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Clinical References
Following are clinical references from the medical literature that address, explore or validate the biomechanical and kinesiological principles upon which TheraTogs are based. They are listed according to these topic groups:
General Support from the Sciences
Trunk / Shoulder/ UE / Elasticized Garments and Joint Supports
Hip and Lower Extremities
Ataxia
Sensory Integration
Ankle Dorsiflexion
General Support from the Sciences (Top)
Neuromotor Reeducation • Purposeful Practice • Repetition • Kinesiology
- Abel MF, Damiano DL, Blanco JS, et al. 2003. Relationships among musculoskeletal impairments and functional health status in ambulatory cerebral palsy. J Pediatr Orthop. 23(4): 535-541.
[129 ambulatory children and adolescents participated in a prospective evaluation that consisted of LE passive motion and spasticity examination, 3-D gait temporal-spatial and kinematic analysis, and acquisition of GMFM and PODCI data.
Conclusion: caution should be exercised when anticipating functional change through the treatment of isolated impairment and that addressing multiple impairments may be needed to produce appreciable effects.]
- Adolph KE http://www.psych.nyu.edu/adolph/students.shtml
- Adolph KE, Vereijken B, Shrout PE. 2003. What changes in infant walking and why. Child Dev. 74(2):475-97.
- Adolph KE. 1997. Learning in the development of infant locomotion. Monogr Soc Res Child Dev. 62(3):I-VI, 1- 158.
- Arnheim DD. (1989) Taping and bandaging. In: Modern Principles of Athletic Training, 314-343.. St. Louis, MO, Los Altos, CA, Toronto, and Boston, MA: Times/Mirror/Mosby College Publishing. [Author uses the old white tape and several layers over joints. Good ideas re taping hip and hand/thumb.]
- Austin K, Gwynn-Brett K, Marshall S. (1994) Illustrated Guide To Taping Techniques. (ISBN 0 7234 1635 4)
London: Wolfe c/o Mosby - Year Book Europe Ltd., Lynton House 7-12 Tavistock Sq., London, WCIH 9LB.
- Bedotto RA. 2006. Biomechanical assessment and treatment in lower extremity prosthetics and orthotics: a clinical perspective. Phys Med Rehabil Clin N Am. 17(1): 203-243.
[Abstract: Biomechanical treatment is like a jigsaw puzzle with two complex counterparts having many pieces. The physical and mechanical components are equally important and cannot be separated from each other. The patient with a prosthesis or an orthosis represents a biomechanical system; total treatment is essential. All of the pieces to the puzzle must be used to complete the picture. Given the present structure of the educational system, there is a separation of disciplines necessary to provide one truly biomechanical treatment. Physical therapists are educated in the bio aspect of treatment, whereas prosthetists/orthotists are educated in the mechanical aspect. Biomechanical treatment requires the direct interaction and integration of the two disciplines. Physical therapists and prosthetists/orthotists need each other. One without the other can provide only half of the treatment necessary for optimal outcomes. The patient needs both.
Physical therapists need to become more familiar with mechanical treatment and learn how to integrate this into their physical treatment program. Prosthetists/orthotists must become more familiar with the importance of physical treatment and the internal corrective forces necessary for efficient ambulation. The traditional label of orthotics and prosthetics and related technology as products must be replaced with biomechanical treatment that includes orthotics and prosthetics services.
Professionals working with each other is a positive step, but they need to be working together as a team toward a common goal. They need to be in the same place at the same time and work together consistently to provide total treatment. This is more than a multidisciplinary approach. It is one treatment. In this way, each benefits the other as they teach and learn simultaneously. At present, this teaching and learning can be done only on an individual basis. It is the author's hope that experienced prosthetists/orthotists and physical therapists reading this article will see the need to combine their efforts to provide truly biomechanical treatment. By working together, they can expand their present knowledge and skills.
In this way, treatment and outcomes can improve and serve as the guiding force for a new generation of rehabilitation specialists. This process can be expedited through the educational system by offering advanced clinical degrees specializing in biomechanical treatment specifically designed for clinical practice rather than research, administrative, or academic positions. For this idea to become reality, educational institutions representing the physical and mechanical aspects of biomechanical treatment also must work together; this would expedite the learning curve so that it would not take so long to put the pieces of the puzzle together.]
- Beynnon BD, Renstrom PA. (1991) The effect of bracing and taping in sports. Annals Chir. Gynaecol. 80(2): 230-238.
