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Re: KT for torticollis

 
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Re: KT for torticollis - February 1, 2007 2:31:00 PM   
Andrew M. Ball PT PhD

 

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From: Charlotte, NC
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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 #: 41
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)
Post #: 42
Re: KT for torticollis - February 1, 2007 2:45:00 PM   
Andrew M. Ball PT PhD

 

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Joined: July 29, 2002
From: Charlotte, NC
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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 #: 43
Re: KT for torticollis - February 1, 2007 3:06:00 PM   
Andrew M. Ball PT PhD

 

Posts: 922
Joined: July 29, 2002
From: Charlotte, NC
Status: offline
Texaspt,

Check your inbox.

Drew

_____________________________

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

(in reply to texaspt)
Post #: 44
Re: KT for torticollis - February 1, 2007 4:45:00 PM   
SJBird55

 

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From: Michigan
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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)
Post #: 45
Re: KT for torticollis - February 1, 2007 5:32:00 PM   
Sebastian Asselbergs

 

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From: Barrie, Canada
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Drew, Drew, Drew. Having trouble reading my posts? Now it has become a challenge on whose tape suggesion is better? Oh my goodness - a p*ssing match!

Drew, check and see if you can find the sentences with a questionmark at their end - in my posts. You see? Those with "new technical knowledge" and such....try to answer some of them, since they refer to statements YOU made.

Furthermore, WHERE do you see me using the word "kinesiotaping"? (pssst: this is a question too...)


Drew, even IF a technique goes "counter" to what the course teaches - WHAT argument do YOU have that the course's technique is any better? Anything at all? Since there is no research or other evidence - except your word....

And Drew - I have NEVER had a patient complain (6 month old or 87 year old) about the removal of the tape - NEVER. The Ultrafix (the base-tape I use) under the Leuko-tape does a great job of adhering without hurting on removal.

And please, please! Think! WHO came up with kinesiotaping? An UNTRAINED person - because they were the first; and likely with some trial and error. Now you imply that that was a unique event and no-one else can come up with it without a course....My goodness....

Don't you see that you are just working very hard here to justify your course fees?

_____________________________

Mundi vult decipi

(in reply to texaspt)
Post #: 46
Re: KT for torticollis - February 1, 2007 6:14:00 PM   
Andrew M. Ball PT PhD

 

Posts: 922
Joined: July 29, 2002
From: Charlotte, NC
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Sebastian,

I politely ignored your questions because I didn't want to point out the obvious and make you look foolish. If you insist, however, so be it . . .

You'd use Leukotape over Ultrafix on an infant's neck?!?!? Forget that it's not possible to tape in an inhibitory fashion with those materials (although it is possible to yank and pull on the contralateral side --- or irritate an infants fragile skin --- especially with the repeated "trail and error" approach suggested earlier in this thread), suggesting that you really don't completely understand the properties of the kinesiotape versus leukotape. It's no wonder that you're holding fast to the idea that you can figure it out . . . you don't realize what you don't know.

I think about your taping suggestion of an infant with torticollis using Ultrafix and Leukotape and one word comes to mind . . .

OUCH!

I'm not all that surprised at the "yank-it-back" to neutral approach, considering that none of the clinicians, other than me (and correct me if I'm wrong), that have offered a solution have ever been pediatric clinicians in the first place. It's even what I may have thought to do before having taken a kinesiotaping course (yes, I just called myself "historically ignorant").

NEWSFLASH --- Inhibitory SCM Kinesiotaping is a heck of a lot more gentile than using Ultrafix and leukotape to yank on the contralateral side. How about we get past the Ultrafix/Leukotape suggestion being too ridiculous to consider --- and THEN we can talk about the effectiveness of gentile inhibitory SCM kinesiotaping? I'd be happy to share information about how, in my experience, more efficient outcomes (in terms of number of visits to successful outcome) when inhibitory SCM kinesiotaping was incorporated into the treatment program.

The next thought is that you've proven my point that new technical knowledge IS required and that SCM inhibition kinesiotaping is NOT self-evident to the average clinician --- but I suppose that point is self-evident to most reading the thread by now.

