Kinesio Tape vs Neuromuscular Stimulation For Conserative of Treatment Hemiplegic Shoulder
Condition: Hemiplegia
MeSH terms: Hemiplegia
Study type: Interventional

Summary: 
      This study aimed to compare the effects of kinesiotaping, neuromuscular electric stimulation
      (NMES), and neuromuscular training on pain, and motor activity and function in patients with
      upper extremity hemiplegia.
    

Detailed description: 
      Hemiplegia in the shoulder complex and upper limb is a common secondary impairment as a
      result of a cerebrovascular event. Although most stroke survivors regain independent
      ambulation, many fail to regain functional use of their impaired upper limb. Actually the
      pathogenesis of post-stroke shoulder pain seems to be multifactorial; differential diagnosis
      is often difficult. Changes in the shoulder complex makes the glenohumeral joint vulnerable
      to subluxation, which may cause pain. Traction of capsule and soft tissue related subluxation
      of the shoulder may take place in the early stages; limited range of motion due to spasticity
      may develop in the later stages of stroke. These biomechanical problems may be the possible
      reason for pain. Rotator cuff tears and rotator cuff and deltoid tendinopathies are also
      possible symptoms related to hemiplegic shoulder observed in magnetic resonance imaging
      findings. These problems in the shoulder disturb the kinetic chain system that connects the
      segments and works sequentially from proximal to distal to achieve the targeted movement.
      When a biomechanical impairment happens in the shoulder or any other segment of the body, a
      loss in the energy produced in the body and transferred to the upper extremity occurs. This
      loss adversely affects the quality of the movement .

      Regaining functional use of the upper limb after a stroke is a challenging task for the
      patient, which has a significant impact on the individual's physical, psychological, and
      emotional well-being. Lack of functional ability in the upper extremities after stroke
      restricts use and causes asymmetric posture and contracture in daily life, thus exacerbating
      functional limitations of the upper limb. Also, low upper limb motor function is related to
      the risk of soft tissue injury during rehabilitation. A patient experienced a stroke may not
      feel any pain due to subluxation. However, different muscle groups may be vulnerable to
      overstretching, increased contraction, and premature fatigue. This can decrease the
      coordination of muscular activity and inhibit the functional use of the upper extremity. The
      posterior fibers of the deltoid, the supraspinatus, and the infraspinatus are the most
      important muscles that prevent the subluxation of the glenohumeral joint.
    

Intervention name(s): NMES; Kinesiotape; Standardized Physiotherapy
Intervention type(s): Other; Other; Other
Intervention description(s): Participants received NMES using a portable, page-sized battery-powered stimulation device, which delivered current-regulated, charge-balanced, asymmetrical biphasic pulses. The implementation was done on the deltoid and supraspinatus muscles; The deltoid and supraspinatus muscles were taped in this study to align the shoulder in correct position to facilitate the function and achieve preferred body alignment. For supraspinatus application, Y strip tape was applied from the muscle insertion at the greater tuberosity of the humerus to its origin at the supraspinatus fossa of the scapula while the muscle was in an overstretched position. No tension was applied to the tape. For deltoid application, Y-shaped tape was used by placing the anchor acromion process. The front tail was implemented in the extended arm position, while the back tail was implemented in the horizontal abducted arm position. Both tails ended below the deltoid tubercule of the humerus. No tension was applied during application.; All participants received rehabilitation including Bobath neurophysiological approach. Bobath approach and other exercise programs were implemented early after the onset of the stroke to prevent immobility and soft tissue contracture and to alter the muscle tone to gain mobility. Through the exercise program and use of weight-bearing techniques, the therapist attempted to maintain and improve trunk and shoulder alignment to allow the functional use of the upper extremity.
Other intervention name(s): Neuromuscular electric stimulation; Taping; Physiotherapy and Rehabilitation
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Taping, stroke; rehabilitation; shoulder pain; electrical stimulation