Abstract
BackgroundElastic tape has been widely used in clinical practice in order to improve upper limb (UL) sensibility. However, there is little evidence that supports this type of intervention in stroke patients.ObjectiveTo verify the effect of elastic tape, applied to the paretic shoulder, on joint position sense (JPS) during abduction and flexion in subjects with chronic hemiparesis compared to sham tape (non-elastic tape). Furthermore, to verify if this potential effect is correlated to shoulder subluxation measurements and sensorimotor impairment.MethodsA crossover and sham-controlled study was conducted with post-stroke patients who were randomly allocated into two groups: 1) those who received Sham Tape (ST) first and after one month they received Elastic Tape (ET); 2) those who received Elastic Tape (ET) first and after one month they received Sham Tape (ST). The JPS was evaluated using a dynamometer. The absolute error for shoulder abduction and flexion at 30° and 60° was calculated. Sensorimotor impairment was determined by Fugl-Meyer, and shoulder subluxation was measured using a caliper.ResultsThirteen hemiparetic subjects (average time since stroke 75.23 months) participated in the study. At baseline (before interventions), the groups were not different for abduction at 30° (p = 0.805; p = 0.951), and 60° (p = 0.509; p = 0.799), or flexion at 30° (p = 0.872; p = 0.897) and 60° (p = 0.853; p = 0.970). For the ET group, differences between pre and post-elastic tape for abduction at 30° (p<0.010) and 60° (p<0.010), and flexion at 30° p<0.010) and 60° (p<0.010) were observed. For the ST group, differences were also observed between pre and post-elastic tape for abduction at 30° (p<0.010) and 60° (p<0.010), and flexion at 30° (p<0.010,) and 60° (p<0.010). Potential effects were only correlated with shoulder subluxation during abduction at 30° (p = 0.001, r = -0.92) and 60° (p = 0.020, r = -0.75).ConclusionElastic tape improved shoulder JPS of subjects with chronic hemiparesis regardless of the level of UL sensorimotor impairment. However, this improvement was influenced by the subluxation degree at abduction.
Highlights
Stroke is one of the leading causes of death and disability in adults [1, 2]
From July 2014 to July 2015, 249 subjects with chronic hemiparesis from a hospital list in São Carlos were assessed for eligibility
13 subjects (3 women and 10 men) were randomly allocated to the two groups: sham followed by elastic tape (n = 7, Sham Tape (ST)) or elastic tape followed by sham (n = 6, Elastic Tape (ET))
Summary
Stroke is one of the leading causes of death and disability in adults [1, 2]. Approximately 70% of post-stroke patients have sensorimotor deficits in the upper limb (UL), which result in contralateral hemiparesis injury. [3]. 70% of post-stroke patients have sensorimotor deficits in the upper limb (UL), which result in contralateral hemiparesis injury. These sensorimotor deficits can include somatosensory alterations, which impair movement control and joint stability [4, 5]. Proprioceptive deficits impair feedback and feedforward control, which negatively influence joint stability, acuity and coordination movements [4, 6], mainly small or precise movements [10], as well as motor skill acquisition [8, 10]. There is little evidence that supports this type of intervention in stroke patients
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