Application of Therapeutic Taping in Evidence-Based Practice (EBP)

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Application of Therapeutic Taping in
Evidence-Based Practice (EBP)

• Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP
• Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS

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Talk the Talk

• One of the key components of Evidence Based
  Medicine is communicating to your patients,
  colleagues and other medical practitioners what
  you are doing and why when you perform an
  intervention.

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Talk the Talk

• What is OUT (not EBP)
• VMO re-education
• Joint Alignment / Patellar re-alignment
• Taping to stimulate nocioceptors,
  mechanoreceptors, thermoreceptors, GTOs, muscle
  spindles, etc things we cant measure
• Taping for prophylaxis (with no injury)

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Talk the Talk

• What is IN
• Taping to unload
• Taping to provide biomechanical support
• Taping for postural awareness
• Taping to decrease over-extension of injured
  tissue
• Decrease pain
• Improve Function

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Research

• Keep in mind when discussing the research out
  there the weight it holds
• Small subject number many lt20
• Lots of case studies
• Few randomized control trial double blind
• Very few comparisons between specific types of
  tape application
• Clinical Objective Measures are still best
  evidence available

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Research

• What it does consistently support
• Decrease in pain rating scales
• Improvement in disability scores
• Improvement in functional tasks
• Decreased incidence of re-injury
• Prevention of over-extension on soft tissues
• Decreased inflammation / edema
• Potential psychological benefits
• Does not make them worse

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Asterisk / Comparable Sign

• This is your best measure of efficacy of your
  intervention.
• It addresses the patients functional goal (their
  complaint, limitation, etc.)
• For example Pt. reports unable to ascend/descend
  1 flight of stairs in their home carrying a
  basket of laundry
• It is objective and measureable
• 8 Step Up/Down Test would be appropriate
• Pre-tape Pt. able to perform 2-3 reps with pain
• Post-tape Pt. able to perform 10 reps with 75
  improvement in pain.

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Asterisk / Comparable Sign

• You may choose to evaluate your efficacy of
  taping from one treatment to the next.
• Day 1 (Taping) Pt. reports has pain 4-6/10
  after typing on computer 30-45 min at work.
• Day 2 (next treatment following taping) Pt.
  reports pain 2-3/10 after typing on computer at
  work 3 hours.

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Asterisk / Comparable Sign

• How do you decide if the tape worked?
• Objective
• Is it measureable?
• Could another clinician repeat the same measure
  with good reliability and validity?
• Functional
• Does it allow the person to accomplish a
  functional task better ADL, work, sport, etc.

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Taping Guidelines

• Tape for function, then pain
• Use least amount of tape to accomplish goal
• One technique at a time, test for efficacy
• Use objective measures
• Be creative, have fun!

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Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP
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Documentation

• Ok, you have this great objective, measureable
  goal and the tape worked. How do you document
  WHAT tape you did?
• This is the same dilemma we have with spine
  mobilizations (PVM, PAVM, FRSB, ERSB, etc.)
• It makes it difficult to reproduce between
  clinicians.

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Documentation

• If it is a technique presented by someone, use
  that
• Kinesio Tape supraspinatus faciliatation
• McConnell Medial Glide x2 (two strips) with
  elastic tape
• McConnell Navicular Lift and low-dye arch support
  with elastic tape

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Documentation

• What if you invented that tape job for that
  patients problem?
• Document what you were trying to accomplish.
• Elastic Tape R abdominal oblique faciliation x2
  and R quadratus lumborum faciliation x2.
• Elastic Tape space correction over L scalenes
  x3.

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Billing

• Taping not well reimbursed for this code
• Bill for goal of taping
• Manual Therapy
• In CO one code for all manual techniques
• In other states, could use Joint Mobilization or
  Soft Tissue Mobilization
• Edema/Lymphedema
• Neuromuscular Re-education
• Patient Education
• Cant bill for tape used in procedure, can have
  patients purchase their tape and teach them the
  technique

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• Questions / Comments / Discussion

dyanna.rezac_at_rezacpt.com scott.rezac_at_rezacpt.com w
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