- Birrer RB, Poole B. (1994) Taping of sports injuries: Review of a basic skill. J Musculoskeletal Med. 11(6): 56.
- Edin BB, Vallbo AB. 1988. Stretch sensitization of human muscle spindles. J Physiol. 400: 101-111. [67
Afferents from the finger extensor muscles were consecutively recorded by microneurography. The units were classified as primary (I) or secondary (II) muscle spindle afferents or Golgi tendon organ (GTO) afferents on the basis of their responses to ramp-and-hold stretches, sinusoidals superimposed on ramp-and-hold stretches, maximal twitch contractions and isometric contractions and relaxations. The muscle was repeatedlystretched and then either kept short or long for a few seconds followed by a slow ramp stretch. The responses of the muscle afferents to the slow stretch were compared under the two conditions. 30 of 38 I spindle afferents, 4 of 11 of the II afferents, and none of the 18 GTOs showed an enhanced response to the slow ramp when the muscle had been kept short compared to the response when the muscle had been kept long.
Conclusion: Stretch sensitization does occur in human muscle spindles and, when present, constitutes firm evidence of the afferent originating from a muscle spindle rather than a GTO.
- Fisher B. 1987. Effect of trunk control and alignment on limb function. J Head Trauma Rehabil. 2(2): 72.
- Ge W, Long CR, Pickar JG. 2005. Vertebral position alters paraspinal muscle spindle responsiveness in the feline spine: effect of positioning duration. J Physiol. 569(Pt 2): 655-665.
[Proprioceptive information from paraspinal tissues including muscle contributes to neuromuscular control of the vertebral column. We investigated whether the history of a vertebra's position can affect signalling from paraspinal muscle spindles.
Single unit recordings were obtained from muscle spindle afferents in the L6 dorsal roots of 30 anaesthetized cats. The L6 vertebra was controlled using a displacement-controlled feedback motor and was held in each of three different conditioning positions for durations of 0, 2, 4, 6 and 8 s. Conditioning positions (1.0-2.2 mm dorsal and ventral relative to an intermediate position) were based upon the displacement that loaded the L6 vertebra to 50-60% of the cat's body weight. Following conditioning positions that stretched (hold-long) and shortened (hold-short) the spindle, the vertebra was repositioned identically and muscle spindle discharge at rest and to movement was compared with conditioning at the intermediate position. Hold-short conditioning augmented mean resting spindle discharge; however, the duration of hold-short did not significantly affect this increase. The increase was maintained at the beginning of vertebral movement but quickly returned to
baseline. Conversely, hold-long conditioning significantly diminished mean resting spindle discharge. The relationship between conditioning duration and the diminished resting discharge could be described by a quadratic revealing that the effects of positioning history were fully developed within 2 s of conditioning. In addition, 2 s or greater of hold-long conditioning significantly diminished spindle discharge to vertebral movement. These effects of vertebral positioning history may be a mechanism whereby spinal biomechanics interacts with the spine's proprioceptive system to produce acute effects on neuromuscular control of the vertebral column.
- Howle, JM (2002) Neuro-Developmental Treatment Approach: Theoretical Foundations and Principles of Clinical
Practice. www.ndta.org.
- Kaze K., Hashimoto T. (1996) Kinesio taping perfect manual: amazing taping therapy to eliminate pain and muscle disorders. Kinesio Taping Association (Available through Progressive GaitWays, LLC.)
- Kaze K. Illustrated Kinesio taping. Kinesio Taping Association. (Available at Medco Sports Medicine: www.medco-athletics.com - 800-556-3326.)
- Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA. 2005. Muscles: Testing and Function with Posture and Pain, 5th edition. Baltimore MD: Williams and Wilkins.
- Ketelaar M, Vermeer A, Hart H, van Petegem-van Beek E, Helders PJ. 2001. Effects of a functional therapy program on motor abilities of children with cerebral palsy. Phys Ther. 81(9): 1534-45.
- Kolban M. (1999)
[Variability of the femoral head and neck antetorsion angle in ultrasonographic measurements of healthy children and in selected diseases with hip disorders treated surgically] Ann Acad Med Stetin. Suppl 51: 1-99. [Article in Polish]
[Abstract: An increase in antetorsion was observed in 56 joints (77%) in a group of38 children with spastic CP subjected to surgery. Mean angle of antetorsion was 37o (SD +/- 11). The angle returned to its preoperative values within 2-3 years from surgery. In the group of 25 children with Perthes disease, increased antetorsion was found in 11 (44%) joints subjected to surgery and in 8 (32%) normal joints. The angle changed during the observation period, confirming the opinion that the increase is a secondary event in this disease. The angle was much greater than normal for age in the group of 21 children with congenital hip dysplasia. Basing on the results of surgery it is concluded that corrective osteotomy of femoral proximal end in cases of increased antetorsion and valgity of femoral neck is not a sufficient procedure to prevent the angle from reverting to pre-operative values and should be supplemented by osteotomy of the pelvis.
