Abstract
Introduction: Leg paralysis, spasticity, reduced interlimb coordination, and impaired balance are the chief limitations to overground ambulation in subjects with incomplete spinal cord injury (SCI). In recent years, the application of KinesioTaping (KT) has been proposed to enhance sensory inputs, decreasing spasticity by proprioception feedback and relieving abnormal muscle tension. Because no studies have examined KT-based techniques in SCI subjects, our goal was to analyze the effects of ankle joint KT on spasticity, balance, and gait.Materials and Methods: A randomized crossover case control design was used to compare the effects of KT and conventional nonelastic silk tape (ST) in 11 chronic SCI subjects, AIS level D, with soleus/gastrocnemius (S/G) muscle spasticity and balance and gait impairments. Treatment: 48 h of treatment with KT or ST was followed by 48 h with the other technique after 1 week. A single Y-strip of Cure© tape (KT) and ST was to the S and G muscles with 0% stretch. Before and 48 h after of application of KT and ST, clinical data on the range of motion (ROM), spasticity, clonus, pain, balance, and gait were collected. Stabilometric platform assessment of center of pressure (COP) movements; bidimensional gait analysis; and recording of electromyographic (EMG) activity of the S, G, and tibialis anterior and extensor hallucis lungus muscles were also performed.Results: Only KT had significant effects on spasticity (p < 0.05), clonus (p < 0.001) and COP movements (p < 0.05), kinematic gait parameters (p < 0.001), and EMG activity (p < 0.001). Comparison between ST and KT improvements pointed out significant differences as concerns ROM (p < 0.001), spasticity (p < 0.001), clonus (p < 0.001), pain (p < 0.001), COP parameters (p < 0.05), and most kinematic gait data (p < 0.05).Discussion: Short-term application of KT reduces spasticity and pain and improves balance and gait in chronic SCI subjects. Although these data are promising, they require confirmation in a larger cohort of patients.
Highlights
Leg paralysis, spasticity, reduced interlimb coordination, and impaired balance are the chief limitations to overground ambulation in subjects with incomplete spinal cord injury (SCI)
Comparison between silk tape (ST) and KT improvements pointed out significant differences as concerns range of motion (ROM) (p < 0.001), spasticity (p < 0.001), clonus (p < 0.001), pain (p < 0.001), center of pressure (COP) parameters (p < 0.05), and most kinematic gait data (p < 0.05)
No participant withdrew from the trial, and all outcome measures were obtained for all SCI subjects
Summary
Spasticity, reduced interlimb coordination, and impaired balance are the chief limitations to overground ambulation in subjects with incomplete spinal cord injury (SCI). Feedback from a variety of sources, such as visual, vestibular, somatosensory, and proprioceptive circuits, must be interpreted and integrated into CPG activity to generate locomotion that is effective under all conditions (Hubli and Dietz, 2013). In this complex framework, sensory feedback and context-specific gait requirements interact in affecting muscle synergies (Horak and Nashner, 1986). Alexander et al reported decreased H-reflex amplitude after KT of the trapezius, suggesting that it influences muscle tone (Alexander et al, 2003) This KT-dependent H-reflex decline indicates that it is inhibitory and adjusts muscle activity through proprioception feedback (Lin et al, 2011). KT has been used in neurological pathologies (Kilbreath et al, 2006; Karadag-Saygi et al, 2010; Cortesi et al, 2011), including stroke and multiple sclerosis, and various orthopedic disorders (Alexander et al, 2003; Halseth, 2004; Thelen et al, 2008; Lin et al, 2011), generally improving muscle tone, range of motion, center of pressure balance parameters, and pain symptoms
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