Thursday, June 21, 2018

Cowboys, others partner on sports center at Frisco's The Star to help athletes raise their game

Great article featuring Alison Taylor!! Alison Taylor will be instructing the Kinesio specialty class, KT4 Hand Specialty, in El Paso, TX Oct 6. For more information please contact Judith Macias-Harris at judith.macias@cox.net or visit our website at http://sseminars.logopediaspeechtherapy.com

https://www.dallasnews.com/news/frisco/2018/06/20/new-sports-research-center-star-offers-state-art-tools-help-athletes-raise-game

Sunday, June 17, 2018

More or Less? Consider the Power of Microtaping Applications (MTA)

Great insights from Elizabeth G. Harvey, DPT, MSR, CKTI, CEIM, about the benefits of using smaller pieces of tape! This has been submitted to Advanced Healing for publication. Full publication with pictures will be uploaded soon!!  Elizabeth will be teaching the Kinesio Standardized Day 1- Day 3 curriculum in Maitland, FL, September 7-9, 2018. Please contact Judith Macias-Harris at judith.macias@cox.net, or visit our Sun Seminar website: http://sseminars.logopediaspeechtherapy.com for more information.



More or Less? Consider the Power of Microtaping Applications (MTA)

Elizabeth G Harvey, PT, DPT, MSR, CKTI, CEIM


Dr. Kase pioneered a therapeutic taping product that can impact body systems thru stimulus on the epidermis. Its design imitates the structure and function of skin. This is critical because as an organ, skin is dynamic, vigilant and adaptable. Within its’ architecture are the sensors that act as our interface with the environment. McGlone calls skin the “entry level to the cortex to … systems controlling perception, attention and emotion, as well as systems that integrate this information …” (2010).

Epidermis-Dermis-Fascia (EDF) taping applications asked you to take a leap of faith from previous dominance of muscle/joint tapings. It was not until the development of new technology, such as fMRI, that it was possible to operatively detect the neurologic changes that occurred. The fMRI research by Dr. Mendoza has shown that even EDF taping applications, which are smallest and most lightweight, influences neurologic activity.

Now we are moving again – to microtaping applications (MTA)! This is a new specialty curriculum created by Judith Macias-Harris and myself. In the case of sensory stimulation, these small but strategic tapings can be very effective. When skin is added to the equation of motor learning, less is more. The thought process behind MTA is the “Minimal Effective Dose”: how little do I need to add to a system to make a positive change? Neural plasticity is powerful. It is the “dynamic biological capacity of the central nervous system (CNS) to undergo maturation, change structurally and functionally in response to experience … achieved by modulating … molecular and cellular mechanisms that influence the dynamics of synaptic connections” (Ismail et al, 2017). Researcher Dr. Jefferey Kleim, works closely with rehabilitation professionals and has comprised a concept of plasticity called “Use it and Improve it” (Kleim and Jones, 2008). This Employs:
ü  Specificity (adaptation: neurologic reorganization)
ü  Repetition (repeated sufficiently)
ü  Intensity (“Goldilocks Zone”: not too easy, not too hard)
ü  Timing (repeated over time: duration)
ü  Salience (interest in activity: tolerance)
ü  Age (developmental age of brain at time of injury).

In addition to sensory benefits, maintaining skin integrity for those with fragile skin, such as pediatric and geriatric populations, is imperative. Esther De Ru’s work on mini-tapings in pediatrics, especially NICU patients, has been an important influence on the size of MTA applications. Her research discusses in detail skin’s maturation process post-partum and differences that occur depending on birth weight and prematurity (2017). The smaller MTAs have, thus far, not caused any skin irritation. They are also easy to apply and remove. Ease of removal is especially critical in cases of skin fragility or neurologic sensitivity. If it hurts coming off, rarely will you get to re-apply!

