Application of Therapeutic Taping in Evidence-Based
Practice (EBP)
Application of Therapeutic Taping in Evidence-Based
Practice (EBP)
Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP
Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS
Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP
Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS
Scott & Dyanna Rezac - Evidence Based Taping
Talk the TalkTalk the Talk
One of the key components of Evidence Based Medicine is
communicating to your patients, colleagues and other medical
practitioners what you are doing and why when you perform an
intervention.
One of the key components of Evidence Based Medicine is
communicating to your patients, colleagues and other medical
practitioners what you are doing and why when you perform an
intervention.
Scott & Dyanna Rezac - Evidence Based Taping
Talk the TalkTalk the Talk
• What is OUT (not EBP)– VMO re-education– Joint Alignment / Patellar re-alignment– Taping to effect nociceptors,
mechanoreceptors, thermoreceptors, GTOs, muscle spindles, etc – things we can’t measure
– Taping for prophylaxis (with no injury)
• What is OUT (not EBP)– VMO re-education– Joint Alignment / Patellar re-alignment– Taping to effect nociceptors,
mechanoreceptors, thermoreceptors, GTOs, muscle spindles, etc – things we can’t measure
– Taping for prophylaxis (with no injury)
Scott & Dyanna Rezac - Evidence Based Taping
Talk the TalkTalk the Talk
What is “IN”– Taping to unload– Taping to provide biomechanical support– Taping for postural awareness– Taping to decrease over-extension of
injured tissue– Decrease pain– Improve Function
What is “IN”– Taping to unload– Taping to provide biomechanical support– Taping for postural awareness– Taping to decrease over-extension of
injured tissue– Decrease pain– Improve Function
Scott & Dyanna Rezac - Evidence Based Taping
ResearchResearch
Keep in mind when discussing the research out there the weight it holds:– Small subject number – many <20– Lots of case studies– Few randomized control trial double blind– Very few comparisons between specific
types of tape application– Clinical Objective Measures are still best
evidence available
Keep in mind when discussing the research out there the weight it holds:– Small subject number – many <20– Lots of case studies– Few randomized control trial double blind– Very few comparisons between specific
types of tape application– Clinical Objective Measures are still best
evidence available
Scott & Dyanna Rezac - Evidence Based Taping
ResearchResearch
What it does consistently support:– Decrease in pain rating scales
– Improvement in disability scores
– Improvement in functional tasks
– Decreased incidence of re-injury
– Prevention of over-extension on soft tissues
– Decreased inflammation / edema
– Potential psychological benefits
– Does not make them worse
What it does consistently support:– Decrease in pain rating scales
– Improvement in disability scores
– Improvement in functional tasks
– Decreased incidence of re-injury
– Prevention of over-extension on soft tissues
– Decreased inflammation / edema
– Potential psychological benefits
– Does not make them worse
Scott & Dyanna Rezac - Evidence Based Taping
Asterisk / Comparable SignAsterisk / Comparable Sign
This is your best measure of efficacy of your intervention.– It addresses the patient’s functional goal (their
complaint, limitation, etc.)• For example “Pt. reports unable to ascend/descend 1
flight of stairs in their home carrying a basket of laundry”
– It is objective and measureable• 8” Step Up/Down Test would be appropriate
– Pre-tape: Pt. able to perform 2-3 reps with pain
– Post-tape: Pt. able to perform 10 reps with 75% improvement in pain.
This is your best measure of efficacy of your intervention.– It addresses the patient’s functional goal (their
complaint, limitation, etc.)• For example “Pt. reports unable to ascend/descend 1
flight of stairs in their home carrying a basket of laundry”
– It is objective and measureable• 8” Step Up/Down Test would be appropriate
– Pre-tape: Pt. able to perform 2-3 reps with pain
– Post-tape: Pt. able to perform 10 reps with 75% improvement in pain.
Scott & Dyanna Rezac - Evidence Based Taping
Asterisk / Comparable SignAsterisk / Comparable Sign
You may choose to evaluate your efficacy of taping from one treatment to the next.– Day 1 (Taping) – “Pt. reports has pain 4-
6/10 after typing on computer 30-45 min at work.”
