I have purposely refrained from discussing specific techniques for a very simple and fundamental reason: it distracts from the focus on addressing the body itself. That is to say, too much attention is focused on ¨what tool / machine / technique are you using¨ as opposed to devoting time and energy into providing the body with the stimulus necessary to heal itself. Although tools and techniques are obviously required to solicit the healing / improvement process, there is an unfortunate tendancy for people to place far too much emphasis on the external rather than emphasize the need for a comprehensive understanding of the human organism...and therefore giving birth to a more effective treatment strategy. The overwhelming trend of ¨window shopping¨ for therapies has been going on for quite some time and continues today. Therefore, it is important for me to mention (and for the reader to understand) that EVERY case requires in-depth analysis and a common sense logic. The template for this is very straightforward:
1) After a careful analysis of all possible treatment options, decide on a specifc rehabilitation platform that the majority of your choices will come from. In other words, any attempts to ¨marry¨ multiple philosophies or treatments together in hopes of benefiting from all is almost always unproductive...therefore select a main philosophy that aligns with your own individual value system and convictions.
2) Once the main platform has been established, you must then go through another round of careful analysis and investigation to determine what (if any) other complimentary options are available. To be precise, ¨what will facilitate the strategy established in the main platform?¨
The benefits of this particular model are quite tangible and typically align with almost every care-seeker and care-giver objectives. To explain these benefits better, an understanding of the primary objectives is necessary. There are essentially 2 main considerations when establishing a rehabilitation protocol (professional perspective) and rehabilitation strategy (care-seeker perspective): Long-Term Considerations and Short-Term Considerations. Effectively, the main rehabilitative platform contributes to the long-term objectives while the complimentary options should be implemented to serve, not only potential short-term objectives, but as a tool to address potential tactical challenges that arise over the long-term process as well as facilitate movement through transitional phases that could potentially be inconvenient or challenge other areas of development (social and cognitive).
It is with this central philosophy that I have decided to open the discussion to a larger (and generally more animated) perspective. I am constantly aware of the ¨pull¨ of specific techniques...they act like gravity to which no one can resist. Therefore I will be very clear and explicit right from the beginning:
In my personal and professional opinion, the only viable rehabilitative platform for disorders of movement and posture is the systematic improvement of the extended fascial / connective tissue system.
With this position made clear (I hope), we then need to examine potential complimentary options and assess their contribution to the overall strategy. Of course, this would be subject to the person´s value system...however, a realistic rationale for implementation should resonate in a ¨bi-partisan¨ way. If it does not, then it may signal a need for re-evaluation.
Why have I decided to discuss Kinesiotaping? Again, an inuitive question that has a very straightforward answer: The fascial paradigm is based on the fundamentals of tensegrity and the concept of the fascia as an adaptive and active contributor to biomechanical, systemic, and metabolic homeostatis. This elaborate system runs thoughout the body in layers (sheets) that are continuous with each other and have functional appearances at the superficial level and deepest levels as well. The concept of Kinesiotaping can be considered a viable extension of this principle: Unlike external, rigid, and restrictive devices such as braces and orthotics, it attaches to the skin and therefore becomes more intrinsic and contributes to the entire fascial system as a whole.
This means that it has a positive contribution to the kinematic chain. To be clear, it does not REPLACE a given platform, nor should it be implemented with the idea to ¨support¨...rather it should be considered as a catalyst that maximizes existing fascial strength.
An interesting characteristic of this specialized tape is its waveform appearance. Similar to connective tissue, it boasts a wavy layout that permits stretch.
This particular technique was invented in 1973 by Dr. Kenzo Kase and was initially used in rehab settings in Japan but since the mid-80´s has gradually introducing itself into the mainstream. There have been a number of recent studies performed on the benefits of kinesiotaping in disorders of movement and posture that have essentially come to similar conclusions: Although it doesnt necessarily contribute to long-term functional performance (GMFM scores remain relatively stable), there is clear evident that it contributes to performance tasks involved in daily life and should therefore be considered for further study and integration into rehabilitative strategies.
(The effects of Kinesio® taping on sitting posture, functional independence and gross motor function in children with cerebral palsy 2011, Vol. 33, No. 21-22 , Pages 2058-2063----Tülay Tarsuslu ŞŞimşşek1, Bahriye Türkücüoğğlu2, Nilay Çokal3, Gonca Üstünbaşş4, & İİbrahim Engin ŞŞimşşek1, Department of Physical therapy and Rehabilitation, Abant Izzet Baysal University School of Physical Therapy and Rehabilitation, Bolu 14100, Turkey).
Conclusions: No direct effects of KT were observed on gross motor function and functional independence, though sitting posture (head, neck, foot position and arm, hand function) was affected positively. These results may imply that in clinical settings KT may be a beneficial assistive treatment approach when combined with physiotherapy.
Following this post, I have embedded another interesting pilot study. Again, it should be understood that my intention is to bring to light the potential complimentary benefit this particular technique has. More importantly, it extends well beyond the simple mechanical contribution. Implementation of this technique can be a very powerful contributor to social and cognitive development (eg. assist in maintaining head position in school, enable and facilitate more coordinated movements during play and social interaction, etc...). Therefore, it quite clearly belongs as a tactical, short-term management tool. As part of the long-term strategy, it is essential to remember that complimentary options may come and go...they may lose their applicability and others may meet the priorities of the changing situation more effectively...however, the main platform remains.
While researching for this post, I questioned whether this relatively well-known application can truly be of significant value. In reflecting over this question, I realized I needed to put aside my strong ¨devotion¨ to the fascial paradigm in it´s pure sense and examine the ¨big picture¨. It has been a long held philosophy of mine (and some of my collegues) that every single ¨micro-improvement¨ is important...and once they accumulate and reach a critical mass, a functional leap occurs. This is precisely how the developmental process in a healthy individual works. For example, you may see an 11 month old child crawling one day...and the next, he/she is walking upright! Not very well, mind you...but this is made possible by hundreds of thousands (if not millions) of micro-improvements combining to achieve a massive leap forward.
As seen in the video, a very simple application has very powerful results. It is important to highlight the fact that this child is relatively mildly affected, however the obvious benefits are evidenced here...especially in the contribution to her cognitive and social development, development of motor intelligence, and general happiness and well-being.
In summary, I should once again stipulate that my intention is not to trumpet Kinesiotaping as the ultimate solution to disorders of movement and posture. On the contrary...I see it quite clearly as a potential tactical compliment (among other options as well) to the overall strategy. To be precise, approximately 80-85% of time and effort should be devoted to the main platform, while the remaining 15-20% be distributed among responsible complimentary interventions.
I will be posting more specifics with respect to Kinesiotape types and applications in the Miscellaneous section of this blog (coming soon) where I will present 3 basic applications of Kinesiotape technique: Lumbar and Lower Spine, Foot and Ankle, Neck and Upper Spine.
Please refer to the pilot study below for a bit more info.
Level 4 Pilot Study Investigating the Effects of Kinesio Taping in an Acute Pediatric Rehabilitation Settin...