Triple Tragus Taping strategy

Initial probes into the effectiveness of these tapings has shown that MTAs can cause change in function/participation and posture, as well as biomarkers such as thermoregulation (Macias-Harris et al, 2017) and respiration (Harvey et al, 2017). Included in this article are several case studies in which manual therapy (Beckman Oral Motor Protocol) was used in conjunction with one MTA, the Tragus Taping (See Image 1). This application was created by Judith Macias-Harris, MS, CCC-SLP, BSLP, CKTI. It is intended to stimulate the skin over the TMJ and area where cranial nerves V and VII (facial and trigeminal) exit the skull. (This is the tape application that sold me on the MTA theory, so I felt it would be a great place to start your journey as well.) In all three cases, this application was applied by the same physical therapist with instruction to the caregiver to remove, from top to bottom, after three days of wear time, unless the child demonstrated discomfort. The therapist saw each patient once a week for an hour. Follow up questions on wear time and progress, as well as questions regarding any irritation from the application were reviewed at each weekly session.

The tape application process is called the “Inchworm Technique”. Minimal tension thru the tape (10%) is used, while the tape is applied with a manual superior to inferior glide up the tape. This is thought to create mini convolutions, or lift, in the skin thru the recoil process. Even in young patients with hyper vigilant sensory systems, this application has been tolerable. It has recently been demonstrated that skin stretch, in and of itself, directly affects motor behavior, or learning (apart from muscle/joint sensors) (Takayuki and Ostry, 2010). 

The MTAs can be used in conjunction with standardized KTA and as an adjunct to other modalities.

Elizabeth G Harvey, PT, DPT, MSR, CKTI, CEIM is owner of ABC Therapies LLC in Moncks Corner, SC. She can be reached at abctherapy@homesc.com

References:
1.    McGlone F, Reilly D. The cutaneous sensory system. Neurosci Biobehav Rev. 2010;34(2):148-159. https://www.ncbi.nlm.nih.gov/pubmed/19712693

2.    Ismail FY, Fatemi A, Johnston MV. Cerebral plasticity: Windows of opportunity in the developing brain. Eur J Paediatr Neurol. 2017;21(1):23-48. https://www.ncbi.nlm.nih.gov/pubmed/27567276


3.    Kleim J, Jones T. Principles of experience-dependent neural plasticity: Implications for rehabilitation after brain damage. J of Speech, Lang and Hearing Research. 2008;51:225-39.

4.       De Ru E. Is applying Elastic Therapeutic Tape on the skin of pre-term infants (NICU) and new-borns safe? Clinical Notes: Elastic therapeutic Taping in Paediatrics: Best Practice. 2017. Downloaded Aug 2016 from https://www.academia.edu/31331942/Clinical_Notes_2_ETT-Ped_taping_pre-term_infants_NICU_and_new-borns._Best_Practice


5.    Harvey EG, Macias-Harris J, Brown, KM. A prospective study of the posture and sensory stimulation method using a touch, treat, tape approach (PaSS Method®) to affect functional outcomes in children with dysphagia. NDTA Network. 2017; 24(3):12-14, 16-23.
6.    Macias-Harris J, Harvey EG, Lavigne T, Su Y. “Comparing surface and core temperatures between non-self-induced inflammation (NSII) and self-induced inflammation (SII) athletes with and without Kinesio tape®” Submitted for Poster Presentation at Kinesio® International Research Symposium and ASHA National Conferences. 2017.

Takayuki I, Ostry DJ. Somatosensory contribution to motor learning due to facial skin deformation. J Neurophysiology. 2010;104(3):1230–1238. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944698/

Monday, April 2, 2018

FAQ for using Kinesio Tape® for swallowing disorders related to Head/Neck cancer


Dysphagia typically presents as a common symptom of head and neck cancer or sequelae of its management (Gaziano, 2002).  Scaring, from surgical dissections in the cervical, upper extremity, and head/neck area, appears to be a universal condition affecting swallowing function. Scaring contributes to adhesions that limit interstitial fluid flow and muscle/tissue pliability. Also, “tissue changes” from treatment methods that address cancer management, affect skin integrity and decrease patient tolerance of stimulation for uses of modalities in these areas.



