Buttock Taping Produces an Immediate Improvement in Hip Extension for Persons following Stroke

Abstract

1817 Following stroke, weak hip extensors can lead to reduced step length of the unaffected leg and consequently a reduction in stride length and walking velocity. A strategy used clinically in neurologically-intact persons to increase hip extension is buttock taping. PURPOSE: This study investigated whether taping applied to the affected buttock of persons following stroke improved hip extension during stance phase of walking. METHODS: Fifteen persons following stroke (age 62 ± 7.2 y; time since stroke 5.2 ± 2.8 y) walked 14 m under 3 conditions (control, placebo tape, and buttock tape). Buttock taping used 3 pieces of tape to lift the buttock: the first piece of tape started from the medial aspect of the buttock crease and was pulled laterally and superiorly along the buttock crease towards the greater trochanter. The second piece was pulled superiorly from the medial aspect of the buttock crease to the top of the buttock above the gluteus maximus muscle belly. The third piece of tape was pulled firmly across from the superior end of the second piece of tape to the greater trochanter. For placebo taping, 2 pieces were applied vertically across the middle of the buttock under no tension. For each condition, subjects completed 5 trials at a self-selected and fast speed. The order of conditions was randomised, as was the speed within each condition. Hip extension, measured in quiet standing, provided a baseline reference. For each walk, subjects' hip angle, unaffected step length, affected step length, stride length and walking velocity were measured. RESULTS: Subjects' hip extension increased significantly (p<0.05) for self selected and fast walking speeds at late stance phase of walk (heel off) with buttock taping (11.1 ± 9.9; 8.1 ± 8.6, respectively) compared to placebo taping (−1.0 ± 10.5, −3.1 ± 10.3) and control conditions (−3.1 ± 6.6, −2.4 ± 5.5). Also, for both self selected and fast speeds, step length on the unaffected side and overall stride length increased significantly with buttock taping by 30 ± 15 mm compared with either the control or placebo conditions. In contrast, affected step length and walking velocity remained unchanged. Finally, there was no significant difference between the control and placebo taping condition for any of the measured variables. CONCLUSIONS: As buttock taping produced an immediate improvement in hip extension at the end of stance phase of walking, it may be a useful adjunct to current rehabilitation gait training strategies. Clinically, those stroke patients who are able to weakly activate their hip extensors but are unable to sustain their activation for the duration of the stance phase of walking are likely to benefit from this form of taping.