Furthermore, ultrasonography has emerged as the best method currently available for measurement of femoral head and neck antetorsion. The correlation coefficient for USG vs. direct (intraoperative) measurement was 0.9 in all groups, reaching 0.93 in the spastic CP group, in which contractures and limited mobility are responsible for very low coefficients in the case of other methods.
The use of USG for assessment of femoral antetorsion has revealed, particularly afterlonger observation periods, that the angle in the apparently normal contralateral extremity exceeded values normal for age.]
- Maruyama Y. (1995) Reusable taping system. National Technical Report 41(3): 25.
- Meuller® Basic principles of athletic taping. (Available at Medco Sports Medicine: www.medco-athletics.com - 800-556-3326.)
- Patel N, Smith CE, Pinchak AC, Hancock DE. (1994) The influence of tape type and of skin preparation on the force required to dislodge angiocatheters. Can J Anesthesiol. 41(8): 73741 (August)
- Poole JL. 1991. Application of motor learning principles in occupational therapy. Am J Occup Ther. 45(6): 531- 537. Review
- Pincivero DM, Bachmeier B, Coelho AJ. (2001) The effects of joint angle and reliability on knee proprioception. Med Sci Sports Exerc 33(10):1708-1712.
The detection of passive knee movement, and the subsequent voluntary response, may be dependent on joint angle. Authors suggest a PPC assessment method that should enhance test-retest reliability.
- Sahrmann SA. (2002) Diagnosis and treatment of movement impairment syndromes. St. Louis, MO: Mosby.
[NOTE: Billi Cusick says this is an essential resource. Tough reading at times, but certainly worth it.]
-Sanders JE, Goldstein BS, Leotta DF. (1995) Skin breakdown in response to mechanical stress: adaptation rather than breakdown - a review of the literature. J Rehabil Res Dev. 32(3): 214-226.
[Note: Billi Cusick says this is a good review of skin tissue adaptability and physiology under loads. Applies to orthotic (compression and shear) more than taping (tensile loading) interventions. Excellent list of references.]
- Manual of Athletic Taping. Published by the Sports Medical Council of British Columbia. (Available at Medco Sports Medicine: www.medco-athletics.com - 800-556-3326.)
- Thomas SS, Moore C, Kelp-Lelane C, Norris C (1996) Simulated gait patterns: the resulting effects on gait parameters, dynamic electromyography, joint moments, and physiological cost index. Gait Posture 4: 100-107.
[Abstract: Authors altered gait function and all other variables by taping the ankle into equinus and setting the knee in flexion on nondisabled subjects. EMG patterns were similar to those reported for children with CP.]
- Thornton JL, Webster JA. (1996) The “tape cast” functional taping for the injured athlete. J Athletic Training 31(2): 179.
- van der Heide JC, Hadders-Algra M. 2005. Postural muscle dyscoordination in children with cerebral palsy. Neural Plast. 12(2-3): 197-203; discussion 263-72.
[Abstract: Until now, 3 children with CP functioning at GMFCS level V have been documented. The children totally or partially lacked direction specificity in their postural adjustments and could not sit independently for >3 seconds. Some children functioning at GMFCS level IV have intact direction-specific adjustments, whereas others have problems in generating consistently direction-specific adjustments. Children at GMFCS levels I to III have an intact basic level of control but have difficulties in fine-tuning the degree of postural muscle contraction to the task-specific conditions, a dysfunction more prominently present in children with bilateral spastic CP than in children with spastic hemiplegia. The problems in the adaptation of the degree of muscle contraction might be the reason that children with CP, more often than typically developing children, show an excess of antagonistic coactivation during difficult balancing tasks and a preference for cranial-caudal recruitment during reaching.]
- Woollacott MH, Shumway-Cook A. 2005. Postural dysfunction during standing and walking in children with cerebral palsy: what are the underlying problems and what new therapies might improve balance?
Neural Plast. 12(2-3): 211-219; discussion 263-72. Review.