Heather Lazarides, certified in the Kinesio Taping® Method, and SLP specialist in swallowing disorders associated with H&N cancer, recommends the following information to consider when using Kinesio Tape®:
1.     There is no “magic placement” (when using Kinesio Tape®) to improve swallowing.
a.     First, provide a global assessment to identify what is causing the dysphagia.
b.     Next, identify how Kinesio Tape® can help treat for the relevant co-morbidities, additional pathologies, and secondary impairments associated with the etiology. 
2.     Physical symptoms to pay attention to:
a.     Scars: Scaring from a lateral neck dissection can restrict laryngeal elevation.
b.     Lymphedema: Assess to see if s/s of swelling on the patient’s suprahyoids is contributing to a decrease in hyoid excursion and epiglottic retroflexion.
c.     Shoulder dysfunction: This can be a secondary impairment from a radial neck dissection and removal of CN XI.

3.    I do feel that Kinesio Tape® is a valuable tool for SLPs to use, specifically those who specialize in H&N cancer. Taking the standardized Day 1-Day 3 curriculum can help to learn how to assess and problem solve how to apply Kinesio Tape® more exclusively in this area.





Speech Language Pathologists are an up and coming Kinesio Taping® discipline. It is always so good to hear from a fellow SLP interested in learning more about how to use Kinesio® Tape!!

Click here to see upcoming Kinesio Seminars

References:

       De Ru, E. (2017). Clinical Notes: Elastic therapeutic taping in Paediatrics: Best Practice. Is applying Elastic Therapeutic Tape on the skin of pre-term infants (NICU) and new-borns safe? Retrieved from  https://www.academia.edu/31331942/Clinical_Notes_2_ETT.
       Gaziano, J.E. (2002). Evaluation and management of oropharyngeal dysphagia in head and neck cancer. Cancer Control, 9(5), 400-409.
       Goodridge, S., (2012). Kinesio Tape application on hypertrophic scar formation. Retrieved from: http://www.aevnm.com/docs/socios/Articulos/Aut-Goodridge%20S.pdf, on 3/28/18.
       Harvey, E.G., Macias-Harris, J., Brown, K.M. (2017). A Prospective Study of the Posture and Sensory Stimulation Method Using a Touch, Treat, Tape Approach (PaSS Method®) to Affect Functional Outcomes in Children with Dysphagia. NDTA Network, May-June 2017, Emotion and Regulation, 24/3, Special Research Report, 1-15.


Disclaimer of Liability and Warranty
Information presented in this blog is designed to promote ideas and stimulate discussion. The goal of this blog is to provide a safe and friendly place to share stories or experiences, build an understanding of various teaching and treatment styles, and to network with each other.
The author(s) of this blog do not dispense medical advice nor prescribe the use of information as a form of treatment for medical problems with or without the advice of a physician. The intent of the author(s) is only to offer information of a general nature to help you cooperate with your doctor and clinical members in your mutual quest for good health. In the event you use any of the information in this blog for yourself, you are prescribing for yourself. The author(s) assume no responsibility for your actions, assessment, nor interpretations. No one associated with this blog will have liability for loss, damage, or injury, resulting from the use of any information found on this or any other page at this site.

FAQ- What is Kinesio Taping®?



I am a speech language pathologist and instructor of the standardized Kinesio® Taping curriculum. I thought it would be helpful to put together a FAQ on Kinesio Taping®, specifically for speech language pathologists!



WHAT IS THE KINESIO TAPING® STANDARDIZED CURRICULUM?
The standardize Day 1, Day 2, and Day 3 are designed to teach the following:
·         Day 1: The science behind Kinesio Tape® and its effects on systems of skin, periphery (nerves), fascia, muscles, joints, and circulatory/lymphatics
·         Day 2: Corrective techniques using specific cuts, tensions, and applications with Kinesio Tex Gold FPTM and Kinesio® Tex Classic
·         Day 3: Kinesio Taping®-  Clinical analysis and applications (e.g., mixing/matching tape products/cuts to address conditions with common etiologies)
·         All disciplines are required to take the same standardized curriculum. SLP/SLPA's are the only discipline required to take all three. This is due to ASHA bylaws on SLP/SLPA's being supervised, educated and certified to use medical modalities. 



