None listed
Conditions
Brief summary
Loss of motor function and shoulder pain are known outcomes of stroke that affect patients’ well being and independence. Physiotherapy routinely uses a variety of approaches to address these issues, including facilitating improved motor activation and better shoulder alignment. Using rigid strapping tape has been shown to have some benefits as an adjunct to treatment however, more recently kinesiology tape which is more flexible has become readily available. This has been used on many patient and athletic groups, but has only been used once in a group with stroke, and this was not at the shoulder. This study aims to determine if kinesiology tape is useful as part of a treatment approach to managing the affected shoulder in acute stroke. Participants will be recruited from admissions to ward G51 at Sir Charles Gairdner Hospital over a period of 4 months. The study will be a single blinded, randomised controlled trial with the control group receiving placebo taping and the intervention group will receive therapeutic taping. Pain, shoulder position, muscle stiffness and range of movement will be recorded every 3 days during the trial to determine how these factors change over time. Measures of motor impairment in the arm will be taken on admission and discharge (or at 14 days, whichever comes first). It is expected that there will be no adverse effects of the taping. It is anticipated there may be some benefit in using the kinesiology tape for shoulder pain and motor activation, however this problem is multifactorial and the effect size is expected to be low. This study is a pilot study to test the protocol and determine effect size with a view to a more extensive study in the future.
Interventions
For the intervention group, kinesiology tape will be applied to the affected shoulder of the participant as clinically required, depending on their presentation which will be assessed by the senior physiotherapist through observation. They will assess for the following features: inferior subluxation, anterior subluxation, internal rotation posturing and scapula elevation with excessive upper trapezius activity at rest. Each of the first three features if found to be present will be separately ad
For the intervention group, kinesiology tape will be applied to the affected shoulder of the participant as clinically required, depending on their presentation which will be assessed by the senior physiotherapist through observation. They will assess for the following features: inferior subluxation, anterior subluxation, internal rotation posturing and scapula elevation with excessive upper trapezius activity at rest. Each of the first three features if found to be present will be separately addressed with a single piece of kinesiology tape, using a vertical, horizontal or rotational technique to cross the shoulder joint. Upper trapezius activity will be addressed with a single piece of tape in an antero-posterior direction across the muscle belly. The tape will be worn by the participant continuously and will be changed by the senior physiotherapist every three days unless the participant withdraws from the study, or there are signs of skin irritation. Taping will continue for 14 days or until discharge from the ward. With each new application, the participant’s skin integrity will be assessed to determine the appropriateness of continuing. Patients will be monitored for 24 hours by nursing staff and daily by the senior physiotherapist, and among other things, this will monitor the progress of the intervention.
Sponsors
Physiotherapy Department, Sir Charles Gairdner Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants will be patients who are newly admitted under neurology with a diagnosis of stroke. The patients will have an upper limb motor impairment as a result of the stroke and on the Chedoke- McMaster Stroke Assessment will be at stage five or less of motor recovery. The patient must also be able to consent to participation in the study.
Exclusion criteria
Participants will be excluded if they have a known tape allergy, have a previous history of stroke and if they have a pre-existing diagnosis of shoulder pathology on the same side as the upper limb impairment that resulted from the stroke. They will also be excluded if they are receiving palliative care or if they are minors under 18 years of age.
Outcome results
None listed