs KTT, placebo, and no taping | -Decreased vertical jump and heel raise performance with chronic ankle instability (CAI)
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| 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
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| 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
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| Knee taping- McConnell | -Developed by Jenny McConnell, PT
-Used for patellofemoral P! syndrome; aka anterior knee P! or patellar maltracking
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| Patella typically deviates abnormally in a ____ direction | -Lateral
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| 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
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| Arch taping | -Purpose: controls excessive pronation
-Types: Low dye- most familiar/ recognized; Augmented low dye-rare; Tear drop-rare
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| 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
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| 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
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| Augmented low-dye benefits in runners | -Delayed onset of gluteus medius, vastus medialis, and vastus lateralis
-Increased lateral midfoot plantar pressure
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| Shoulder taping | -Shoulder complex: Supraspinatus/Biceps tendon tendonitis/-osis
-Indication: lowest tolerant pts when gravity is irritating their condition, better option than sling
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| 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
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| 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
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| Spinal taping cont... | -Lumbar spine for ext bias
-Meta-analysis on spinal P! and disability- taping lacked firm support and not clinically relevant
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| Kinesio-tex Taping | -Developed by Dr. Kenzo Kase, DC
-Unidirectional elasticity
-Latex free
-Hypoallergenic- last 3-5 days
-Water resistant version available
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| 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
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| 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
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| KTT evidence | -No change with thoracic myofascial trigger points compared to placebo
-Did not facilitate muscle performance at the knee
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| KTT evidence: CAI vs athletic tape | -Similar or greater performance
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| KTT evidence: CAI vs athletic and no taping | -No significant effect on EV mm activity
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| 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
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| KTT evidence: CAI vs athletic, placebo, and no taping | -Better vertical jump and heel raise performance
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