WHO CAN TAKE THE KINESIO TAPING® STANDARDIZED CURRICULUM?
In order to attend a Kinesio Taping® seminar, each attendee must meet all of the following criteria:
1. Must have completed 80 course hours of anatomy and physiology
2. Must have a working knowledge of the musculoskeletal system
3. Must be able to do assessments by evaluating and/or diagnosing injuries and conditions.
4. Proof of completion of K1, 2 & 3 is required for KT4 participation.
5. Must have achieved or is a student in their junior or senior year (transcripts must be provided) working towards one or more of the following credentials: ARNP, ATC, CAT(C), CCSP, CDP, CHT, CLT, CMBT, CMT, CNMT, COMT, COTA, COTA/L, CPO, CPT, CPTA, CRN, CST, CT, DC, DO, DOM, DPT, Lac, LAT, LLCC, LMBT, LMP, LMT, LOT, LOTA, LPT, LPTA, MD, MDT, MLD, MOT, MOTR/L, MPT, MT, MTC, NCMT, NCTMB, NDT, NMD, NMT, NP, NRC, OCS, ODT, OMD, OPA, OT, OTA, OTC, OTR, OTR/L, PT, PT-C, PTA, PA, RMT, RN, RPT, RPTA, SLP/SLPA.

ARE CEU’S AWARDED FOR SPEECH LANGUAGE PATHOLOGISTS? WHAT IS THE PROTOCOL TO USE IT CLINICALLY AS AN SLP/SLPA?
·         Sun Seminars (http://sseminars.logopediaspeechtherapy.com) is the only partner-hosted venue offering CEU’s  (24 hours or 2.4 CEU’s)  for SLP/SLPA’s who take Day 1-Day 3.
·         All SLP/SLPA participants must register for a Day 1-Day 3 block session listed (all other disciplines can take Day 1-Day 2 only, with Day 3 and KT4 seminars being optional).
·         SLP/SLPA’s must take the certification class (Day 3) and pass the exam to become certified to use Kinesio Tape® for clinical and billing purposes.
·         Pre/post assessments will be administered for Day 1-Day 3

ARE THERE ANY KINESIO TAPING SEMINARS FOR SPEECH RELATED AREAS?
Our KT4's are specialty classes. We are getting ready to launch our newest KT 4 called "Microtaping applications for fragile populations using Kinesio Tape). I am the lead author of this curriculum. It was also co-written by my very good friend and colleague, Elizabeth G. Harvey, DPT, MSR, CKTI, CEIM.

Here is the class description: 
KT4 Specialty Class: Microtaping (MTA) applications for fragile populations using Kinesio Tape®
(Prerequisite, completion of KINESIO UNIVERSITY approved Day 1- Day 3 courses)
This course offers the participant taping strategies using smaller cuts, lighter tensions, and specific taping products (Kinesio Tex Gold Light Touch Plus (LT) and Kinesio Tex Classic Fan Cuts) to address postural alignment, core stabilization, jaw stability, tongue control and lip mobility. Also included are taping strategies to promote respiration, digestion, and scar management. A new cut, the “Long and Short”, will be introduced for multidirectional fascia release. The purpose of the class is to focus on “minimal effective approaches” to promote function (e.g., alignment/stability, balance, swallowing), skin integrity, and comfort for fragile populations (e.g., infants, geriatric, neurologic populations (adult/ped). The participant will be introduced to case studies, focusing on incorporating standardized Kinesio taping applications with microtaping (MTA) applications.


INFORMATION AND LITERATURE ON KINESIO TAPING® USED IN THE HEAD AND NECK AREAS:
1.     S-tape technique designed to address drooling

2.     The Clinical Effectiveness of Using Kinesio Tape Following Wisdom Teeth Extraction. Henderson, Sarah Louise and Alexanders, Jenny and Shaw, Thomas in Journal of Physiotherapy and Physical Rehabilitation

3.     Taping in the orofacial region. 

4.     Effectiveness of Kinesiologic Taping Therapy in Drooling Management among Children with Cerebral Palsy N=30 Aged 2-6
Romana Pervez, Ayesha Kamal But, Noreen Tabassum 

5.     Dr. Dwajee's study Lip tape therapy in patients with a
cleft lip – a report on eight cases.

6.     The Kinesiology Taping as a method supporting central
facial nerve damage (VII) therapy English abstract only

Other studies:

1.     Does Elastic Therapeutic Tape Reduce Postoperative Swelling, Pain, and Trismus After Open Reduction and Internal Fixation of Mandibular Fractures?


