Session 406: Active Care Pain Control Techniques & Tools to Clinically Progress Patient Outcomes

Transcription

1 To comply with professional boards/associations standards: I declare that I (or my family) do have a financial relationship in any amount, occurring in the last 12 months with a commercial interest whose products or services are discussed in my presentation. Additionally, all planners involved do not have any financial relationship. Requirements for successful completion are attendance for the full session along with a completed session evaluation. Vyne Education and all current accreditation statuses does not imply endorsement of any commercial products displayed in conjunction with this activity. Session 406: Active Care Pain Control Techniques & Tools to Clinically Progress Patient Outcomes John Hisamoto, PT, ATC & Shawn Burger, PT, DPT Leading the Way in Continuing Education and Professional Development.

2 John Hisamoto PT, ATC Owner, Pro Active Physical Therapy Shawn Burger, PT, DPT Owner, PearFIT Physical Therapy Before we get started Phones Names on workbooks Bathrooms Waiver Pre test Latex Allergies? Anything else

3 Today s Schedule Evidence based Pain Relief Tools & Techniques Kinesiology Tape Topical Analgesic Biofreeze Cryotherapy Pain Relief Tools

4 31 websites on kinesiology taping reviewed 58% had anecdotal testimonials to promote Websites are poor quality and present misleading, imbalanced information Buetel & Cardone IJSPT. 9(5):666 73

5 Effectiveness of Kinesiology Tape on musculoskeletal pain & disability > 4 weeks Moderate effect size for kinesiology tape on pain reduction vs. minimal interventions More tension and longer applications associated with lower effect size A Mega Review of Kinesiology Taping Research (Page et al. 2015) + Trivial benefit; as effective Harmful ++ Clinically beneficial? Unclear/ inconclusive 0 No benefit

6 Kinesiology Tape Research Summary Various studies (and reviews) have various outcomes As effective as other minimal interventions for musculoskeletal pain Reduces pain acutely (about 1 week) Potential for small improvements in muscle and joint Limited research on neurological & circulatory Kinesiology Tape should not be used as standalone intervention May speed recovery when combined with other Kinesiology Tape Facts Mechanism of action unclear Research supports short term pain relief (Lim & Tay 2015) Other outcomes remain unproven (Page 2015) Specific patterns, directions, and tensions are not substantiated Tape tension is important; less is probably better (Lim & Tay, 2015) You don t need certification or a training course to tape! XactStretch TM Integrated stretch guides for 25% and 50% XactStretch TM Performance Best in class adhesion and durability Research Most comprehensive research library (over 200 studies) including over 140 techniques Integrated stretch guides for 25% and 50% Performance Best in class adhesion and durability Research Most comprehensive research library (over 200 studies) including over 140 techniques

7 XactStretch Integrated Stretch Guides *Different brands have different available tensions ~0% paper off tension ~100% Available tension Easier to provide EXACT tension XactStretch TM 0% Paper Off Tension 25% of Available Tension 50% of Available Tension TheraBand Kinesiology Tape Stress Strain Kinesiology Tape tension exponentially increases after 50% elongation Recoil?

8 Specified Kinesiology Tape Tensions with Positive, Significant Outcomes (Page et al. 2015) Number of Studies with Significant Outcome, by tension % 0 25% 25 50% 50 75% 100% In well controlled studies with significant outcomes, 86% of studies utilized tension <50%; The most common tension used was <25%. Kinesiology Tape Techniques Application Recommended Tension* Muscle Support < 50% Joint Support < 50% to facilitate motion > 50% to restrict motion Neurological Support < 25% Circulatory Support < 25% Greater than 50% tension may increase skin irritation Use XactStretch Indicators! *We are not making claims that these tensions produce these results TheraBand Kinesiology Tape increases skin blood flow regardless of tension, and continued for 3 days of wear (Alexander et al. 2015)

9 A comparison of adhesion qualities of kinesiology tapes (Topp et al. 2015) *Significantly less adhesion TheraBand Kinesiology Tape *KinesioTex Tape *KT Tape TheraBand Kinesiology Tape provides significantly more adhesion than competitors Cut Measure length Cut & Shape Remove backing Tear backing 2 anchors Bandaid tear Apply Posture Anchor Tension Rub Handle the Tape Tape Cuts and Patterns

