Kinesio Taping On Gluteal Muscles: Does It Affect Balance, Functionality, And Participation In Children With Unilateral Spastic Cerebral Palsy?
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Timed Up and Go test (TUG)
研究概览
简要总结
BACKGROUND: Walking and balance problems are among the most common problems in individuals with cerebral palsy (CP). Hip abduction and extension muscle function insufficiencies are common in children with CP.
OBJECTIVE: The aim of this study was to investigate the immediate and long-term effects of Kinesio® Taping (KT) applied on the gluteus maximus and gluteus medius muscles on walking, functionality, balance, and participation in children with unilateral spastic CP.
METHOD: This study was designed as a randomized controlled trial. The study included 20 children with unilateral spastic CP: 11 in the taping group and 9 in the control group. KT was applied in the taping group for 4 weeks in addition to a physiotherapy program. The control group received only the physiotherapy program. Body structure and functions were evaluated with the Pediatric Berg Balance Scale (PBBS). Activity was evaluated with the Timed Up and Go Test (TUG), Functional Mobility Scale (FMS), Gross Motor Function Scale (GMFM-88), the BTS G-Walk Spatiotemporal Gait Analysis System. Participation was evaluated with the Canadian Occupational Performance Measure (COPM). Evaluations were made at the beginning of the study and 30 minutes after the first tape application, and at the end of 4 weeks in the taping group. The level of significance was accepted as p<0.05.
详细描述
INTRODUCTION Walking and balance problems are frequently seen in individuals with cerebral palsy (CP). In individuals with CP, co-contraction of the distal and proximal muscles increase and muscle activation patterns are not fluent. Spasticity causes a decrease in muscle strength and length and a reduction in muscular coordination. Secondary to all this, decreases are seen in the energy production of the muscles.
Insufficiencies in hip abduction and extension muscle function are common in CP. Excessive muscles tonus in the hip adductors and flexors and a loss of reciprocal inhibition cause a weakness in the gluteus medius and maximus. This weakness negatively affects the movement patterns of the lumbar spine, pelvis, and hip region, and also causes incorrect loadings in hip joint and abnormalities in hip biomechanics. Gait anomalies occur and pelvis stabilization is impaired. In particular, negative impacts on participation are a concern. With the physiotherapy and rehabilitation approaches, these negative effects may be minimized by facilitating the gluteal muscles. Gait training and exercises to strengthen the gluteal muscles are routinely used in the rehabilitation of CP. With these approaches, it is aimed to maximize the gait function and promote independence and participation.
The somatosensory system may be affected in unilateral spastic CP. These children often suffer sensory impairments that could affect the development of future motor skills. Kinesio Taping® (KT) is used for pediatric rehabilitation to reduce pain, facilitate or inhibit muscle activity, prevent injuries, reposition joints, aid the lymphatic system, support postural alignment, and improve proprioception.
Yasukawa et al. stated that the use of KT for children with CP might influence the cutaneous receptors of the sensory motor system, resulting in an improvement in voluntary control and coordination via a physiotherapy program. Therefore, facilitating the gluteal muscles by KT may affect walking and balance positively.
In the literature, the clinical use of KT techniques in children with CP is generally at the upper extremity. In studies in which KT is applied to the lower extremity, it is generally applied to the distal part of extremity. In addition, most of the studies have investigated the immediate effect. There are few studies investigating the effects of KT applied to the gluteus medius and gluteus maximus muscles, which are located in the proximal hip with important contributions in stabilization.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 6 Years 至 12 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •having unilateral spastic CP
- •being in an age between 6 years and 12 years;
- •being classified in levels I or II of the Gross Motor Function Classification System (GMFCS); -having spasticity at lower extremity 2 or less according to Modified Ashworth Scale
- •being able to follow and accept verbal instructions.
排除标准
- •having any orthopedic surgery or botulinum toxin injection in the past 6 months
- •having allergic reactions to the adhesive compound of Kinesio Taping
研究组 & 干预措施
Control Group
Every group received routine traditional physiotherapy twice a week over the period of 4 weeks. This routine traditional treatment consisted of stretching, weight bearing, functional reaching, walking, and electrotherapy.
Kinesio Taping
Every group received routine traditional physiotherapy twice a week over the period of 4 weeks. This routine traditional treatment consisted of stretching, weight bearing, functional reaching, walking, and electrotherapy. Sessions were 40 minutes. The children in the taping group were taped 6 days per week for 4 weeks. The children were checked for allergies before applying the tape. A 5-cm tape was applied and kept in position for 3 days, and the region was then left to rest for 24 hours.
干预措施: Kİnesio Taping (Other)
结局指标
主要结局
Timed Up and Go test (TUG)
时间窗: baseline, 30 minutes after the first tape was applied, and at the end of the 4th week
The TUG measures various components such as walking speed, postural control, functional mobility, and balance. Change in functionality was assessed between baseline, 30 minutes after the first taping, and at the fourth week.
BTS G-Walk Spatiotemporal Gait Analysis System
时间窗: baseline, 30 minutes after the first tape was applied, and at the end of the 4th week
Gait parameters were assessed using the BTS G-Walk Spatiotemporal Gait Analysis System. In this system, the analysis results of the sensor attached to the L5-S1 level of the patient was transferred to a computer via Bluetooth. This system allows gait analysis by comparing the left and right extremities with normal values, and it also enables a 3-dimensional kinematic analysis of the pelvis (11). The track length was preset as 10 meters. The children with CP were asked to walk the 10-meter track three times. Three measurements were averaged in the analysis. Change in gait parameters was assessed between baseline, 30 minutes after first taping and at the fourth week.
Pediatric Berg Balance Scale (PBBS)
时间窗: baseline and after 4 weeks
Balance was evaluated with the Pediatric Berg Balance Scale (PBBS).On this scale minimum score is 0 and maximum score is 56. As the score increases, the balance improves. Between baseline and fourth week the balance change was assessed.
Functional Mobility Scale (FMS)
时间窗: baseline and after 4 weeks
The walking ability of the participants was evaluated with the Functional Mobility Scale at 3 different distances (5 meters-indoor, 50 meters-school, 500 meters-community). Inter-observer reliability of the FMS, which can reveal changes that cannot be detected with the GMFCS, was also demonstrated.On this scale the minimum score is 1, and the maximum score is six. The higher the score, the better the functional status.Change in functionality was assessed between baseline and at the fourth week.
Gross Motor Function Measurement (GMFM)
时间窗: baseline and after 4 weeks
Gross motor function was assessed using dimensions D and E of the Gross Motor Function Measurement (GMFM), which consists of standing, walking, running, and jumping. The GMFM is a valid, reliable, and sensitive method, which demonstrates the change in motor functions in children with CP and other disabilities via videotape recordings. Minimum score is 0 and maximum score is 74. The higher the score, the better the functional status. Between baseline and fourth week the motor performance change was assessed.
Canadian Occupational Performance Measure (COPM)
时间窗: baseline and after 4 weeks
Participation was assessed using the Canadian Occupational Performance Measure (COPM). The COPM is a client-centered outcome measure to identify and prioritize everyday issues that restrict individuals' participation in everyday life.There is no minimum maximum score on this scale. The pre- and post-treatment scores of the person are compared. Between baseline and fourth week the participation change was assessed.
次要结局
未报告次要终点
研究者
Seda Nur Kemer
Physiotherapist, Master of Science, Lecturer, Principal İnvestigator
Ondokuz Mayıs University