Anti-pronation taping is commonly used by clinicians in the management of lower limb musculoskeletal pain and injury. Despite its frequent use in the clinical setting the mechanism(s) underlying its efficacy is not completely understood. For example, there is evidence that anti-pronation taping produces a biomechanical effect, but there has been little investigation of other mechanisms such as neurophysiological or psychological effects. Additionally, studies to date have been performed in mostly asymptomatic populations and have focused on the initial effect of tape (i.e. immediately following application and through a short duration of activity). Improved understanding of the underlying physiological mechanism(s) of anti-pronation tape is likely to facilitate improved knowledge of the technique, which may optimise its clinical application and contribute to clinical selection guidelines. The aims of this thesis were developed to address several of the limitations in the current anti-pronation taping literature. To facilitate an investigation of the comparative initial physiological effect of anti-pronation tape in a symptomatic and asymptomatic population, the first aim of this thesis was to compare neuromotor control (control of muscle activation and movement patterns) of gait, foot posture and foot mobility between asymptomatic individuals and individuals with a history of exercise related leg pain. The second aim of this thesis was to investigate the initial physiological effects of anti-pronation tape, specifically its neurophysiological (i.e. effect on muscle activation patterns) and biomechanical (i.e. effect on movement patterns, foot posture, foot mobility) effects. Thirdly this thesis aimed to investigate the duration of these initial physiological effects following tape removal. The fourth and fifth aims were to investigate the long term biomechanical and neurophysiological effects of anti-pronation taping i.e. following continual use over a clinically relevant period. In the first instance our aim was to investigate the effect of continual use on neuromotor control of gait, foot posture and foot mobility, and secondly to investigate the effect of continual use on the technique’s initial neurophysiological and biomechanical effects. Individuals with exercise related leg pain demonstrated lower activation of gluteus medius and lateral gastrocnemius during gait, but we observed no differences in lower limb movement patterns or foot posture and foot mobility between the two groups. The initial effect of tape was similar in individuals with and without exercise related leg pain. Specifically application of tape produced a reduction in activation of tibialis posterior, tibialis anterior and medial gastrocnemius, and increased activation of peroneus longus. There was a reduction in foot mobility, ankle plantarflexion and abduction excursion and an increase in ankle dorsiflexion and adduction excursion. Reduced muscle activation and increased motion was also observed at more proximal segments (knee, hip, pelvis), but were of smaller magnitude than at the foot and ankle. Changes in foot mobility, ankle kinematics and leg muscle activity did not continue following the removal of tape, but at more proximal segments (i.e. pelvis, hip and knee) small changes in kinematics and muscle activity were observed following the removal of tape. In regards to long term effects, continual use of tape for approximately 12 days produced a small increase in arch height when compared to a control. We did not observe a change in muscle activation or motion patterns, nor did continual use of the technique influence its initial neurophysiological or biomechanical effects (i.e. reduction in muscle activity, reduction in foot mobility, altered lower limb motion). The studies from this thesis provide evidence that anti-pronation tape should be considered in the management of individuals where reduced midfoot mobility, control of ankle motion or reduced activation of the leg muscles is desired, regardless of symptomatic status. When applied for approximately 12 days, anti-pronation tape produced a small increase in arch height ratio, but no alteration in neuromotor control. We are not aware of any definitive data on what constitutes a clinically meaningful increase in arch height, but results from a published case series suggests that our findings of a small increase in arch height may be clinically relevant for the treatment of lower extremity overuse injuries. Continual use of tape for a clinically relevant period does not alter its initial effects on foot posture and mobility or neuromotor control during gait. It would appear that the initial effects of anti-pronation tape are robust even after continuous use over a period of 11 days.
| Identifer | oai:union.ndltd.org:ADTP/286112 |
| Creators | Melinda Franettovich |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
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