Today I’ll address a question from Facebook follower Mahendranath: Hi madam, Can you share kinesiology taping techniques for cerebral palsy children to reduce spasticity or abnormal patterns?
Just a clarification: I use a generalized technique, so that’s what I’ll be discussing here.
First, you must prepare the skin area you’re going to tape. It has be clean– no lotions, hair trimmed (not shaved, but an electric trimmer will do the trick on hairy folk)– and dry (towel dried is fine.) If you’ve got a person with sensitive or thin skin (children, elderly, really sick people), you might want to consider putting down a skin protectant as some brands of tape can cause skin irritation other brands don’t. I hear rubbing on some milk of magnesia does the trick, although I’ve never done it. Let that dry too. Ok, now you’re ready to tape.
So now for cutting the tape. I use “I” shaped strips almost exclusively. Like this:
However, I do round the corners, so they don’t get caught on clothes, sheets and pull off the tape prematurely. I’m not good at guessing the length of tape needed, so I always over guesstimate and trim off the excess as I lay down the tape.
Then you need to set-up the patient. Whatever skin you are taping needs to be stretched as much as possible during the application. Example: say you’re taping a quad. The knee needs to be flexed and the hip extended as much as the patient can tolerate. Positioning pillows can help with this.
Now we need to decide what our plan of attack is. To counteract spasticity we can either 1) directly inhibit the spastic muscle, 2) indirectly inhibit by facilitating the spastic muscle’s antagonist or 3) both of the above. Usually I do trial and error here. Different approaches work for different people, so I’ll try them all and see which one gives me the best results.
And the fun part: application. Peel off an inch to 1.5 inches of the backer paper at one end. This is your first base. Apply that over one end of the muscle you’re working on with 0% stretch stretch. Now, depending on what you decided your plan of attack is, you’ll apply the working center portion of the tape. To inhibit your spastic muscle, lie down the center with 0% stretch. To facilitate the antagonist, lie down the center either 25% stretch over muscle belly or 50% stretch over fibrous areas (tendons, ligaments, fascia areas). Leave one to 1.5 inches at the end of your strip for your second base which lies down with 0% stretch again like your first base.
Here’s a video of the basic technique over a hamstring. Here they are facilitating. They use more stretch to facilitate than I do though.
Side note: the fellow applying the tape in the video is the guy that taught me. Also, the company he reps for has lots of good application videos on their website.
Remember as you lie it down to try to not touch the tape and also do not leave any wrinkles as they both decrease the stickiness and therefore the effectiveness of the tape.
Nice job! Now we’ve got it down, how do we get it off? When I wear tape, I notice a HUGE decrease in it’s proprioceptive input once it’s been wet. Although most brands I’ve tried do not completely disintegrate in water in. But because the water reduces the tape’s effectiveness, it should be replaced every 2-3 days anyway. Again, may need to douse with baby oil for those sensitive skins first or take it off when the patient is the shower, so the tape is thoroughly wet. To remove it, take it off in a proximal to distal fashion or whatever way the hairs in that area grow to decrease irritation. Go slow. Really. No ripping it off like a Band-Aid. (This HURTS and leaves a rash for days, from personal experience.) I tell my patients instead of pulling the tape off, work the skin off the tape as you pull the tape taught.
Here’s a video on taking the tape off:
So that’s it! Remember the anatomy below the skin you’re taping: which parts are muscle belly, which parts are fibrous and the pathophysiology of the condition you’re treating: what is driving the spasticity. If the root cause isn’t addressed, you won’t have as good of outcomes with the tape. So for example, maybe the patient is in a lot of pain today, so their spasticity is really severe. Address the pain first, then address the baseline spasticity.