Can kinesio tape be used as an ankle training method in the rehabilitation of the stroke patients?
Introduction
Stroke is one of the serious causes of long-term disability in older population. Stroke survivors usually have neurological deficits and complications such as motor weakness, spasticity, poor balance, communication disorders, depression and other affective symptoms, and cognitive impairments due to stroke [1], [2]. Even, after completing standard rehabilitation, many people are left with a walking deficit and approximately 50%–60% of stroke patients still experience some degree of motor impairment, and approximately 50% are at least partly dependent in activities-of-daily-living (ADL) [3], [4], [5].
Post-stroke gait dysfunction is among the most investigated neurological gait disorders and is one of the major goals in post-stroke rehabilitation [3]. Stroke survivors walk slower than the healthy subjects and have poor selective motor control. They use synergistic mass patterns of the affected lower leg rather than isolated joint movements during a walk [3], [6], [7], [8], [9], [10].
The features of stroke gait are identified by stiff-legged gait (reduced range of knee motion) and drop foot (lack of ankle dorsiflexion during swing) leading to raised hip during swing [7], [8], [10]. In post-stroke patients, the function of cerebral cortex becomes impaired, while that of the spinal cord is preserved. Specific training strategies that acting on the distal physical level and influencing the neural system can be used to reorganize the cortex for walking [3]. It has been asserted that ankle movement training facilitates brain reorganization [11], [12]. Dobkin et al. [13] demonstrated that the supraspinal sensorimotor network for the neural control of walking can be assessed indirectly by ankle dorsiflexion.
Kinesio taping (KT) has long been used as an adjunct during the rehabilitation program in various diseases to strengthen weakened muscles, control joint instability and muscle tones, assist with postural alignment, relieve soft tissue inflammation and pain, relax overused muscles, improve active range of motion, balance, functional use and gait ability [5], [14], [15], [16], [17], [18].
Although there has been extensive interest in the literature about KT application to various lower extremity muscles of the stroke patients, limited data exist to support the effectiveness of KT application on rehabilitation outcomes in these population. The aim of this study was to investigate the effects of the KT application to the tibialis anterior, in order to train ankle movement, on motor recovery, spasticity, gait, ADLs, depression and HRQoL in patients with stroke.
Section snippets
Participants
Twenty patients with stroke (duration of less than 12 months, 10 M, 10 F) were consented to participate in the study. We recruited participants from inpatient rehabilitation department of an academic rehabilitation hospital. Stroke had been diagnosed clinically by a neurologist and confirmed by a computed tomography scan or MRI before admission to the hospital for rehabilitation. The exclusion criteria included recurrent stroke, severe aphasia, impaired level of consciousness (≤15 points on the
Results
The demographic and clinical characteristics of the groups are shown in Table 1 and Table 2. There were no differences between the groups as regards age, sex, duration of the disease, affected side of the patients, etiology, BMRS, FAC, MAS, MMSE, BDI, Barthel score, sensorial abnormality, 6MWT, SF-36 score at the beginning of the study.
Table 3 and Table 4 show the assessment measures of each group before and after the treatment. Compared with the control group and the baseline, a statistically
Discussion
The primary goals of rehabilitation programs in patients with stroke include to improve weakness, spasticity and poor balance and ultimately enable the patients to walk, manage and perform their daily activities independently [1], [2], [3], [4].
Walking ability of the patients with stroke has been found to be associated with their motor and sensory recovery, balance, spasticity, aerobic capacity and the level of independence, function and ADLs [4], [6], [31]. In addition, walking ability may
Study limitations
The current study has some limitations. The sample size was small and the patients participated in the study were only from one rehabilitation hospital. Despite the fact that, our hospital is the largest national rehabilitation hospital in Turkey and accepts patients from all over the country, our sample cannot be considered as representative of the general population of patients with stroke.
Because it is difficult to elicit information from nonresponsive patients, patients who had an impaired
Conclusions
Given these limitations, this is one of the few studies that comprehensively investigated the effects of KT application to the tibialis anterior on clinical variables and HRQoL in the stroke population. The results of this study suggest that the use of KT as an adjunct to the conventional rehabilitation program are promising and it can be used as an ankle training method like as peroneal nerve stimulators, FES and AFO to improve walking ability, motor recovery, spasticity, ambulation capacity,
Conflicts of interest
Financial disclosure statements were filed and no conflict of interest was reported by the authors or any individuals responsible for the content of this article. None of the authors have financial or commercial interests in connection with this study.
References (47)
- et al.
Step length asymmetry is representative of compensatory mechanisms used in post-stroke hemiparetic walking
Gait Posture
(2011) - et al.
Ankle dorsiflexion as an fMRI paradigm to assay motor control for walking during rehabilitation
Neuroimage
(2004) - et al.
Assessment of coma and impaired consciousness. A practical scale
Lancet
(1974) - et al.
Determinants of walking function after stroke: differences by deficit severity
Arch. Phys. Med. Rehabil.
(2007) - et al.
Correlations between ankle-foot impairments and dropped foot gait deviations among stroke survivors
Clin. Biomech. (Bristol, Avon)
(2013) - et al.
Rehabilitation in stroke syndromes
Stroke rehabilitation
- et al.
Rehabilitation of gait after stroke: a review towards a top-down approach
J. Neuroeng Rehabil.
(2011) - et al.
Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence
Expert Rev. Neurother.
(2007) - et al.
The effect of muscle facilitation using kinesio taping on walking and balance of stroke patients
J. Phys. Ther. Sci.
(2014)