[Abstract: The efficiency of balance recovery can be improved in children with CP, indicated by both a reduction in the total center of pressure path used during balance recovery and in the time to restabilize balance after training. Changes in muscle response characteristics contributing to improved recovery include reductions in time of contraction onset, improved muscle response organization, and reduced co-contraction of agonists/antagonists. Clinical implications include the suggestion that improvement in the ability to recover balance is possible in school age children with CP.]
- Woods E. (1998) Jenny McConnell: The woman behind the technique. PT Magazine - April issue: 32-39.
- Winstein CJ, Rose DK, Tan SM, et al. (2004) A randomized controlled comparison of upper-extremity rehabilitation strategies in acute stroke: A pilot study of immediate and long-term outcomes. Arch Phys Med Rehabil. 85(4): 620-8.
- Wright K, Whitehill W. Cramer® Comprehensive manual of taping and wrapping techniques, 2nd edition. (Available at Medco Sports Medicine, www.medco-athletics.com / 800-556-3326.)
Trunk / Shoulder/ UE / Elasticized Garments and Joint Supports (Top)
- Aubin CE, Labelle H, Ruszkowski A, et al. 1999. Variability of strap tension in brace treatment for adolescent idiopathic scoliosis. Spine. 24(4): 349-354.
[Abstract: A mechanical evaluation of brace strap tensions to document their variability in different patient positions and to assess their biomechanical effectiveness.
OBJECTIVES: To measure the strap tensions at which adolescents with scoliosis are wearing their braces and to determine the variations in strap tension in different patient positions.
SUMMARY OF BACKGROUND DATA:
The biomechanical action of thoracolumbosacral orthoses is still not well understood, and there is no standardized strap tension at which the brace should be fastened to obtain optimal results. METHODS: This study was conducted in 34 adolescents with idiopathic scoliosis wearing thoracolumbosacral orthoses. Brace straps were instrumented with load cells and tightened at four tensions (the ones prescribed by their treating physician and three standardized values: 20, 40, and 60 N). In each case, the tension was recorded while the patients assumed nine positions corresponding to normal daily tasks. The variability of strap tension was evaluated by comparing the changes from the original standing position. RESULTS: The prescribed tensions measured in thoracic and pelvic straps were markedly variable. The greatest changes in tension occurred when the patients were lying down. Relaxation of strap tension was found when the patients returned to the standing position after having completed the tasks. CONCLUSIONS: If strap tension affects the biomechanical actions of the brace, these results indicate that regular brace strap tension adjustments are needed and raise
questions about the efficacy of nighttime bracing to correct spinal deformities.
- Beynnon BD, Good L, Risberg MA. (2002) The effect of bracing on proprioception of knees with anterior cruciate ligament injury . J Orthop Sports Phys Ther 32(1):11-15.
[Abstract: After ACL injury, application of an elastic bandage or neoprene sleeve improved joint position sense and showed no effect on recovery of position sense after 2 years of wear.]
- Birmingham TB, Kramer JF, Inglis JT, et al. (1998) Effect of a neoprene sleeve on knee joint position sense during sitting open kinetic chain and supine closed kinetic chain tests. Am J Sports Med 26(4): 562-566.
[“Although the sleeve effects were small… 72% of subjects felt the sleeve improved their overall test performance.”]
- Birrer RB, Poole B. (1996) Athletic taping, part 4: the shoulder and elbow . J Musculoskel Med 13(1): 52.
- Blair, E., J. Ballantyne, S. Horsman, P. Chauvel (1995) A study of a dynamic proximal stability splint in the management of children with cerebral palsy. Dev Med Child Neurol 37:544-554.
[The Upsuit is a custom-made, Lycra trunk suit. Significant effect on postural stability and UE movement, and carry-over noted. Advocated particularly for athetoid and dystonic subjects. Limit wear to 6 hours/day to avoid dependence on it.]
- Bower E, McLellan DL. 1992. Effect of increased exposure to physiotherapy on skill acquisition of children with cerebral palsy. Dev Med Child Neurol. 1992 Jan;34(1):25-39.
- Bravard S, Diehl D, Hogan A, Moeding J, Wallace M. (1997) The effectiveness of inhibitory taping of the upper trapezius muscle during a functional reach as determined by electromyography . Phys Ther 77(5): s-29.
[Abstract: Authors found reduced EMG output for both shoulder shrug and shoulder forward flexion in all 37 PT student subjects.]
- Cholewicki J, Juluru K, Radebold A, Panjabi MM, McGill SM. 1999. Lumbar spine stability can be augmented with an abdominal belt and/or increased intra-abdominal pressure. Eur Spine J. 1999;8(5):388-95.
