Plantar heel pain is a common disorder that can involve considerable pain. Many treatments have been suggested to manage the condition however few have been rigorously evaluated. Two treatments commonly recommended in clinical practice are adhesive taping applied to the foot and calf muscle stretching. The effectiveness of neither treatment is supported by good quality evidence. Aim: To examine the effectiveness of two short-term interventions, low-Dye taping and calf muscle stretching, for the treatment of plantar heel pain. In addition, the effect of the interventions on biomechanical variables was investigated. Design: Four studies were undertaken in the thesis. The first study in the thesis (Chapter 3) investigated the biomechanical effect of low-Dye taping on the lower limb by systematically reviewing appropriate clinical trials. Meta-analyses were undertaken where appropriate. The second study (Chapter 4) was a blinded randomised trial conducted to evaluate the effectiveness of low-Dye taping for the short-term treatment of plantar heel pain. The third study (Chapter 5) investigated the effect of calf muscle stretching on ankle joint range of motion by systematically reviewing appropriate clinical trials. Meta analyses were again undertaken where appropriate. The fourth and final study (Chapter 6) was another blinded randomised trial conducted to evaluate the effectiveness of calf muscle stretching for the short-term treatment of plantar heel pain. Setting: Both randomised trials were conducted at a university-based clinic in Sydney, Australia. Participants In the randomised trials, 184 participants who met the inclusion and exclusion criteria for plantar heel pain were recruited from the local community. In the first trial 92 participants were evaluated over a one-week period and randomly allocated to receive either low-Dye taping or a sham intervention. In the second trial 92 participants were evaluated over a two-week period and randomly allocated to receive either calf muscle stretching or a sham intervention. Outcome measures In the first systematic review, all trials that met the inclusion and exclusion criteria evaluated the effect of low-Dye taping on kinematic, kinetic and electromyographic outcomes. For the second systematic review, all trials that met the inclusion and exclusion criteria examined the effect of calf muscle stretching on the outcome of ankle joint dorsiflexion range of motion. Both randomised trials in this thesis used the Visual Analogue Scale and the Foot Health Status Questionnaire as primary outcomes. In the stretching randomised trial secondary outcomes were also assessed, namely the Foot Posture Index-6 and the Ankle Lunge Test. Results: The first systematic review found that low-Dye taping provides a small, statistically significant increase in navicular height immediately after application (weighted mean difference 5.90mm; 95% confidence interval 0.41 to 11.39; p=0.04)1 indicating a reduction in foot pronation. However, after exercise, taping had no statistically significant effect on navicular height (weighted mean difference 4.70mm; 95% confidence interval –0.61 to 10.01; p=0.08). In addition, taping had no statistically significant effect on maximum rear foot eversion (weighted mean difference –0.59°; 95% confidence interval ����2.53 to 1.35; p=0.55) or total rear foot range of motion while walking (weighted mean difference 2.3°; 95% confidence interval –0.64 to 5.24; p=0.13). The first randomised trial found that low-Dye taping had a significantly greater decrease in ‘first-step’ pain compared to a control group. The estimate of the mean difference between the groups (measured on 100mm Visual Analogue Scale) favoured the taping group (-12.3mm; 95% confidence interval -22.4 to -2.2; p=0.017). There 1 P values are provided to three decimal places except when values were generated using systematic review software, Review Manager 4.2.7, which sometimes only calculates results to two decimal places. were no differences detected in any of the other outcome measures. The taping was associated with mild to moderate short-lived adverse events that could be minimised with the use of hypoallergenic tape and careful application of the tape to reduce tightness. The second systematic review found that calf muscle stretching provides a small, statistically significant increase in ankle joint dorsiflexion. Stretching for ≤15 minutes (in a single session or accumulated over multiple sessions) provides a weighted mean difference of 2.07° (95% confidence interval 0.86 to 3.27; p(less than)0.001). 15 to 30 minutes (accumulated over multiple sessions) increased dorsiflexion by a weighted mean difference of 3.03° (95% confidence interval 0.31 to 5.75; p=0.03), and >30 minutes of stretching (accumulated over multiple sessions) increased dorsiflexion by a weighted mean difference of 2.49° (95% confidence interval 0.16 to 4.82; p=0.04) indicating no further increase in dorsiflexion is achieved by stretching for >30 minutes. The second randomised trial found that calf muscle stretching compared to a control group, had no significant effect on ‘first-step’ pain, foot pain, foot function or general foot health. Stretching was associated with mild to moderate adverse effects that were short-lived once stretching ceased. Conclusion: When used for the treatment of plantar heel pain, low-Dye taping provides a small increase in navicular height, and after one week, produces a small reduction in the ‘first-step’ pain. Calf muscle stretching increases ankle joint dorsiflexion approximately 2 to 3 degrees but has no effect on plantar heel pain after two weeks. It can therefore be concluded that low-Dye taping is effective for the short-term treatment of the ‘first-step’ pain associated with plantar heel pain, but calf muscle stretching is not effective for plantar heel pain. / Doctor of Philosophy (PhD)

No description available.

