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

Scott & Dyanna Rezac - Evidence Based Taping 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.

Scott & Dyanna Rezac - Evidence Based Taping Talk the Talk What is OUT (not EBP) – –VMO re-education – –Joint Alignment / Patellar re-alignment – –Taping to effect nociceptors, mechanoreceptors, thermoreceptors, GTOs, muscle spindles, etc – things we can’t measure – –Taping for prophylaxis (with no injury) What is OUT (not EBP) – –VMO re-education – –Joint Alignment / Patellar re-alignment – –Taping to effect nociceptors, mechanoreceptors, thermoreceptors, GTOs, muscle spindles, etc – things we can’t measure – –Taping for prophylaxis (with no injury)

Scott & Dyanna Rezac - Evidence Based Taping 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 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

Scott & Dyanna Rezac - Evidence Based Taping Research Keep in mind when discussing the research out there the weight it holds: – –Small subject number – many <20 – –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 Keep in mind when discussing the research out there the weight it holds: – –Small subject number – many <20 – –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

Scott & Dyanna Rezac - Evidence Based Taping 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 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

Scott & Dyanna Rezac - Evidence Based Taping Asterisk / Comparable Sign This is your best measure of efficacy of your intervention. – –It addresses the patient’s 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. This is your best measure of efficacy of your intervention. – –It addresses the patient’s 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.

Scott & Dyanna Rezac - Evidence Based Taping 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 min at work.” – –Day 2 (next treatment following taping) – “Pt. reports pain 2-3/10 after typing on computer at work 3 hours.” 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 min at work.” – –Day 2 (next treatment following taping) – “Pt. reports pain 2-3/10 after typing on computer at work 3 hours.”

Scott & Dyanna Rezac - Evidence Based Taping 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. 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.

Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP 10 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! Scott & Dyanna Rezac - Evidence Based Taping

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. 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.

Scott & Dyanna Rezac - Evidence Based Taping 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 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

Scott & Dyanna Rezac - Evidence Based Taping Documentation What if you invented that tape job for that patient’s 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. What if you invented that tape job for that patient’s 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.

Scott & Dyanna Rezac - Evidence Based Taping Billing Follow your state’s regulations first and foremost! Taping – not well reimbursed for this code Bill for goal of taping – –Manual Therapy Codes – –Edema/Lymphedema – –Neuromuscular Re-education – –Patient Education Can’t bill for tape used in procedure, can have patients purchase their tape and teach them the technique Follow your state’s regulations first and foremost! Taping – not well reimbursed for this code Bill for goal of taping – –Manual Therapy Codes – –Edema/Lymphedema – –Neuromuscular Re-education – –Patient Education Can’t bill for tape used in procedure, can have patients purchase their tape and teach them the technique

Questions / Comments / Discussion Scott & Dyanna Rezac - Evidence Based Taping