How many times in your clinical practice do you hear from your patients, “I have been diagnosed with severe knee degeneration, and I have been told to limit certain activities”?
For some, this occurs way too often. When your patients hear this, what do you think it does to their perception of movement? What if they have fallen in the past? Disempowered patients are a big problem, and a defeatist mentality can further impair their outcomes.
It is your job as a clinician to restore movement and return patients to their desired lifestyles while reducing the likelihood of further impairment. There are many tools to assist you in this endeavor but, to put it most simply, clarifying their perception and eliminating uncertainty or fear of movement is usually the first step.
A good way of doing this is to incorporate gait assessment with kinesiology taping.
Balance and pain
In assessing the gait of your elderly populations, be aware of several factors. First is balance. The majority of patients have been walking around in shoes that have not only compressed the foot but also reduced the ability to stimulate the thousands of sensory receptors located there.
Most can’t feel the ground, and if they cannot feel the ground, they cannot properly organize their movement.
In addition, their feet have likely become weak, providing an unstable platform; this affects balance as well. As patients experienced fatigue more quickly, their risk of falling also increases.
The second factor to consider is pain. You know that nociception (i.e., the chemical signals the body can interpret as pain) affects motor output. If patients are in pain, their bodies continually move around the pain to continue interacting with the environment—this is how movement compensations progress.
For example, if you have heel pain, you might adopt a more forefoot strike with your gait. You might load the opposite limb to decrease pressure on that heel, or you might come up with a different strategy to continue moving and avoid pain.
Many faulty motor engrams are established to “protect” a person from their pain—all of which are dependent on their past medical history, environment or development. While in the interim these behaviors can change one’s perception of pain, in the end it can result in chronic deficits in mechanics, potentially leading to an array of other medical problems or conditions.
Finally, assess your patients’ confidence. Are they moving with assurance? How can you reduce their fear of moving and improve their proprioception—their body awareness—so they can walk better and improve their quality of living?
If you’ve ever been lost, or tried to walk in a room with the lights off, you know how nerve-racking that can be. Your movements become cautious and guarded and you lose the predict- ability of your surroundings, which in turn can be alarming.
To improve proprioception, the use of kinesiology tape can assist the mental “mapping” of movement by not only stimulating fascial receptors but also providing mechanical lift and shear on superficial layers of skin (via decompression or the lifting effect created by the tape).
By increasing spatial awareness—especially within a structure like the foot—you can tap into the sensory role that this limb plays for the rest of the body; thus, patients who are more in tune with their feet become better in tune with their environment.
What the research reveals
In addition to restoring balance, kinesiology tape has been shown to provide resistance to fatigue. A 2017 study was conducted to determine whether taping the knees and quads can reduce balance deterioration after a fatigue protocol of 30 minutes of downhill walking to induce fatigue. The results of this study suggested that “the use of kinesiology tape mitigated the exercise-related deterioration of balance observed when no tape was used,” meaning better performance and subjective confidence with movement.1
Additional research also supports the use of kinesiology taping for improving spatial awareness in populations with sensory ataxia. These subjects were more accurately able to “reproduce” limb angles when tape was applied as compared to controls without the additional benefit of kinesiology taping.
Another study demonstrated the importance of foot intrinsic strength and overall muscle performance of the gluteus maximus and the gluteus medius.2
The takeaway is that the foot is important for all populations—not just the elderly—and mechanisms that can increase perception and body awareness can go a long way toward improving not only patient outcomes but also the overall life experience of your patients.
Courtney Conley, DC, graduated from the National University of Health Sciences in 2003. She also holds a BS in kinesiology and exercise science from the University of Maryland. Conley currently owns and operates Total Health Solutions in Golden, Colorado, where her team of skilled professionals treat patients ranging from the weekend warrior to the ultra-distance athlete. She can be contacted through RockTape.com.
References
1 Simona Hosp S, et al. Eccentric Exercise, Kinesiology Tape, and Balance in Healthy Men. J Athl Train. 2017;52(7):636-642.2 Janda V. Muscle strength in relation to muscle length, pain, and muscle imbalance. International Perspectives in Physical Therapy. 1993:83‐97