2.     Kinesio Taping for temporomandibular disorders: Single-blind, randomized, controlled trial of effectiveness


Disclaimer of Liability and WarrantyInformation presented in this blog is designed to promote ideas and stimulate discussion. The goal of this blog is to provide a safe and friendly place to share stories or experiences, build an understanding of various teaching and treatment styles, and to network with each other.
The author(s) of this blog do not dispense medical advice nor prescribe the use of information as a form of treatment for medical problems with or without the advice of a physician. The intent of the author(s) is only to offer information of a general nature to help you cooperate with your doctor and clinical members in your mutual quest for good health. In the event you use any of the information in this blog for yourself, you are prescribing for yourself. The author(s) assume no responsibility for your actions, assessment, nor interpretations. No one associated with this blog will have liability for loss, damage, or injury, resulting from the use of any information found on this or any other page at this site. 


Tuesday, March 13, 2018

Elastic Therapeutic Tape in the Facial Region: Perspective


Recently, I was asked to comment on a picture where elastic therapeutic tape was applied on the face. I immediately noticed the facial taping strategy was listed as “The taping strategy for facial paralysis”. I could understand why and how the authors considered the taping strategy as such. My initial taping strategies focused on prescriptive strategies vs applying the properties of tape to treat for effect. After becoming more versed in using elastic therapeutic tape, I have learned many things. Specifically, using less tape in the facial region is best!! 
(Image obtained from https://mir-s3-cdn-cf.behance.net/project_modules/disp/c6330c11823015.5625673dd9a09.jpg)
To reiterate, elastic therapeutic tape does not treat for etiologies. It treats for the relevant co-morbidities, additional pathologies, and secondary impairments associated with the etiology.  In this case, what information, i.e., co-morbidity, additional pathology, and secondary impairment, had been factored as contributing to “facial paralysis”. Was it due to swelling, neuro damage, tonic/phasic muscle relationships, or a combination of these factors? Second, what did the assessment data suggests on how to best use tape as a treatment modality? 
A colleague I admire, follow, and learn from is Esther De Ru. Esther is a well-respected physiotherapist from the Netherlands (click here to see Esther's work). She has been an allied health professional for 50 yrs. She is a leading published expert, instructor, and researcher with a focus on using elastic therapeutic tape related to taping in geriatrics, pediatrics, neurology and head/neck and orofacial disorders. 
She also provided feedback on using elastic therapeutic tape in facial areas that I would like to share:
1.    Good diagnostics are needed to determine how tape will be used.
2.    Taping goals should be established before tape applications are applied.
3.    After applying tape, tape application should be re-assessed for an immediate effect, otherwise, not used.

She also added other applicable considerations about the facial area:
1.    Please be very careful when applying tape in the facial area. Please remember that all muscles, unlike the rest of the body are innervated by cranial nerves as well. The skin is thinner around the eyes... be extra careful there.... the circulation of the facial skin is more profuse, the division of areas of extra mechano-receptors is also different to the rest of the body.
2.    Meridians end in the face. A swelling as after wisdom tooth removal, can be addressed nicely with a lymph technique but be careful when 'addressing facial paralysis'. 

The effectiveness of using elastic therapeutic tape relies heavily on understanding its properties. What are your thoughts?

Looking forward to sharing more on this topic in future blogs!!
Best, J

For more information on upcoming Kinesio Taping Seminars, click here


Disclaimers: Information presented in this blog is designed to promote ideas and stimulate discussion. The goal of this blog is to provide a safe and friendly place to share stories or experiences, build an understanding of various teaching and treatment styles, and to network with each other. The author(s) of this blog do not dispense medical advice nor prescribe the use of information as a form of treatment for medical problems with or without the advice of a physician. Clinicians are recommended to receive proper training and certification as governed by their professional association. The intent of the author(s) is only to offer information of a general nature.  The author(s) assume no responsibility for your actions, assessment, nor interpretations. No one associated with this blog will have liability for loss, damage, or injury resulting from the use of any information found on this or any page of this site.

