Kinesio Tape Subluxed Shoulder – Evidence-Based Occupational Therapy Treatment (2019)

Research

• Systematic Review on Effectiveness of shoulder taping in Hemiplegia: provides sufficient evidence to suggest taping is a beneficial method for reducing pain and shoulder subluxation among stroke subjects (Ravichandran, et. al, 2019).
• Stroke patients with hemiplegic shoulder pain can experience greater reductions in Shoulder Pain and Disability Index, pain, and improvement in shoulder flexion, external, and internal rotation after 3 weeks of Kinesio taping intervention compared with sham Kinesio taping. Kinesio taping may be an alternative treatment option for stroke patients with hemiplegic shoulder pain (Huang, et. al, 2017).
• A significant reduction of pain was observed immediately after taping was applied on the first day. The immediate effectiveness of kinesiology taping in modulating pain was reported in previous studies focusing on treating impinged shoulder pain, neck pain, and low back pain. However, the mechanism for the immediate effect is still unknown (Yang, et. al, 2018).
• Kinesio tape has been found to be more effective than the local modalities at the first week and was similarly effective at the second week of the treatment (Kaya, et. al, 2011).

Taping Methods

Various taping methods have been utilized in research studies. They are presented below, in no particular significant order.

Method 1 – Huang, et. al

1. I-type strips were used with light tension (15–25%) for the supraspinatus with the arm in adduction. The strip was crossed over the line of shoulder joint. A Y-shaped strip was then applied to the biceps and deltoid muscles with light tension (15–25%) using the insertion-origin muscle technique.
2. The head of the second strip was applied to the radial tuberosity where the biceps is inserted. The first tail of the second strip was applied along the short head of the biceps tendon to the deltoid muscle. The other tail of the second strip was applied along the long head of the biceps tendon to the deltoid muscle.
3. The third strip was applied from the anterior to the posterior shoulder, covering the acromioclavicular joint with a 50–75% stretch.

Method 2 – Yang, et. al

1. First, the supraspinatus was taped. The shoulder was positioned in an abduction potion at about 30 degrees with a slight flexion and internal rotation, and the humeral head was repositioned to the normal place. The first 4 cm of the tape was applied to the original site of supraspinatus (superior medial border of the scapula) with no tension. Then, the remaining strip was applied over the muscle to the insertion site (greater tubercle of humerus) with about 25–50% of the full available tension.
2. After this, the patient’s shoulder was placed in abduction at 30 degrees. Taping of the middle part of deltoid muscle begun by attaching the first 4 cm of the strip over the acromion process with no stretch. Then, the rest of the strip was stretched downward to the deltoid tuberosity with 20–30% of tension.
3. For taping the teres minor, the shoulder was flexed with a little internal flexion. The base of the tape was placed on the inferior angle of scapular. The rest of the strip was stretched with 15–25% of tension and placed along the axillary border of the scapula to the greater tuberosity of the humerus.
4. The last one tape was used to reduce the subluxation of the shoulder and was cut into Y shape before taping. After reposition of the shoulder, the base of the tape was applied to the acromion process, and then, the two strips were stretched with a tension of 50–70% and placed along the anterior and posterior borders of deltoid separately to the deltoid tuberosity.

Method 3 – Kaya, et. al

1. We started with the supraspinatus muscle which mainly provides scapular stability and placed the base of the strip 3 cm below the greater tubersity of the humerus with no tension. Then, the patient adducted the shoulder with lateral neck flexion to the opposite side. The rest of the strip was applied along the spinous process of the scapula with a relatively lighter tension which is described as 15–25% of the full stretch application (100%).
2. Secondly, we applied the taping to the deltoideus muscle. The base of the Y-shaped strip was placed 3 cm below the deltoid tuberosity of the humerus without tension. Both anterior and posterior tails were applied with light (15–25%) tension. The anterior and posterior tails were placed along the outer borders of the anterior and posterior deltoid muscle, respectively, without tension.
3. Lastly, we performed the taping of the teres minor muscle. The I-type strip was placed on the lower facet of the greater tuberosity of the humerus with no tension. Then, the patient abducted the shoulder in horizontal flexion with internal rotation. We placed the rest of the strip along the axillary border of the scapula with light (15–25%) tension.

Method 4 – California Tri-pull; Hayner, AJOT

The three pieces of rigid tape were applied to the patient’s shoulder on top of the already applied self-adhesive cotton tape.

1. The first piece (medial) was applied from 1.5 in. below the deltoid tuberosity running straight up the middle of the arm to 2 in. above the top of the glenoid fossa between the clavicle and the spine of the scapula.
2. The second piece (posterior) was located from 1.5 in. below the deltoid tuberosity to 1.5 in. above the middle of the spine of the scapula. The medial border of this second piece ran along the acromial process.
3. The third piece (anterior) was located from 1.5 in. below the deltoid tuberosity to run around the front of the humeral head and over the coracoid process, up to 1.5 in. above the clavicle (Figure 1).

The tape was removed and new tape applied every Monday, Wednesday, and Friday and remained on the patient for 3 consecutive weeks.

Which kinesio tape method have you used in occupational therapy practice for subluxed shoulders?

Sources:

American Journal of Occupational Therapy, November/December 2012, Vol. 66, 727-736. doi:10.5014/ajot.2012.004663

Huang, Y. C., Chang, K. H., Liou, T. H., Cheng, C. W., Lin, L. F., & Huang, S. W. (2017). Effects of Kinesio taping for stroke patients with hemiplegic shoulder pain: a double-blind, randomized, placebo-controlled study. Journal of rehabilitation medicine, 49(3), 208-215.

Kaya, E., Zinnuroglu, M., & Tugcu, I. (2011). Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome. Clinical rheumatology, 30(2), 201-207.

Ravichandran, H., Janakiraman, B., Sundaram, S., Fisseha, B., Gebreyesus, T., & Gelaw, A. Y. (2019). Systematic Review on Effectiveness of shoulder taping in Hemiplegia. Journal of Stroke and Cerebrovascular Diseases, 28(6), 1463-1473.

Yang, L., Yang, J., & He, C. (2018). The Effect of Kinesiology Taping on the Hemiplegic Shoulder Pain: A Randomized Controlled Trial. Journal of healthcare engineering, 2018.