- Deivert RG. (1994) Functional thumb taping procedure. J Athletic Training 29(4):357.
- Diamond W. (1995) Upper extremity: shoulder. In Myers, R.S.: Saunders Manual of Physical Therapy Practice, 789-839. Philadelphia, PA: W.B. Saunders Co.
[Shows taping for shoulder dislocation, p. 823.]
- Gericke T. Postural management for children with cerebral palsy: consensus statement. Dev Med Child Neurol. 2006 Apr;48(4):244. A Mac Keith Multidisciplinary Meeting formulated the following consensus statement concerning postural management for children with cerebral palsy (CP) based on evidence from clinical experience and scientific literature: Definition: A postural management programme is a planned approach encompassing all activities and interventions which impact on an individual's posture and function. Programmes are tailored specifically for each child and may include special seating, night-time support, standing supports, active exercise, orthotics, surgical interventions, and individual therapy sessions.
- Gracies JM, Marosszeky JE, Renton R, Sandanam J, Gandevia SC, Burke D.Short-term effects of dynamic lycra splints on upper limb in hemiplegic patients. Arch Phys Med Rehabil. 2000 Dec;81(12):1547-55.
- Gracies JM, Fitzpatrick R, Wilson L, et al. (1997) Related Articles, Lycra garments designed for patients with upper limb spasticity: mechanical effects in normal subjects. Arch Phys Med Rehabil 78(10):1066-71.
- Host HH. (1995) Scapular taping in the treatment of anterior shoulder impingement. Phys Ther 75(9): 803-812.
- Hylton N, Allen C. (1997) The development and use of SPIO Lycra compression bracing in children with neuromotor deficits. Pediatr Rehabil. 1(2): 109-116.
[Stabilizing Pressure Input Orthosis, developed by a parent, Cheryl Allen and Nancy Hylton,PT, is a development off the BENIK trunk supports, using lighter and
cooler layers of Lycra. Spio reportedly evolved in parallel with the Australian, Ballantyne’s Upsuit. Review article with photos of cases and suggested protocols, in combination with “DAFOs”. ]
- Jerosh J, Schmidt K, Prymka M. (1997) Proprioceptive capacities of patients with retropatellar knee pain with special reference to effectiveness of an elastic knee bandage. Unfallchirurg 100(9): 719-723. [In German]
[The bandage improved proprioception in the injured knees.]
- Johnson MP, McClure PW, Karduna AR. (2001) New method to assess scapular
upward rotation in subjects with shoulder pathology. J Orthop SportsPhys Ther 31(2):81-89 .
[Authors used a modified digital inclinometer, and found good to excellent validity.]
- Kluzik J, Fetters L, Coryell J. 1990. Quantification of control: a preliminary study of effects of neurodevelopmental treatment on reaching in children with spastic cerebral palsy. Phys Ther. 70(2):65-76; discussion 76-8.
- Knox, V. (2003). The use of lycra garments in children with cerebral palsy: a report of a descriptive clinical trial. British Journal of Occupational Therapy, 66(2), 71-77.
- Marin R. (1998) Scapular winger’s brace: A case series on the management of long thoracic nerve palsy. Arch Phys Med Rehabil 79: 1226-1230.
- Marcus RL, Sands WA, Nicholson DE. (2001) The effects of compression garments on movement function in motor impaired children. Poster presentation – Gait and Clinical Movement Analysis Society – Annual Meeting, Sacramento, CA. April.
[Abstract: Author investigated claims made by Blair et al (1995) and Hylton et al (1997) by using gait analysis to detect effects of wearing compression garments on kinematics and kinetics of gait and of single limb stance phase. No significant effect was reported. So I invited Robin to consider repeating the study using elasticized strapping in addition to compression garments to alter gait kinematics.]
- Morin L, Bravo G. (1997) Strapping the hemiplegic shoulder: a radiographic evaluation of its efficacy to reduce subluxation. Physiotherapy Canada Spring: 103-112.
[Authors compared typical sling with elastic adhesive taping for 15 patients with shoulder subluxation, 5 days each, and then combined them. The two supports combined were most effective.]
- Nicholson JH, Morton RE, Attfield S, Rennie D. (2001) Assessment of upper limb function and movement in children with cerebral palsy wearing lycra garments. Dev Med Child Neurol. 43: 384-391.
[Abstract: Functional gains from increased proximal stability were often outweigh |
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