The purpose of this study was to compare the protective characteristics of four different ankle braces and one form of ankle taping. An inversion and plantar flexion platform was used to induce ankle movements. The subjects used in this study consisted of 10 volunteer male students. The subjects had no sprains five months prior to testing. All subjects were tested in the same size 10 shoes, high tops and low tops. A Certified Athletic Trainer applied all ankle braces and ankle tapings. A closed basketweave with heel locks, adherent spray, and pre-wrap was used for all taping conditions.After the application of the ankle braces or taping, each subject performed two tests on the inversion and plantar flexion platform. A random order was used among the subjects. An ankle inversion platform was modified to induce 30 degrees of inversion and 35 degrees of plantar flexion simultaneously. The subjects will be filmed using a Locam 16mm at 200 frame/second. All subjects were filmed from the posterior plane with markings on the posterior aspect of the lower leg to help analyze the movement at the subtalar joint. A Calcomp 9100 series digitizer that was interfaced with a VAX computer was used to analyze the data and calculate the amount of angular displacement at the subtalar joint. An ANOVA with repeated measures was used to determine significant differences between support techniques. University procedures for the protection of human subjects was followed. ANOVA procedures indicated no significant difference in angular displacement between braces. A statistical analysis indicated that low top shoes provided significantly more support than high top shoes in braced ankles. / School of Physical Education

Thesis--Auburn University, 2009. / Abstract. Vita. Includes bibliographical references (p. 36-42).

Thesis--Auburn University, 2009. / Abstract. Vita. Includes bibliographical references (p. 36-42).

Thesis (M.A.)--University of North Carolina at Chapel Hill, 2005. / Includes bibliographical references (leaves 109-114). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M.A.)--University of North Carolina at Chapel Hill, 2005. / Includes bibliographical references (leaves 109-114).

M.Tech. (Chiropractic) / Myofascial Pain Syndrome, is a common source of frustration for both healthcare practitioners and patients. It is the second most common reason for patients visiting their health care practitioner and constitutes up to 85% of the reasons for visits to pain clinics (Han and Harrison, 1997). As muscle pain is the most common work-related injury (Hubbard, 1998), it costs billions of dollars in lost revenue every year due to lost productivity (Fricton, 1990). Hong (1994), states that dry needling has been extensively studied and has been shown to decrease or even abolish myofascial pain. However post dry needling soreness is a common side effect of dry needling. Stuart (2010), states that applying kinesio tape® to a musculoskeletal injury during rehabilitation could result in a quicker recovery by allowing the body to biomechanically heal itself. Garcia-Mura et al (2009), results suggest that kinesio tape® is a method highly appropriate in the treatment of myofascial trigger points by normalising muscular function, increasing lymphatic and vascular flow, diminishing pain and aid in the correction of possible articular malalignment. The aim of this study was to determine the effects that kinesio tape® has on the trapezius trigger point one post needling, to determine whether there is an increase in the therapeutic effect of dry needling and an increased recovery time of the myofascial trigger points, with regards to changes in pressure pain threshold, pain and cervical range of motion. Participants for this study were recruited either by an advertisement which was placed on the information board of the Chiropractic Day Clinic at the University of Johannesburg as well as advertisements placed in and around the University of Johannesburg at the Doornfontein Campus. Also, many participants were made aware of this study via word of mouth from candidates already involved in the study. Thirty participants were randomly assigned into one of two groups, each consisting of 15 participants. Group A received dry needling of the trapezius trigger point one followed by the application of kinesio tape® whereas group B received dry needing of trapezius trigger point one only. Participants were treated 5 times with objective and subjective measurements taken at the 1st, 3rd and 5th visits. Objective measurements consisted of readings taken with an algometer and cervical range of motion (CROM) device. The subjective measurements consisted of the Numerical Pain Rating Scale (NPRS) and the Vernon Mior Neck Disability Index. The results of the study showed clinically and statistical significant improvements for both groups in regards to alleviating pain subjectively (Numerical Pain Rating Scale and Vernon-Mior Neck Pain and Disability Index), increasing pressure pain threshold objectively (Algometer) and increasing range of motion objectively (Cervical Range of Motion device). However group A (dry needing and kinesio tape®) showed a greater improvement in both subjective and objective measurements. Based on the results of the study, it could be concluded that both dry needling on its own as well as applying kinesio tape® post dry needling can be effective in the treatment of myofascial trigger points in the upper trapezius muscle, however applying kinesio tape® post dry needling seemed to be more effective.

