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KT for torticollis

 
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KT for torticollis - January 28, 2007 9:13:00 AM   
texaspt

 

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I have a 6 mos old with recent dx of CTM. Parent does not want to try the TOT collar until therapy has been attempted for about a month. I was going to use kinesiotaping to assist with keeping her head in midline (particularly an issue while traveling in the carseat). Does anyone have the protocol on KT for torticollis babies? Thanks in advance!
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Re: KT for torticollis - January 28, 2007 9:10:00 PM   
Andrew M. Ball PT PhD

 

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Please be advised that the Kinesiotaping Association makes course participants sign legal agreements to not teach their techniques outside of a continuing education course. Furthermore, only those with the CKTI designation (level three certification plus oral exam) are permitted to teach courses.

Had you taken a kinesiotaping course, you surely would have learned the technique.

Although you may be able to find information regarding the technique for use in children in a book somewhere, I STRONGLY advise against using the technique for a child with torticollis until you've been trained . . . there is a fine line between using the technique to inhibit SCM spasticity and incorrect application of the tape in a way that FACILITATES the very SCM spasticity that should be avoided.

Stick with the standard HEP protocols until you've taken the course.

Dr. Andrew M. Ball, PT, DPT, PhD
(Level 2 Kinesiotaping Certified)

_____________________________

Andrew M. Ball, PT, DPT, Ph.D.
Orthopedic Physical Therapy Resident
Carolinas Rehabilitation

(in reply to texaspt)
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Re: KT for torticollis - January 29, 2007 7:58:00 PM   
bonmar

 

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Drew,

Are you saying that the Kinesiotaping Assoc will not allow a PT teach a patient how to kinesiotape? I am a bit confused about that comment. Could you please elaborate.

Thanks, Bonnie

(in reply to texaspt)
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Re: KT for torticollis - January 30, 2007 5:15:00 AM   
Andrew M. Ball PT PhD

 

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The kinesiotaping association prohibits certified clinicians from teaching the techniques in inservice, continuing education, or online forum settings.

Drew

_____________________________

Andrew M. Ball, PT, DPT, Ph.D.
Orthopedic Physical Therapy Resident
Carolinas Rehabilitation

(in reply to texaspt)
Post #: 4
Re: KT for torticollis - January 30, 2007 8:11:00 AM   
dfjpt

 

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So, basically they want to keep their expensive tape from escaping their expensive courses/money wringing strategies?

Kinesio tape is available online to anyone - you don't have to have gone to a taping seminar (where you will be taught to use vast gobs of it) - instead, go ahead and order some. It comes with some instruction suggestions on paper! (Wherein you are again taught to waste too much tape IMO..)

Figure out how to use small strips of it here and there to relieve pain. Then go ahead and show others your own techniques if you want! The stuff works well, and c'mon, no one can kill anyone by putting tape on them. This whole secrecy tape cult thing is totally annoying.

(in reply to texaspt)
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Re: KT for torticollis - January 30, 2007 2:04:00 PM   
Sebastian Asselbergs

 

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The embargo on teaching is only for certified clinicians.....That is good - it opens up the market for everyone else to share (as dfjpt pointed out so correctly) their clinical tidbits.

Application of tape does NOT require "new" anatomical, physiological, neurological, biomechanical or other knowledge. All necessary knowledge for the application is already available. Someone started with this tape-use as the first one, without a teacher or course... NO-ONE is holding any trade mark on "applying" tape.

Use your judgement, logic and available knowledge to apply - no harm has ever been reported from this type of taping.....

_____________________________

Mundi vult decipi

(in reply to texaspt)
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Re: KT for torticollis - January 30, 2007 2:51:00 PM   
Andrew M. Ball PT PhD

 

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Again, let me re-iterate, there is a fine line between using the technique to inhibit SCM spasticity and incorrect application of the tape in a way that FACILITATES the very SCM spasticity that should be avoided.

It does not require new anatomical, physiological, neurological, or biomechanical knowledge . . . but it DOES require new technical knowledge with respect to using the taping techniques for neurofacilitory or neuroinhibitory purposes. I have NEVER seen an untrained clinician apply kinesiotaping for torticollis correctly. Not ever. Usually, it's WAY to aggressive, on the wrong side of the neck, or facilitatory (e.g. encouraging the very torticollis that we the clinician are being paid to correct). For this technique, go to a course to learn how to do it correctly, or don't use it at all.