I am NOT a kinesiotaping instructor. I teach courses on evidence-based pediatric and adult neurorehabilitation. Kinesiotaping is not a topic covered in any of my courses. Nevertheless, I think that TexasPT would agree that exploration of a kinesiotaping course would be in her best interest should she continue to treat kids with torticollis.

Unless TexasPT would like to share some concluding thoughts, I think we're done here.

Drew

_____________________________

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

(in reply to texaspt)
Post #: 47
Re: KT for torticollis - February 1, 2007 10:25:00 PM   
SJBird55

 

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Joined: May 11, 2004
From: Michigan
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Yeah... TexasPT... you definitely SHOULD register for a kinesiotaping course - a course that is unproven and lacking evidence. Oh, there are LOTS of testimonials... and if you go to the CSM, you'll find the vendor there ready to share all the special properties of the tape AND LOTS of testimonials. Weak research or research only funded by their very own institute is readily available too!

HeHe Drew even has his own testimonials! Good to know.

If we look at the history of McConnell taping (basically the combination of that nice soft white protective tape with a top layer of Leukotape), it is very, very interesting that studies have shown that no one needs any special training... a patella can be yanked even the wrong theoretical way and respond to the tape in a positive fashion... and doing nothing with the forces of the tape but just slapping it on will have an effect... hmmm... apparently proprioceptive information is proprioceptive information.... hmmm...

Drew, your hole gets deeper and deeper each time you post - would you like a rope? Ah, but the question is, would you trust me to help pull you out? ;)

(in reply to texaspt)
Post #: 48
Re: KT for torticollis - February 2, 2007 12:01:00 AM   
nari

 

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From: Australia
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SJ,

Good post.

Nobody needs special courses for McConnell, as placement of the tape does not matter much....it is the tape that talks to mechanoreceptors in the skin, not its anatomical placing. It certainly does not alter the considerable forces behind the patella's tracking. Resolve pain with a strip of tape, and a few exercises seem to work well. And that is using only Ultrafix/Fixomull or whatever.

Removing tape from skin is hardly traumatic if it is done with consideration. The only real ouch comes from removal off hairy skin and babies have a shortage of that - or ought to. At least on their neck regions....

Testimonials are a sure indicator of pseudoevidence. Which everyone knows.

Nari

(in reply to texaspt)
Post #: 49
Re: KT for torticollis - February 2, 2007 5:24:00 AM   
Sebastian Asselbergs

 

Posts: 2293
Joined: September 30, 1999
From: Barrie, Canada
Status: offline
Dear Drew, you have absolutely NO IDEA what my taping is all about - have you used it?

"It's not possible"....
Have you tried it? Have you seen any evidence of it being "bad"? Have you ANY idea what kind of inhibition or fascilitation can be obtained with the (my) tape technique? And WHERE is the evidence for yours? Remember, I am NOT making claims of being better than you - you are making claims of being better than those poor un-enlightened in the Kinesiotape-magic....

And where do you see that there is "yanking on the contra-lateral side"?

I have never irritated an infant's skin - ever. You seem to have some evidence of this happening. Care to share it? Or is it too personal an experience?

Geesh, it's not just a deep hole you are digging - you seem to be intent to close it over yourself...

Oh my. I will stop - I am getting embarrassed for PTs everywhere that YOU - supposedly MORE educated in research and its dissimination - can make such a fool of yourself. Don't worry, my boy, I will not bug you any longer - on this subject....

_____________________________

Mundi vult decipi

(in reply to texaspt)
Post #: 50
Re: KT for torticollis - February 2, 2007 8:18:00 AM   
texaspt

 

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Joined: January 28, 2007
From: Houston, TX
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Wow, I didn't realize this question would evoke such a hot topic. :) Thanks everyone for responding. I am going to wait a couple of weeks prior to initiating any taping - mom is extremely conservative in her approach to treatment of this infant... and the baby seems to be tolerating stetching well. My main concern was her positioning while traveling in the carseat - other things such as towel rolls, pillows etc are not working in keeping her positioned at or near midline. The main problem is her carseat, which has little recline to the backrest. In any event, I am attending a taping course this Spring. Dani Trees, PT

(in reply to texaspt)
Post #: 51
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