Abstract
BackgroundApproximately 50 to 70% of post-stroke subjects present a reduction in the upper limb (UL) function even during the chronic phase. An adjuvant technique widely used in neurorehabilitation is elastic taping applications. However, its efficacy in UL treatment for post-stroke subjects still requires further investigation.ObjectiveTo verify the effects of elastic tape (ET) used on the paretic shoulder in upper limb (UL) performance during a drinking task.MethodA single-center randomized sham-controlled crossover trial randomized thirteen post-stroke subjects with mild to moderate UL impairment for group allocation to receive first Sham Tape (ST) or first Elastic Tape (ET), with one month of washout. Kinematic measures of a drinking task were taken before and after each intervention (elastic and sham tape), using Three-Dimensional Motion Analysis, and studied using feature analysis and Statistical Parametric Mapping. Outcome measures included spatiotemporal variables, scalar kinematic parameters (starting angles, range of motion—ROM, and endpoint angles) and time-normalized kinematic waveforms of trunk and UL joint angles (scapulothoracic, humerothoracic and elbow).ResultsElastic tape provided common modifications throughout the task (shoulder more towards midline, reduced scapula protraction and trunk flexion) and important alterations at specific time-instants. At the end of the reaching phase, for both groups (ET and ST), the elastic tape increased elbow extension [ET: CI = 12.57 (6.90 to 18.17), p<0.001; ST: CI: 12.89 (6.79 to 18.98), p<0.001). At the end of transporting the glass to the mouth, patients who underwent the elastic tape intervention presented more shoulder elevation [ET: CI = 16.40 (4.28 to 28.52), p = 0.007; ST: CI: 15.13 (5.79 to 24.48), p = 0.002)]. Moreover, an increase of elbow extension at the end of transporting the glass to the table was observed for both groups [ET: CI = 8.13 (1.48 to 14.79), p = 0.014; ST: CI: 8.20 (4.03 to 12.38), p<0.001)]. However, no changes in the spatiotemporal parameters were observed for both groups during all the phases of the task (p>0.05).ConclusionThe ET changed UL joint motions and posture during a drinking task in chronic hemiparetic subjects, which defines its role as an adjuvant therapy.
Highlights
Stroke is the most frequent cause of adult disability worldwide [1]
The elastic tape (ET) changed upper limb (UL) joint motions and posture during a drinking task in chronic hemiparetic subjects, which defines its role as an adjuvant therapy
These altered movement patterns are associated with alterations in range of motion (ROM) [5, 7, 8] and in the joint angles at static initial and final positions [4, 6]. These impaired movement patterns could induce disabilities in functional tasks, such as self-care and feeding activities due to difficulty performing reaching, picking up and holding onto objects [2]. Besides these alterations in kinematic scalar parameters, an alternative approach for continuous field analysis, called Statistical Parametric Mapping (SPM), demonstrated that chronic hemiparetic subjects presented a higher number of joint angle alterations at the static starting position and during the reaching phase [6]
Summary
50 to 70% of post-stroke subjects present a reduction in the upper limb (UL) function even during the chronic phase. Its efficacy in UL treatment for post-stroke subjects still requires further investigation
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