Allergic Effect of Kinesio Tape on a Child with Spastic Cerebral Palsy- Juniper Publishers
Juniper Publishers-Journal of complementary Medicine
Abstract
Background and purpose: Kinesio taping is
widely used now on pediatric population. Recently, it has been used to
promote function, facilitate muscle action and inhibit spasticity of
children with cerebral palsy. The aim of this article to highlight an
existing problem we faced during the applying of kinesio tape on a child
with spastic cerebral palsy which is skin allergy.
Methods: Muscle Inhibitory Kinesio tape was
applied on the calf muscle of a female child of spastic cerebral palsy,
in order to inhibit muscle spasticity.
Results: Despite the child had passed the sensitivity test, after 2 kinesio tape applications, a skin allergic reaction appeared.
Conclusion: A skin allergy may appear after using the kinesio tape despite passing a pre-application sensitivity test.
Keywords: Kinesio tape; Skin; Allergy; Spasticity; Cerebral palsyAbbreviations: KT: Kinesio taping; GMFCS: Gross Motor Function Classification System; PDMS: Peabody Developmental Motor Scales; H/M: Hoffman Reflex/Muscle Response Ratio
Introduction
Kinesio taping (KT) application is a relatively new
technique used in the rehabilitation of children with spastic cerebral
palsy [1]. KT is a thin, elastic tape with thickness and elastic
properties similar to skin. KT is applied directly onto the skin [2]. It
is made of 100% cotton with elastic properties which allows KT to work
with soft body tissues. KT is free of latex and is applied to the
backing paper with 10% available stretch, and it can be stretched 40-60%
from the resting length. The adhesive on the KT is medical grade
acrylic which is heat sensitive. To apply the KT on the skin, it must be
rubbed in order to adhere [3].
KT is applied to the skin and as in every method
which contact the patient, it must be sure that it doesn’t produce any
harm. A sensitivity test via a test patch is applied prior KT
application [4].
Patient Information
We are reporting a 2year, 7 months female with
spastic cerebral palsy; Spasticity appeared unilaterally on the left
side of her body (left hemiparesis). She is on level II on gross motor
function classification system (GMFCS). Her developmental age was 9
months according to Peabody developmental motor scales (PDMS). No
medications were taken except Omega 3.
Methods
Evaluation materials
Modified Ashwar scale was used to evaluate the degree of spasticity which was graded 1, which meant a mild spasticity.
Hoffman Reflex/Muscle response ratio (H/M) ratio was
performed to clarify the presence of spasticity, and it was confirmed
that there was a presence of spasticity on the left soleus muscle GMFCS
was used to declare her level of gross motor function; she was on level
II which means that the child can be locomotive using assistive aid or
cursing on objects and furniture.
Management materials
KT was chosen to be applied in a muscle inhibitory
manner, in order to inhibit the soleus muscle spasticity as supported by
Karadag-Saygi et al. [5].
A sensitivity test was applied to the patient to
discover if she had any allergy to the KT or not. The skin was cleaned
carefully to remove any oil or dirt via water. A test patch was cut 5cm x
5cm square, it was placed on the soleus muscle and it was left for 3
successive days. The child was monitored by her care giver
and she reported that no itchy sensation by the child nor a red
patch appeared.
After the child passed the test, The KT was applied for the
purpose of calf muscle inhibition. Prior the application the skin
was cleaned probably via water.
One Y strap was prepared for the child. Maximum stretch of
calf muscle was applied, then the distance from tendonachllis and
the crease of the knee was measured. The KT was cut according
to the measured distance. The Y strap was applied from insertion
(anchor) to origin direction (base) from the tendonachllis to the
origin of soles muscle and gastrocnemius with 15% stretch of the
tape length, and then rubbed to adhere probably to the skin. The
KT was applied for six days and removed for 1 day as supported
by Gómez-Soriano et al. [6] to allow skin perspiration.
Observation and Outcome
It was planned that the child would receive 12 sessions of
KT application besides her regular physical therapy sessions,
but only after her second KT application it was reported that
child was in a continuous crying and her skin was very irritating
surrounding the tape, Also the skin covering the left calf muscle
was started to swell. The KT was removed immediately after
this notice and the area was cleaned properly via cold water to
remove any excess adhesive parts from the tape and to decrease
the irritation.
The mentioned allergy manifestations stopped after
removing the tape just in few hours. We stopped the usage of KT
application for this child.
Discussion
This study noticed a skin allergic reaction of KT on a child
with spastic cerebral palsy. KT is a great technique that is less
invasive to children due to its thin and elastic structure that
is similar to human skin tissue [2]. It is latex Free and formed
100% of cotton [7] which made it more likely to be less allergic
to children skin. It wasn’t the first time that it was reported a
case of skin allergy after KT application. It was reported before
that a neurologic patient with tetraplegia showed a skin allergy
following the use of KT [8]. A multi-centre study was performed
in four countries revealed that the incidence of skin reaction to
patients who used KT may reach 9.38% [9].
In previous studies we already report the presence of
skin allergic reaction after taping application, although all
precautions, preparations, sensitivity test and even proper KT
application was ensured [10-11]. Another observational study of
sixty neurological cases revealed that KT can cause Kinesio tape
can cause allergies [12].
Some suggested factors that may cause allergy, although a
further research is needed, such as applying to much stretch to
the KT, applying stretch to the anchor, hair follicle irritation to
the unshaved areas and skin irritation of fleshy shaft areas [13].
Regular checking up of skin following KT application is a must, to
notice any allergic reaction.
Conclusion
The KT sensitivity test is essential prior any KT application
but still it is not a total grantee. Some patients may pass the test
successfully but may be- later on - show allergic reaction to the
KT, even with proper application.
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