Taping, Compression and Slings

Question 1

Pressure Therapy Treatment Goal

Answer 1

Empty the lymphatic or venous system without increasing the load on the heart or damaging vascular tissue.
o Can improve venous pump
o Reduce capillary filtration
o Facilitate lymphatic drainage

Question 2

Pressure Therapy Treatment Parameters

Answer 2

Intermittent or continuous pressure
Periodic compression for venous drainage is usually done in a nonuniform and graded way to encourage the flow of fluid from the periphery towards the heart

Dosage
* 20-30 mm Hg = low
* 30-40 mm Hg = moderate
* 40-50 mm Hg = high

Question 3

Research Evidence: Pressure Therapy

Answer 3

• Pressure higher than 35 mm Hg does not increase venous peak flow
• Limited evidence that intermittent pressure therapy may improve healing when added to compression bandages
• Compression on skin ulcers is better than no-compression, however, intermittent pressure therapy is no more effective than constant pressure

Question 4

Types of bandaging

Answer 4

• Gauze: Conforming or retention
• Cotton: Light support
• Elastic: Compression

Question 5

Treatment Goals: Bandaging

Answer 5

• Reduction in swelling: Positive external pressure is used to reduce the outflow of swelling including blood and vascular cellular exudates
• Reduction in pain
• Immobilisation or support

Question 6

Cervical sling

Answer 6

Supports forearm, wrist and hand

Question 7

Shoulder-arm Sling

Answer 7

Supports injury to the shoulder girdle and humerus

Question 8

Sling and swathe

Answer 8

Provides immobilisations for shoulder injury and dislocation

Question 9

Collar and Cuff Sling

Answer 9

Supports injuries to the elbow and upper arm

Question 10

Principles of sling application

Answer 10

• Keep patient still
• Ensure sling size is correct
• If aiming to immobilise, you need to immobilise the joints directly proximal and distal to the injury
• Avoid tying off behind the patient’s neck

Question 11

Taping/Strapping: Purposes

Answer 11

1. Pain reduction
2. Increase passive stability of anatomical structures
3. To reduce strain on injured or vulnerable tissue
4. Prevention of injury or re-injury
5. Biomechanical effect
6. Muscle inhibition
7. Muscle facilitation
8. Enhancement of proprioception
9. Compression (oedema or lymphatic drainage)

Question 12

Principles of tape application (basic/push/pull method)

Answer 12

• Basic philosophy: Tape is applied under tension, with the tissue in a shortened position
• Push method: Clinician pushes tape towards target region as the soft tissues are pulled towards the advancing tape
• Pull method: Clinician pulls the tape towards the target region as the soft tissues are pushed toward the advancing tape

Question 13

Taping Affects: Neuromuscular

Answer 13

• Inhibit or facilitate muscle activity
• Alter timing of muscle activation
• Increase joint position sense

Question 14

Taping Affects: Psychological

Answer 14

• Increased confidence and comfort

Question 15

Taping Affects: Fluid Movement

Answer 15

Theory: Applying an elastic tape on the skin creates a lifting effect, decompressing the subcutaneous layers beneath the tape

Question 16

Tape can be used for…

Answer 16

• Acute injury
• Prevention of injury
• Rehabilitation of injury
• Pain relief
• Any combination of the above

Question 17

Don’t use tape when…

Answer 17

• Allergy to the materials used
• Active infection or irritation

Question 18

Application of tape

Answer 18

• Skin preparation
  Remove – dirt, sweat/water, hair (if possible) Cover - wounds/abrasions
• Optimise position
  Patient’s position
  Your position
• Utilise bony landmarks for anchoring
• Aesthetics
• Specific sporting requirements

Question 19

Removal of tape

Answer 19

• Don’t just rip tape off: cut it and peel tape back on itself
• Ripping tape off can result in bleeding
• Underwraps can make removal less unpleasant
• Numerous products available to assist
• Regular cooking oil can help
• Clean skin properly afterwards