Slide 1. Slide 2. Slide 3 Topic 13 5: Tapotement TAPOTEMENT DEFINED

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1 Slide 1 Slide 2 TAPOTEMENT DEFINED French derivation of an Old French term taper: a light blow, which in turn was derived from the Anglo-Saxon term taeppa, meaning to tap, in the sense of draining fluid from a cavity. Percussion comes from percussio, which means a striking Slide 3 Rapid, rhythmic percussion stroke using hands in various formations to drum on client. Varies depending on speed, force, length of application. Short bursts of forceful tapotement stimulating to both local area and body as whole. Longer applications relax body area and body as whole.

2 Slide 4 (physiological) Very light tapotement with fingertips causes vasoconstriction of superficial capillaries. Moderate drumming applied with medial sides of hand causes vasodilation and increased circulation. Brief applications of light percussion help tone atrophied muscles. Long applications of moderate percussion help soothe areas of hypersensitivity. Slide 5 Should not be used directly after athletic activity; may cause muscles to cramp Tapotement over kidneys and floating ribs contraindicated; may be damaged by stroke. Slide 6 Avoided on boney areas (especially spine) and over bruises and varicose veins. Check with client regularly to ensure strokes are comfortable.

3 Slide 7 Hold hands in different formations for different types of tapotement. Hacking uses ulnar side of hand. Cupping uses hands shaped like cup. Slide 8 Hands held open in slapping. In pincement fingertips used to pick up small bits of superficial tissue. See Technique 22: Tapotement. Slide 9 Applied to dry or oiled skin; even over drape. Often called percussive stroke; similar to drumming. Rhythm very important in delivery. Irregular strokes that suddenly speed up or slow down can feel irritating to client s nervous system.

4 Slide 10 Move up and down and across body area fluidly. Avoid overtreating one area. Keep moving stroke. Slide 11 Keep your wrists and fingers loose. Stiff wrists or fingers may hurt client or yourself. Practice on soft surface like pillow, with music, to improve your rhythm and regularity. Slide 12 TAPOTEMENT TECHNIQUE tapping, pincement, hacking, cupping, beating, pounding, slapping,, quacking, plunging, bonging Thicker, heavier muscled areas absorb more force, and thinner tissue delicate areas require a smaller, lighter tap. Endangerment areas require care with the application of tapotement.

5 Slide 13 TECHNIQUE Percussion may be applied directly to the skin or through the drape. Begin with light pressure & moderate strike speed, gradually increasing speed and finally diminish speed & depth. Deliver stroke rhythmically, allowing your hand to spring back after contact To avoid bruising, keep wrists loose & fingers relaxed while making skin contact. This technique take a lot of practice. Slide 14 TAPPING TAPOTEMENT Use fingertips of one or both hands. Vary time & speed of tap to produce a variety of tapping sensations. Rapid, but consistent delivery of pressure and speed produces punctuation tapotement. (a hard version is excellent for the feet) Pulsing tapotement is performed one handed, with alternate deep & light tap. Raindrop tapotement is commonly used on the face or scalp & feels like light rain. Slide 15 PINCEMENT TAPOTEMENT Pincement or plucking tapotement lift the skin in a similar manner to skin rolling. Grasp the skin using quick striking motion, lifting & releasing the tissue while the opposite hand follows suit. This action is classified as tapotement but resembles petrissage because of its distinct lifting effect.

6 Slide 16 HACKING TAPOTEMENT Use the ulnar border of one or both hands. Alternately strike the skin. Hold hands loosely with fingers slightly spread. On contact, the momentum of the stroke causes each finger to contact the one below it. Slide 17 HACKING TAPOTEMENT CONT. Hacking across large mm fibers, with fingers transverse to the mm grain, stimulates mm spindle activity. (stimulating small contraction in the mm) Quacking is a variation of hacking which places both palms together. The skin is struck using only the sides of the third, fourth, and fifth finger or just the fifth finger and the ulnar border. The air moving out of the hands makes a quacking sound. Slide 18 CUPPING TAPOTEMENT Curve the palmar surface of the hand into a cup, as if holding water. Strike the skin with the edge of the cupped hand. A hollow popping sound will occur. This is the treatment of choice for loosening mucus & phlegm in chest. This stroke may not be pleasant to some, so end with several soothing strokes You can induce positional drainage by positioning the head lower than the chest using bolsters and pillows.

7 Slide 19 POUNDING / BEATING TAPOTEMENT Performed with sides of one or both loose fists. Deliver blows rhythmically beginning with moderate pressure and increasing to patient tolerance. A variation called rapping looks like knocking on a door. Pounding / Beating tapotement is designed for heavier muscled regions. Slide 20 SLAPPING TAPOTEMENT Performed with the palmar surface of the hand. Creates a loud smacking sound. This is a very invigorating stroke. This technique is not recommended for patients who are known survivors of abuse as it may trigger painful past episodes of abuse. Slide Stimulates nerve endings initially, becoming sedative if continued 2. Aid in decongesting the lungs by loosening and mobilizing phlegm in the respiratory tract 3. Tone atrophied muscles 4. Increase local blood flow 5. Access deeper structures such as hip rotators 6. Create an ultrasound effect manually 7. Relieve pain (perhaps due to the gate theory) 8. Desensitize a hypersensitive area after a few minutes of tapotement stimulation.