10 May be used up to 5 days Caution with > 50% Remove if symptoms worsen Remove if skin irritation (itch, burn) Dry with towel Press down on bare skin next to tape and pull Aftercare is critical! The sustainability of the tape depends on the application 8 Colors Ranging from Subtle to Bold Black/Black Black/Gray Black/White Beige/Beige Pink/White Blue/Blue Hot Red/Black Electric Green/Yellow What can Kinesiology Tape help? TMJ Neck pain/whiplash Shoulder Impingement Elbow Pain Low back pain Anterior Knee Pain ACL Reconstruction Knee OA Total Knee Replacement Plantar Fasciitis Maxillofacial surgery Chronic Spinal Cord Injury Lymphedema Cerebral Palsy Impairments Limb lengthening surgery Chronic venous insufficiency Focal Dystonia

11 Additional Pain Relief Tools Cryotherapy effects of Biofreeze Cryotherapy effects induced by Biofreeze products include: Decreased skin temperature (Benkaci 2005) Increased skin blood flow (Craighead & Alexander 2016) Decreased arterial blood flow (Olive et al. 2010, Topp et al. 2011, 2013, 2014) 0 Statistically Significant AND Clinically Meaningful Changes in Pain neck back knee hand 0.5 Change in Pain (VAS score) * * * Minimal Clinically Important Difference * Clinically important Difference (Bishop 2011, Zhang 2009, Topp 2013, and Sundstrup 2014)

12 A comparison of topical menthol during delayed onset muscle soreness n = 16 healthy subjects Induced DOMS in biceps; applied ice or Biofreeze 2 days later Biofreeze reduced DOMS significantly more than ice by 63% The Effects of Biofreeze on Self Discharge Rates Setting Outpatient PT clinic in New York History Average discharge rate 6.5% over 3 previous years One and done self discharged patients Study Provided Biofreeze Spray to all new patients over 6 month period Results Self discharge rate reduced to 1.6% (a 75% reduction) Biofreeze Professional Pain Reliever Optimized Formula Smoother consistency Lasts longer Available in: Gel Roll On Spray 360 Available only to healthcare professionals! Optimized Formula!

13 Biofreeze Professional Pain Reliever Biofreeze in Practice In the Clinic: At Home: Manual Therapy Pre/Post Treatment Soft Tissue Mobilization Ultrasound Kinesiology Tape Pain (4x/day) Pre/Post home exercise Kinesiology Tape Biofreeze and Ultrasound There is no evidence of the effectiveness of phonophoresis with Biofreeze or any other menthol based topical analgesic. DO NOT use Biofreeze as a 100% coupling agent during ultrasound it may diminish the transmission of sound waves or damage the sound head crystals. MIX Biofreeze with ultrasound coupling gel at ratios between ½ and ¼ Biofreeze to Ultrasound Gel (Rigby et al. 2014, Myrer et al. 2001) Use 1.0 w/cm 2 at 3 MHz

14 "Tape & Spray" Use TheraBand Kinesiology Tape and Biofreeze at the same time for pain relief How to apply TheraBand Kinesiology Tape and Biofreeze Spray safely at the same time: 1. First apply TheraBand Kinesiology Tape as indicated 2. Apply Biofreeze spray on and around tape up to 4 times a day Using Biofreeze Safely Avoid contact with mucous membranes Apply no more than 4 times a day Mild burning sensation, subsides over time Do not use with a heating pad Do not bandage tightly Wash hands after application Topical Menthol, Ice, Peripheral Blood Flow, and Perceived Discomfort Menthol and Ice reduce blood flow through different mechanisms. When combined, they have an additive effect.

15 When frozen, pearls create the frozen peas effect, and offer ice therapy without sacrificing flexibility When microwaved, pearls conform and deliver soothing heat therapy to the desired body part. Thera Pearl Key Benefits of THERA PEARL Technology Conforms to body when frozen No condensation or leakage Place directly on skin Maintains temperature for 20 min Velcro straps Reusable Clinical Retail Offering Sports Pack Sports Pack with Strap Back Wrap Neck Wrap Knee Wrap Ankle/Wrist Wrap Face Mask Pals for Kids

16 Janda s Upper Crossed Syndrome Neck Pain Stability Mobility Pain Control Lateral Epicondylitis Stability Mobility Pain Control

17 Shoulder Impingement Stability Mobility Pain Control Janda s Lower Crossed Syndrome Lower Back Pain Stability Mobility Pain Control

18 Anterior Knee Pain Stability Mobility Pain Control Performance Health Academy Research Articles Exercise Videos and Techniques CE Courses Appendix: Taping Techniques

19

20

21

22

23