Kinesiotaping the post-stroke shoulder
It is estimated that 17-72% of patients who suffer a stroke will have difficulties with their shoulder movements. Pain and associated difficultly with active range of motion are common issues faced by physiotherapists working with stroke patients.
Muscle weakness is often named as the main cause of shoulder dysfunction following stroke, and without proper activation of the muscles, the tendons and soft tissue may be prone to stretch and shoulder dislocation.
The aim of this study was to investigate whether the additional use of kinesiotape in physiotherapy treatment supported the muscle activation and improved shoulder pain following stroke.
A double-blinded and placebo-controlled clinical trial with 19 participants was conducted. The participants were >30 years of age, had suffered a stroke between 1 and 6 months prior to the study, and had been diagnosed with having hemiplegic shoulder pain for over 1 month.
All participants received treatment once a day for 5 consecutive days and over the course of 4 weeks. The treatment group received electrical therapy, taping and exercise therapy. The purpose of taping was to support neuromuscular function and (according to the authors) to help mechanically support the shoulder.
Exercises consisted of passive and active assisted exercises. Active range of motion exercises were kept to less than 90 degrees of flexion and abduction to avoid impingement of the shoulder. Shoulder exercises were given for 20 minutes, and an additional 40 minutes of exercise for the trunk and lower limbs was provided.
This study found a clinically relevant change in pain intensity and subluxation on the first day of treatment in the taping group. No significant changes were present in the control group. On the first day, no significant differences between groups were present in active range of motion.
After 4 weeks, the taping group showed significant improvements in pain, subluxation, as well as active range of motion towards abduction and flexion as compared to the control group. Therefore, the authors of this article conclude that the kinesiotaping is a successful modality to assist in stroke recovery.
Expert opinion by Jessica Povall
This article highlights the importance of addressing pain as well as function for post-stroke clients with shoulder dysfunction.
While the authors of this article state that taping was used partially as a mechanical restraint, kinesiotaping is not designed to provide this kind of support.
However, the tactile feedback that kinesiotaping provides could be an added method of biomechanical feedback, causing the participants to be more aware of muscle activation. This may be a mechanism supporting muscle rehabilitation and activation in the long run over several weeks and months.
> From: Yang et al., J Healthc Eng 2018 (2018) (Epub ahead of print). All rights reserved to The Author(s). Click here for the online summary.