Monday, March 5, 2018

The beginning of an SLP Kinesio Taping® Practitioner/Instructor


I am excited to see more and more SLP’s becoming Kinesio Taping®  practitioners!

In 2013 I was asked to provide dysphagia therapy to a 13-year old boy with a medical diagnosis of Cerebral Palsy. He enjoyed eating, but required many modifications, i.e., mechanically soft diet supplemented with honey thick liquids, for safety. He received hydration and supplemental feedings through a G-tube. He was recommended not to have thin water for oral hydration or sampling. He was a wonderful candidate for NMES (neuromuscular electrical stimulation) however, NMES was judged to be of limited benefit. He presented with global low tone and postural malalignments as secondary effects associated with his medical diagnosis. In essence, this level of therapy could improve areas above the neck, but very little below the neck. And everything below the neck matters! Swallowing is described as a “pressure driven system”. Think of a sink and water trying to get down. You need an interplay of positive and negative pressure to quickly project something forward and to forcefully suction it down. In this person’s case, both pressure systems (above and below the neck) appeared to be functioning ineffectively and inefficiently. 

At that same time, I had an SLP colleague and friend who informed me how Kinesio® Tape had helped her planter fasciitis during a recent race. After some research on the coursework, I felt there was something to be gained with learning more about the Kinesio Taping® Method.

This was the first time participating in an interdisciplinary seminar series where I was not the clinical expert. This course educated me on whole body anatomy. I learned the Kinesio Taping® Method orthopedic/musculoskeletal perspective. Although professionally my focus is more neuromusculoskeletal, I was able to apply the clinical concepts and taping applications to his specific needs.

I used a combination of Kinesio Tape® applications and NMES for a period of six (6) weeks. He received a follow-up modified barium swallow study. I was present and anxious to hear the results! The study cleared him for an upgraded change in textures of solids and liquids. His words to me were, “Now I can drink out of a juice box just like everyone else”. On the way out, he took a sip from a water fountain. I literally cried all the way home!!!

Well, so much has changed for me these last five (5) years as a Kinesio Taping® Practitioner. I have learned the intricate relationship between the physiologic systems of “skin”, “nervous system”, “fascia”, and “circulation”. I have learned skin to be “the outer brain”. I have learned manual techniques using tape cuts, placement strategies, and use of tension to encourage improvement of underlying factors that affect neuromusculoskeletal conditions associated with dysphagia and “the periphery”. In 2014 I became a Certified Kinesio Taping® Instructor and currently teach the standardize Kinesio Taping® curriculum to interdisciplinary participants. 

(Me with the incredible Dr. Kenzo Kase, mentor and inventor of the Kinesio Taping® Method)

It may sound a bit odd for an SLP to instruct to professionals more versed in orthopedic areas, however, it has been a refreshing experience! Although clinicians specialize in different areas and practice under separate constructs, collectively we were all parents, siblings, friends, and family members with a person affected by a neurological condition. I am happy to provide a different perspective and use of Kinesio Tape® that is relevant and applicable to the head/neck and peripheral regions! (See list below for literature and references on using elastic therapeutic tape for head/neck regions)


I look forward to sharing more of my experiences using Kinesio Tape® in future blogs!

Best, J

Disclaimers: Information presented in this blog is designed to promote ideas and stimulate discussion. The goal of this blog is to provide a safe and friendly place to share stories or experiences, build an understanding of various teaching and treatment styles, and to network with each other. The author(s) of this blog do not dispense medical advice nor prescribe the use of information as a form of treatment for medical problems with or without the advice of a physician. Clinicians are recommended to receive proper training and certification as governed by their professional association. The intent of the author(s) is only to offer information of a general nature.  The author(s) assume no responsibility for your actions, assessment, nor interpretations. No one associated with this blog will have liability for loss, damage, or injury resulting from the use of any information found on this or any page of this site.