None listed
Conditions
Brief summary
People in hospital with broken ribs can experience a lot of chest pain which makes it hard to take a deep breath, cough and move around. The treatment of broken ribs includes various types of pain relief and physiotherapy to improve breathing ability and help you get up and moving. However, people with broken ribs may still have pain despite this treatment. We are doing a study to see if kinesiotaping is helpful for people with broken ribs. Kinesiotape is an elastic, adhesive, cotton-based tape that is applied to the skin. Its elastic properties mean it can be stretched over the involved area to support the tissues underneath. Kinesiotape is most often used for sporting injuries (e.g. knee, shoulder), but little research has been done about its effectiveness for people with broken ribs. While our usual practice at the Royal Adelaide Hospital has been to not use any type of taping after broken ribs, we are interested in doing a study to look at the effectiveness of kinesiotaping for people with broken ribs. This is an introductory study and if we find that kinesiotaping is beneficial and has no side effects we may consider doing a larger study in the future. The Royal Adelaide Hospital admits approximately 100 patients per year with rib fractures. Given our relative inexperience with kinesiotaping and the heterogeneity of this patient group we do not believe a randomised controlled trial would be a practicable study design in the first instance. Instead, this introductory study will comprise a series of 5 single-subject studies using an ABAB design. Depending on the ease of recruitment, sensitivity of the outcome measures and the results, a randomised controlled trial may be considered in the future. Two of the investigators will screen all in-patients admitted with rib fractures regarding their eligibility to participate. This screening is already part of physiotherapy routine clinical practice. For pragmatic reasons concerning the availability of the investigators and ability to follow-up with taping interventions and outcome measurements over the 4-day study period, patients will only be recruited on Mondays and Tuesdays. Any decision to exclude an otherwise eligible person will be reviewed by one of the other study investigators to minimise the potential for selection bias. When a potential participant is identified, one of the investigators will approach the person regarding participation from 0800 on that day. A written information form that explains the aims and format of the study will be supplied. Informed consent will be obtained from those willing to participate. If the patient agrees to participate, the study period will commence later that same morning. Apart from the application of taping, no other aspect of medical, nursing or allied health management will be changed.
Interventions
Kinesiotape is an elastic, adhesive, cotton-based tape. Apart from the application of taping, no other aspect of medical, nursing or allied health management will be changed. The study protocol comprises an ABAB design, where A = baseline (i.e. no taping) and B = intervention (i.e. kinesiotaping). Each phase will last 24 hours, resulting in a study duration for each participant of 4 days. During B phases, kinesiotape will be applied by one of the study investigators in the interval between 0800 and 1000 hours and removed 24 hours later. The location of the rib fracture(s) will be confirmed by review of the chest xray and/or computed tomography. The application of the kinesiotaping (50-100mm width) will be similar to that described by Sareen et al and as recommended by physiotherapy colleagues in The Netherlands. A length of tape will be applied initially over the fractured area, with ~ 50% tension, and then the tape will be extended anteriorly and posteriorly along the margins of the involved ribs (0% tension), with repeated lengths of tape as required to support the fractured ribs. Due to the ABAB design of the study, adherence to the intervention will be monitored daily by one of the investigators.
Sponsors
Study design
Eligibility
Inclusion criteria
Admitted to the Royal Adelaide Hospital with acute (< 48 hours) rib fracture(s) and aged at least 18 years.
Exclusion criteria
Refuse consent; intubated and mechanically ventilated; non-invasive mechanical ventilation; other major medical conditions or injuries that could affect the biomechanics of the rib cage and/or application of the kinesiotape; previous skin condition in the affected area; previous history of allergy to tape; pregnancy; inability to communicate effectively and easily in English..