Taping in Children With Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      Kinesio taping (KT) has been commonly used in rehabilitation in children with Unilateral
      Cerebral Palsy (UCP). However, there is a lack of studies that verified the effects of KT in
      CP. We aimed to verify the effects of KT in the performance of sit to stand movement (STS) in
      children with spastic UCP (USCP). A blinded, placebo and repeated-measure design was applied.
      The setting was the rehabilitation clinic of the university and care facilities. Eleven
      children, aged from 6 to 12 years old (10.5±-2.8 years), diagnosed with USCP, Gross Motor
      Function Classification System levels I and II were evaluated. KT was applied over rectus
      femoris (RF) muscle of the affected limb. We considered three taping conditions: KT, without
      KT (with tension) and placebo (KT without tension). Mean root mean square (mRMS) of RF;
      initial, final and peak angles, and range of motion of trunk, pelvis, hip, knee and ankles
      joints; and total duration of STS were considered. STS was evaluated from three seat heights,
      neutral (100%), lowered (80%) and elevated (120%). Mixed ANOVA test was applied for angular
      variables of hip, knee and ankle, and mRMS of RF. Repeated ANOVA was applied for angular
      variables of trunk and pelvis, total duration.
    

Detailed description: 
      We evaluated a non-probability convenience sample. Participants were recruited in the
      rehabilitation clinic of the university and care facilities, between July of 2013 and July of
      2014.

      Body structures and functions and functionality component of the International Classification
      of Functioning, Disability and Healthy, were evaluated. Muscle activity (electromyography)
      and trunk and lower limbs alignment (kinematics) were evaluated as body structures and
      functions measures. Time used to perform STS was used as functionality measure.

      We evaluated sit to stand in three conditions: a) without taping; b) with KT, which was
      characterized as the use of KT with tension; c) placebo.

      Baseline measurement: STS without taping. The child was seated in a seat with adjustable
      height, without shoes. Both feet were symmetrically positioned shoulder width apart and arms
      were crossed over the chest. The participants could not use their arms to push up off the
      chair. Also, the child should be seated with gluteal and the upper thighs regions supported
      in seat. Children performed STS in a speed that simulated the one usually adopted in daily
      routine.

      Baseline measurement was evaluated in three seat heights: neutral, elevated and lowered.
      Neutral corresponded to a seated position with 90° of hip, knee and ankle flexion. Lowered
      and elevated were defined as, respectively, 80 and 120% of neutral height.The order of seat
      heights was randomized by drawing lots. A interval of 5 minutes was allowed between each seat
      height.

      Evaluations were carried out in two testing episodes, with one-week interval between them. On
      the first day, additional to baseline, the child performed STS with KT or placebo. The
      determination of which tape condition would be applied was randomized by drawing lots. A
      15-minute interval between baseline and tape condition was established. On the second day,
      the tape condition that was not performed on the first day was evaluated. In all conditions,
      the child performed STS in three seat heights.
    

Intervention name(s): Kinesio taping
Intervention type(s): Device
Intervention description(s): We applied a hypoallergenic, porous and adhesive tape of cotton (Kinesio Tex Gold) placed over Rectus Femoris muscle of the affected limb. Children were taped in accordance to Kenzo Kase's Kinesio manual. We used a facilitation technique, from muscle origin to insertion, in a Y shape. For KT condition: base of the KT strip 3cm below the anterior iliac spine, over the RF muscle until the upper edge of the patella and stretchered with 100% tension. For placebo condition: same technique without tension in the entire tape.
We verified the immediate effect of KT/placebo. After the evaluation, KT/placebo was removed.
Other intervention name(s): taping
Allocation: Non-Randomized
Intervention model: Crossover Assignment
Intervention model description: We used a blinded and repeated-measure design, with the application of a placebo condition
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: taping; functionality; rehabilitation; muscle activity; electromyography