Bakgrund: I takt med att Sveriges befolkning blir äldre ökar behovet av vård och kompressionsbehandling. För att kunna ge en optimal sårvård behöver distriktssköterskan ha kompetens inom venös insufficiens, sårläkningsprocessen, sårläkningshämmande faktorer, cirkulationsbedömning och kompressionsbehandling. Vid behandling av venösa bensår ska distriktssköterskor arbeta patientsäkert och ta ansvar för sina handlingar. Syfte: Beskriva hur distriktssköterskor erfar sin kompetens och behovet av kompetensutveckling gällande kompressionsbehandling av venösa bensår. Metod: En kvalitativ metod med induktiv ansats tillämpades i studien. Datainsamlingen genomfördes med semistrukturerade intervjuer med tio distriktssköterskor inom primärvården. Det insamlade materialet analyserades utifrån en kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre huvudkategorier. Kategorierna beskrev distriktssköterskors erfarenhet av sin kompetens samt resurser och strategier för kompetensutveckling. Distriktssköterskor som ofta utförde kompressionsbehandling ansåg sig ha kompetens inom området och hade förmågan att utföra en korrekt bedömning samt behandling. Distriktssköterskor som istället erfor sin kompetens som bristfällig uttryckte ofta utmaningar i arbetsmomentet. Utmaningar beskrevs vara att motivera patienter till att använda kompressionsbehandling samt att förmedla information om behandlingens fördelar. Slutsats: Kunskap inom kompressionsbehandling är en förutsättning för att vårda patienter med venösa bensår Kompetensutveckling samt stöd och kunskapsutbyte med medarbetare har fördelaktig inverkan på distriktssköterskans individuella kompetens. Hinder i kompetensutveckling var tidsbrist samt att utbildning inte prioriterades. / Background: As the population of Sweden grows older, the need for care and compression treatment increases. In order to provide optimal wound care, the district nurse needs to have expertise in venous insufficiency, the wounds healing process, inhibiting factors in wound healing, circulation assessment and compression treatment. When treating venous leg ulcers, the district nurses must work patient-safe and take responsibility for their actions. Aim: Describe how district nurses experience their competence and the need for competence development regarding compression treatment for venous leg ulcers. Method: A qualitative method with an inductive approach was applied in the study. The data collection was conducted with semi-structured interviews with ten district nurses in primary care. The collected material was analyzed on the basis of a qualitative content analysis.  Findings: The categories described district nurses' experience of their competence as well as resources and strategies for competence development. District nurses who often performed compression treatment considered themselves to have competence in the area and had the ability to perform a correct assessment and treatment. District nurses who experienced their skills as deficient often expressed challenges in the work step. Challenges were described as motivating patients to use compression therapy and providing information about the benefits of the treatment. Conclusion: Knowledge in compression treatment is a prerequisite for caring for patients with venous leg ulcers. Competence development and support and knowledge exchange with employees have a beneficial effect on the district nurse's individual competence. Lack of time and low prioritized education were described as obstacles in skills development.

Dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Durban University of Technology, 2009. / Headaches are one of the most common clinical conditions in medicine, and 80% of these are tension-type headaches (TTH). TTH has a greater socioeconomic impact than any other type of headache due to its prevalence. Within the TTH category, episodic TTH are more prevalent than chronic TTH. The mainstay in the treatment of TTH are simple analgesics and NSAIDs. Unless contraindicated, NSAIDs are often the most effective treatment for ETTH. However patients suffering with TTH tend to relate their headaches to increased muscle stiffness in the neck and shoulders and thus the non-pharmacological treatment of ETTH could be directed at the associated musculoskeletal components of ETTH. It is therefore proposed that the Kinesio Taping® Method may have an effect in the treatment of the muscular component of ETTH. Method: This study was a prospective randomised clinical trial with two intervention groups (n=16) aimed at determining the relative effectiveness of a NSAID and the Kinesio Taping® Method in the treatment of ETTHs. The patients were treated at 5 consultations over a 3 week period. Feedback was obtained using the: NRS – 101, the CMCC Neck Disability Index and a Headache Diary. Results: The Headache Diary showed a reduction in the presence and number, mean duration and pain intensity of ETTH in both groups. These treatment effects were sustained after the cessation of treatment with the exception of mean pain intensity in the Kinesio Taping® Method group. The mean NRS score decreased in both groups but at a slightly faster rate in the Kinesio Taping® Method group. The CMCC showed an improvement in the functional ability of the patients in both groups. Conclusion: There seems to be no significant difference in the relative effectiveness of the treatment modalities. We can thus state that the overall short-term reduction in symptomatology supports the use of NSAIDs or Kinesio Taping® Method in the treatment of ETTH.