There is a WORLD of difference between "faking it" through using a little kinesiotaping for edema control on an adult, or in a facilitatory manner or an adult . . . versus in an inhibitory manner on an infant. "No harm no foul," you say? Let's hear you use that philosophy with a parent of a child with torticollis and craniomalformation . . . or are you REALLY honest enough to disclose that you haven't been trained and have a more likely chance of making the situation worse than better with your self-taught techniques?

Please.

This thread is clearly a lot of "chest pounding" devoid of reality. No one is that reckless to "just try it" with an infant with torticollis. If you think the techniques might be valuable, take the course (they're cheap), learn the techniques. If you do it correctly, you generally use LESS tape and save money.

Drew

_____________________________

Andrew M. Ball, PT, DPT, Ph.D.
Orthopedic Physical Therapy Resident
Carolinas Rehabilitation

(in reply to texaspt)
Post #: 7
Re: KT for torticollis - January 30, 2007 4:33:00 PM   
Sebastian Asselbergs

 

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Oh please Drew - get off your high horse!

This is such pseudo-science drivel: "new technical knowledge with respect to using the taping techniques for neurofacilitory or neuroinhibitory purposes." - sounds like its straight from the course flyer!

Can you assure me that this technique has been rigorously tested for all its applications BEFORE anyone used it? How did they start - what side effects did they record? Unless there is recorded stuff like that - there is NO leg to stand on for this alarmist behaviour.

Another doozie: "I have NEVER seen an untrained clinician apply kinesiotaping for torticollis correctly. Not ever." And this means exactly what? How many did you see? How bad was the effect? What was the case?

And your statement:
"There is a WORLD of difference between ...(....)versus in an inhibitory manner on an infant."
No sh*t sherlock. And this is the "new technological knowledge"? What PT would see this ANY different than you?....Geesh.

You are so full of yourself - YOU talk about chest pounding devoid of reality.....

_____________________________

Mundi vult decipi

(in reply to texaspt)
Post #: 8
Re: KT for torticollis - January 31, 2007 6:33:00 AM   
SJBird55

 

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I really don't know a ton about kinesiotaping, but Drew... geesh... are you telling me that if a parent thought the tape was not beneficial or the infant was responding worse that the parent wouldn't just take the tape off?

You don't have kids, do you? Well, let me tell you something that is really, really simple. If a parent believes that something is actually hurting a kid and the parent can control that issue, the parent will step in and do what parents do. So... if a little piece of tape seems to be making an infant more uncomfortable, ummm... the parent will take the tape off! Simple... don't go scaring poor TexasPT over a piece of tape. Geesh...

I've actually never read in any peer-reviewed journals that kinesiotaping is effective or harmful for anything. So, if there really isn't anything published on the effectiveness... and there isn't anything published in harm directly linked to kinesiotaping and the technique utilized... ummm, Drew, technically you are just spouting out your own opinion of the matter. Opinon is nice, but it isn't anything proven to be true.

(in reply to texaspt)
Post #: 9
Re: KT for torticollis - January 31, 2007 1:21:00 PM   
Andrew M. Ball PT PhD

 

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Kinesiotaping is too new to have any good research out on it yet, and yes, I have my opinions on the subject, but ya'll are missing the point.

If you've made up a taping technique using the kinesiotaping product then OWN IT as your own. If it works, great, but if it doesn't, don't rob the patient of a technique that might prove effective if provided by an adequately trained professional because they believe, in error, they've had it in the past. Sheesh guys, given the times ya'll have whined about a now non-compliant patient who came from a chiropractor or "shake-n-bake" physical therapist only to walk into your office months later insisting that "I've had physical therapy and I don't really know why I'm here other than I'm trying to avoid surgery," I'd expect a little less venom on the issue.

Or is it only unethical when YOU come up short?

And FYI, the inhibitory techniques for using kinesiotaping properly on an infant with torticollis ARE NOT self-evident to the average clinician. It takes more practice than you think to get it right. It's not rocket science --- once you've been shown how to do it correctly. So no, I'm not on a high-horse about this --- try again.

Go ahead and tape, but call it what it is, "some crap I just made up that I think will work" if the patient trusts you enough to run with that, more power to you, but to rob the patient of the informed information that while you've not been trained, there are others that are is, at least in my opinion, less than honest.

