This was the Journal Club article we looked at this month at the hospital. It came across my desk last year as I began studying to take the Neurological Clinical Specialist (NCS) exam.
It starts out with some fantastic basic review of the anatomy, physiology and pathophysiology of the hemiparetic upper extremity, trunk and posturing. In this section, it is emphasized that before we can consider how the upper extremity is functioning, we must assess and address the posture and hemiplegia deficits of the trunk and scapula. The trunk and scapula are the base of upper extremity function, so if those don’t work like they’re supposed to, we can forget about the arm working too.
Then it gets into the Kinesiotaping part. Honestly, I keep this section of the article in my clinical reference notebook at the office and suggest anyone that deals with hemiparesis on a regular basis that wishes to implement Kinesiotape as a treatment option do the same. There are instructions there on how to do several specific KT jobs including: facilitating trunk extensors, inhibiting upper traps; support mid/lower traps and align scapula,;improve humeral/scapula alignment, reduce soft tissue overstretch, reduce edema and pain; decrease humeral subluxation, decrease medial scapular winging. If nothing else, I would suggest commiting the one for reducing subluxation to memory. It’s the most difficult one of the whole group and may require a few practice runs to really “get.”
But more important than the specific KT uses there in the article, you can infer principles of KT, which can be applied to any number of situations and body parts. These include: facilitation= distal -> proximal attachment applied with muscle in anatomical neutral posture with KT stretch released as applied; inhibition: distal -> proximal attachment applied with muscle in anatomically stretched position with paper-off tension; support weak muscle: proximal -> distal attachment applied with paper-off tension; decrease over stretching and provide proprioceptive input: distal-> proximal attachment with paper-off tension.
Anyway, like I said, I keep the pictures with descriptions and KT principles written on the edges as a reference in my clinic and recommend you do the same. Please do also keep in mind that for KT to work, there has to be at least a flicker of muscular activation for KT to work. So KT is not appropriate for completely flaccid muscles.