– Day 2 (next treatment following taping) – “Pt. reports pain 2-3/10 after typing on computer at work 3 hours.”
You may choose to evaluate your efficacy of taping from one treatment to the next.– Day 1 (Taping) – “Pt. reports has pain 4-
6/10 after typing on computer 30-45 min at work.”
– Day 2 (next treatment following taping) – “Pt. reports pain 2-3/10 after typing on computer at work 3 hours.”
Scott & Dyanna Rezac - Evidence Based Taping
Asterisk / Comparable SignAsterisk / Comparable Sign
How do you decide if the tape worked?– Objective
• Is it measureable? • Could another clinician repeat the same
measure with good reliability and validity?
– Functional• Does it allow the person to accomplish a
functional task better – ADL, work, sport, etc.
How do you decide if the tape worked?– Objective
• Is it measureable? • Could another clinician repeat the same
measure with good reliability and validity?
– Functional• Does it allow the person to accomplish a
functional task better – ADL, work, sport, etc.
Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP10
Taping GuidelinesTaping Guidelines
• Tape for function, then pain
• Use least amount of tape to accomplish goal
• One technique at a time, test for efficacy
• Use objective measures
• Be creative, have fun!
• Tape for function, then pain
• Use least amount of tape to accomplish goal
• One technique at a time, test for efficacy
• Use objective measures
• Be creative, have fun!
Scott & Dyanna Rezac - Evidence Based Taping
Scott & Dyanna Rezac - Evidence Based Taping
DocumentationDocumentation
• Ok, you have this great objective, measureable goal and the tape worked. How do you document WHAT tape you did?
• This is the same dilemma we have with spine mobilizations (PVM, PAVM, FRSB, ERSB, etc.)
• It makes it difficult to reproduce between clinicians.
• Ok, you have this great objective, measureable goal and the tape worked. How do you document WHAT tape you did?
• This is the same dilemma we have with spine mobilizations (PVM, PAVM, FRSB, ERSB, etc.)
• It makes it difficult to reproduce between clinicians.
Scott & Dyanna Rezac - Evidence Based Taping
DocumentationDocumentation
If it is a technique presented by someone, use that:– Kinesio® Tape – supraspinatus
faciliatation– McConnell Medial Glide x2 (two strips)
with elastic tape– McConnell Navicular Lift and low-dye arch
support with elastic tape
If it is a technique presented by someone, use that:– Kinesio® Tape – supraspinatus
faciliatation– McConnell Medial Glide x2 (two strips)
with elastic tape– McConnell Navicular Lift and low-dye arch
support with elastic tape
Scott & Dyanna Rezac - Evidence Based Taping
DocumentationDocumentation
• What if you invented that tape job for that patient’s problem?
• Document what you were trying to accomplish.– Elastic Tape – R abdominal oblique
faciliation x2 and R quadratus lumborum faciliation x2.
– Elastic Tape – space correction over L scalenes x3.
• What if you invented that tape job for that patient’s problem?
• Document what you were trying to accomplish.– Elastic Tape – R abdominal oblique
faciliation x2 and R quadratus lumborum faciliation x2.
– Elastic Tape – space correction over L scalenes x3.
Scott & Dyanna Rezac - Evidence Based Taping
BillingBilling• Follow your state’s regulations first and
foremost!• Taping – not well reimbursed for this code• Bill for goal of taping
– Manual Therapy Codes– Edema/Lymphedema– Neuromuscular Re-education– Patient Education
• Can’t bill for tape used in procedure, can have patients purchase their tape and teach them the technique
• Follow your state’s regulations first and foremost!
• Taping – not well reimbursed for this code• Bill for goal of taping
– Manual Therapy Codes– Edema/Lymphedema– Neuromuscular Re-education– Patient Education
• Can’t bill for tape used in procedure, can have patients purchase their tape and teach them the technique
Questions / Comments / Discussion
Questions / Comments / Discussion
Scott & Dyanna Rezac - Evidence Based Taping
[email protected]@rezacpt.com
www.rezacpt.com
Top Related