Drew

_____________________________

Andrew M. Ball, PT, DPT, Ph.D.
Orthopedic Physical Therapy Resident
Carolinas Rehabilitation

(in reply to texaspt)
Post #: 10
Re: KT for torticollis - January 31, 2007 2:50:00 PM   
SJBird55

 

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Well, that's where you're missing the point, Drew. Technically, you may be considered an "adequately trained" professional, but the treatment in which you were adequately trained isn't proven. The "research" listed at the kinesiotape site was crap. Inhibitory techniques using kinesiotape are not proven to be effective (doesn't matter who applies the sticky stuff).

So, reality is... all anyone can really say is, "hey, I'd like to apply some special tape to see if a continual proprioceptive awareness through the skin provides any input to reduce the torticollis in your kid." THAT'S the only thing that is honest.

You can have an "adequately trained" person applying tape for an unproven technique OR you can have anyone appplying tape for any reason. Works out in the wash that either way, there is no guarantee that anything effective will actually result. The only probable chance of risk in taping an infant would be a potential for an allergic skin reaction.

Drew... sometimes I wonder about you. You paid to be a Level 2 taper... you made that educated, clinically responsible decision (in light of the importance of evidence based practice) based on what? One day, I think it would be fun to meet you - I just might be able to sell you dirt AND you'd be so proud of that dirt and you'd believe you got an awesome deal!!! :) This topic isn't about you, but I think jabbing at you is called for in this matter.

(in reply to texaspt)
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Re: KT for torticollis - January 31, 2007 3:43:00 PM   
Andrew M. Ball PT PhD

 

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Oy vay. You've lost it.

Drew

_____________________________

Andrew M. Ball, PT, DPT, Ph.D.
Orthopedic Physical Therapy Resident
Carolinas Rehabilitation

(in reply to texaspt)
Post #: 12
Re: KT for torticollis - February 1, 2007 1:51:00 AM   
jbird007

 

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Do any PT's manipulate newborns/infants/toddlers?

JBird

btw, I pray for you Drew. sheeeeeesh

(in reply to texaspt)
Post #: 13
Re: KT for torticollis - February 1, 2007 5:34:00 AM   
Sebastian Asselbergs

 

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Drew, I can't keep going on this but this remark of yours goes to the heart of the matter:

"--- once you've been shown how to do it correctly. "

Who shows you how to do it correctly? Based on what level of real knowledge that is different than what the well-trained PT already has? Based on what priciple that is so different that only those who follow a course can do it? How did the course developer come to this knowledge?

You mention "new technical knowledge" - what does that mean? What does it entail? Where is it from?

Unless you answer these backed up with some REAL evidence - all YOU have is: "I have taken a course in taping" - no matter what level it is.


And you suggest that those who apply tape without having taken a course are "robbing the patient of the informed information" are less than honest....
Now, what "informed information" are you giving them? Since there is as you admit, no research on it....An elegant theoretical model?
What makes you think that those who apply tape without the course don't do the same thing?
Why would the "certified PT" be ANY more ethical that those who don't take the course?

You have made not-so-veiled accusations....It seems they are made to justify the money YOU spent on acouple of courses - courses WITHOUT any MORE evidence than those taping independently....

_____________________________

Mundi vult decipi

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Re: KT for torticollis - February 1, 2007 1:50:00 PM   
nari

 

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In the meantime, texaspt is wondering: Wow, what did I do wrong with an innocent question??

Taping is no great skill and I would assume that every PT has been involved with taping, be it inhibitory or facilitatory or whatever, along the way. Why hasn't texaspt been given a simple reply?

Taping neuromodulates and works well for pain. Without any pain present, it still affects muscle tonicity. A few trials in the clinic, with a couple of strips, should be fairly quick and demonstrate at the same time how the mother can apply it; which is most important.


Nari

(in reply to texaspt)
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Re: KT for torticollis - February 1, 2007 2:31:00 PM   
Andrew M. Ball PT PhD

 

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Okay Sebastian, if it's so simple to do an inhibitory taping for a child with right SCM torticollis --- then go ahead an "wow" us.

I'd be happy to inform if that might be concurrent or countercurrent to what's generally taught in a kinesiotaping course --- or do you REALLY not understand the undercurrent of what's happening here?

Beyond that, let's recognize that when a PT calls a technique something that it is not, be it kinesiotaping, the Maitland approach, the McKenzie approach, etc. --- it erodes the ability of researchers to cleanly (particularly upon retrospective chart review) assess effectiveness. This discussion is not dissimilar to the way that children are diagnosed for autism under slightly different criteria on the east cost than they are on the west coast. A lot of that has to do with determining children eligible for government or school services . . . but it has the effect of changing what an autistic child is. The effects of which are not insignificant. A study examining the effectiveness of a particular treatment technique upon children with autism in California, for example, isn't the same as a study done on children in North Carolina (the latter of which uses more liberal criteria).

