Kinesio Taping Along With Functional Activation Pattern in Stroke Patients
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      In stroke; gait deviation occurs usually due to weakness in the tibialis anterior and over
      activation/spasticity of planter flexors. The lack of ability to dorsiflex properly
      contributes to foot drop that leads to the issue in proper foot clearance. This results in
      decreased walking speed, decreased stance and asymmetrical step length. If these issues will
      be addressed through application of kinesio tape and functional activation pattern throughout
      the gait cycle; this may improve lower limb kinematics in terms of gait parameters and
      dynamic balance. Therefore, current study gives us insight to gain the combined effects of KT
      and functional activation patterns in chronic stroke patients.
    

Detailed description: 
      Stroke is a cerebrovascular disease caused by ischemia or hemorrhage of the brain tissues.
      Chronic stroke patients usually present compensatory movement of the hip, knee and ankle
      instead of having normal movement. Stroke survivors face difficulty in clearing off the
      ground. This abnormality results from weakness of ankle dorsiflexors or excessive activity of
      plantar flexors. Ineffective ankle dorsiflexion may result in an abnormal gait pattern. The
      focus of stroke rehabilitation is largely on the recovery of impaired movements and functions
      as it often leads to balance impairment, impaired postural control, mobility and gait
      abnormalities. Various approaches have been used to improve these long-term disabilities. Two
      out of those are taping and functional activation. Taping is used to improve motor control,
      postural stability and joint alignment adjustment. This happens through facilitation of ankle
      dorsiflexors, whereas functional activation improves gait and balance.In chronic movement
      disability, deficits of foot and ankle proprioception are most highly associated with falls.
      The disturbance in motor function can cause muscle weakness, spasticity, and a decrease in
      the ability to maintain balance, as well as abnormal gait patterns. There are different
      imaging modalities (magnetic resonance imaging or computed tomography) used for the confirm
      diagnosis of stroke.

      In a recent study, application of Kinesio tape has been reported to improve balance ability
      and gait performance. It restricts the excessive movements on the joints. It also acts as a
      facilitator helping the weak muscle to perform movement. In our study, we will apply Kinesio
      tape to the Tibialis Anterior Muscle (Prime dorsiflexor) and to the gastrocnemius. KT is a
      thin, air permeable, water resistant and elastic adhesive tape which can be stretched to up
      to 120-140% of its resting length. The protective effect provided by KT is purportedly
      related to its ability to improve proprioception by stimulating mechanoreceptors located in
      muscle, tendon, joint capsule or skin.Therefore, strengthening of muscle and improvement of
      range of motion of the ankle are also required to improve balance and gait ability.

      Activation of the tibialis anterior muscle in particular enables enough dorsiflexion to
      prevent the toes from dragging on the ground during the swinging phase. According to recent
      studies, the application of Kinesio tape can reduce the hyperactivity of the gastrocnemius
      and increase the activity of the tibialis anterior (TA) in the correction of foot drop (such
      as neutralizing the foot), and aid in the correction of equinus deformity, with a more
      positive effect on joint angle and walking ability in stroke patients with foot drop.
      Applying a Kinesio tape to the lower extremity during post-stroke rehabilitation is reported
      to relieve lower-extremity spasticity, improving lower-extremity motor function, improving
      balance, and enhance ambulation and gait parameters in patients.

      This will be a randomized controlled trial and will recruit patients through convenience
      sampling. Diagnosed patients of Stroke will be confirmed for inclusion through Computed
      Tomography or Magnetic Resonance Imaging. The patients will be divided into 2 groups. Group 1
      will receive conventional treatment and Group 2 will receive taping and functional activation
      along with Conventional Treatment. This treatment will be given for 30-40 mins for 3 days a
      week for 4 continuous weeks. The outcome measures will be 6 Min walk test (test- retest
      reliability for those require an assistive device to walk (ICC = 0.914, TUG (timed up and go)
      for mobility, Berg Balance Scale (for balance and fall risks), OGA (Observational Gait
      Analysis) for gait parameters (cadence, gait velocity, step length) before and after the
      interventions. The data will be analyzed using SPPS software version 25.
    

Intervention name(s): Functional activation with kinesio tapping; Conventional physical therapy
Intervention type(s): Other; Other
Intervention description(s): These exercises will be carried out thrice a week for 4 weeks. The exercises will be performed for approximately 35-45 minutes, 1 to 2 times a day, in sitting or standing position; strengthening and stretching, combined with Ankle ranges and Hip strengthening. (6) The exercises performed will be Calf stretches, Heel and Toe raises, Hip marching in sitting/standing; 4 days a week for 4 weeks
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: tape, gait, balance, stroke