Again, if you've not been to a course, don't call it kinesiotaping because it's not what you're doing (call it something else). The merits of kinesiotaping shouldn't be assessed on the basis of what untrained therapists have made up on their own. Many of the techniques are NOT intuitive.

Drew

_____________________________

Andrew M. Ball, PT, DPT, Ph.D.
Orthopedic Physical Therapy Resident
Carolinas Rehabilitation

(in reply to texaspt)
Post #: 16
Re: KT for torticollis - February 1, 2007 2:38:00 PM   
dfjpt

 

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Exactly, Sebastian and Nari and further up, SJ.

Here's what to do.
1. Take a little piece of tape.
2. Put it on the baby, somewhere you've carefully considered.
3. Observe the baby for several seconds to a minute.
4. If the baby seems more agitated, take it off, and try a new piece somewhere else.
5. Observe closely again.
6. Repeat steps 1. through 5. until you have the right size of tape on the right place the right way with the right degree of stretch.
7. You will observe that the baby relaxes, moves its wee head better, or is less cranky, or some combination thereof, when the tape is on "right."

If you have sufficient time, go ahead and take the time required to get this particular baby's neck happy with tape on.

Going to a taping course may give you ideas which may save you a bit of time, but it won't make you smarter or better able to problem solve, at least, not unless some tape genius does a study to prove this way is truly better than that way.

And do NOT bow to anyone's piece of paper or pieces of paper in general, or believe that you are somehow bestowed with an elevated status from being to someones tape cult course, learning secret info in exchange for money, keeping the info all clandestine because if the taping secrets were ever publically revealed they would seem less ...valuable. They would still be valuable, plus they would be shared rather than sold.

And do NOT feel inferior, or let anyone make you feel inferior, if you don't happen to possess or care to possess anyone else's scraps of paper certifying that you've paid them $x for listening to them download their opinions on you.

The secret tape cult thing, the superfluous sense of ownership of taping capacity that must be commodified, certified, bought and sold, irritates me nearly as much as certain individuals upholding that as a valid course of action, implying that without the course someone fully trained and licensed to observe and treat patients is still an ignoramus.

If you don't want to take a tape course and "pay" for someone else's "opinion" on the best way to tape, and come away with a "certificate" that you've taken on that individual's belief system, does that make you automatically by comparison, an ignorant idiot with no capacity to evaluate treatment processes in a baby? I don't think so.

(in reply to texaspt)
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Re: KT for torticollis - February 1, 2007 2:45:00 PM   
Andrew M. Ball PT PhD

 

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DFJPT,

That's fine. Just don't call it kinesiotaping. Also, I'm guessing you don't really treat too many kids to think that it would be acceptable to tape, rip-off, and re-tape several times (or possible to do so without REALLY agitating the kid).

FYI pulling on the contralateral SCM, which is the most common taping approach (because, I suppose, it initially "looks like it's achieving the desired effect", is REALLY irritating the the child and ends up increasing tone in the very muscle you're trying to relax, so whatever approach you try, don't do that.

Drew

_____________________________

Andrew M. Ball, PT, DPT, Ph.D.
Orthopedic Physical Therapy Resident
Carolinas Rehabilitation

(in reply to texaspt)
Post #: 18
Re: KT for torticollis - February 1, 2007 3:06:00 PM   
Andrew M. Ball PT PhD

 

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From: Charlotte, NC
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Texaspt,

Check your inbox.

Drew

_____________________________

Andrew M. Ball, PT, DPT, Ph.D.
Orthopedic Physical Therapy Resident
Carolinas Rehabilitation

(in reply to texaspt)
Post #: 19
Re: KT for torticollis - February 1, 2007 4:45:00 PM   
SJBird55

 

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AH... okay. So, document that you used the material kinesiotape during the treatment intervention of the infant... describe what you did with the kinesiotape, but don't say you used a kinesiotaping technique (because you haven't had any kinesiotape training). LMAO Yeah, I hear you, but how confusing. Explain to me exactly how using kinesiotape isn't a kinesiotaping technique? And, let's pretend a chart review was performed and let's pretend that charts were electronic medical records AND let's pretend that the search words used were "kinesiotape." How would one ensure that a kinesiotape certified person applied the kinesiotape when anyone can purchase it especially when attempting to do a search of records with kinesiotaping with a particular goal of determining potential effectiveness?

(in reply to texaspt)
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