The stroke is the second cause of death and the first of disabilities in the world. Although a motor spontaneous recovery is observed, around 50 to 70% of the hemiparetic upper extremity present alterations of upper extremity, limiting the performance of daily activities even after 2 to 4 years of strokes. More recently used in neurological rehabilitation, the ability to promote sensory-motor facilitation is given to the Elastic Tape (ET). However, its safety and efficacy in the treatment of post-stroke individuals still require further investigation. Thus, the objective of this project is to evaluate the immediate effects of ET, applied to the paretic shoulder on proprioception during movements of abduction and flexion of the shoulder and muscle activation and kinematic variables for the reaching in chronic hemiparetic. Fifteen subjects with chronic hemiparesis will participate these crossover sham-controlled trial. Participants will be randomized into two condition: elastic tape (ET) followed by sham tape (ST- strapping) or ST followed by ET. One month of washout period was considered. The motor impairment and the dominance before stroke will be evaluated by Fugl-Meyer scale and the Inventory Side dominance of Edinburgh, respectively. ET will apply deltoid (anterior, middle and posterior). Assessment before and after the application of ET will be performed. For proprioception assessment (joint position sense) will be evaluated using a dynamometer. Absolute error for shoulder abduction and flexion at the 30° and 60° was calculated. For the assessment of motor performance in a functional task (reach a glass of water), spatio-temporal parameters (total duration of the motion, peak velocity, time to peak velocity) and three-dimensional joint kinematics of the trunk, scapula, shoulder, and elbow (total range of motion, joint angle maximum and minimum) will be used. Concomitantly, bilateral activation of the deltoid (anterior, middle and posterior), trapezius (upper and lower), serratus anterior and pectoral major will be assessed by electromyography during reach. The following electromyographic variables will be analyzed: activation amplitude, muscle onset and maximum and minimum activation. For statistical analysis, the normality and homogeneity tests will be applied. If the variables have a distribution considered normal and homogeneous, Two-way ANOVA with repeated measures gift will be applied. Otherwise it will be applied to non-parametric statistics Friedman. Will be considered a 0.05 significance level for all statistical tests.
- Elastic tape application in shoulder Other
ARM 1: Kind: Experimental Label: Elastic Tape Description: Tape placing will consider as the initial anchor the acromioclavicular joint, and as the final one the point immediately below the insertion of the deltoid muscle. Two centimeters anchor will be considered for all the participants, and the active zone will be equivalent to the distance between two anchors. The first tape will be placed to the anterior portion of the deltoid with the shoulder at 30° passive extension. The second tape will be placed to the middle portion of the deltoid with the shoulder at 30° of passive horizontal adduction. For placing the third tape to the posterior deltoid, the limb will be positioned at 90° of passive flexion of the shoulder. The elastic tape tension will be placed as previously described as "paper tension" and it is equivalent to 10-15% of the total elastic tape tension. ARM 2: Kind: Experimental Label: Sham Description: The sham elastic tape will be placed using the same tape to the paretic shoulder of the hemiparetic subjects and to the non-dominant limb of the healthy subjects. However, the tape will be placed without tension, i.e. the tape is completely removed from the paper, then it will be placed above the acromioclavicular joint in the sagittal plane (Figure 4). The placement will consider the anchor region, where there is no effective participation in the method, according to previous literature (Gomez-Soriano et al., 2014; Karadag-Saygi, Cubukcu-Aydoseli, Kablan, & Ofluoglu, 2010).
- Allocation: Randomized
- Masking: Open Label
- Purpose: Supportive Care
- Intervention: Parallel Assignment
|Type||Measure||Time Frame||Safety Issue|
|Primary||Change from Baseline in joint sense position (proprioception) at 10 minutes||baseline and 10 minutes post-application of placebo ou elastic tape||Yes|
|Primary||Change from Baseline in joint kinematics of reach at 10 minutes||baseline and 10 minutes post-application of placebo ou elastic tape||Yes|
|Primary||Change from Baseline in Electromyography during the reach at 10 minutes||baseline and 10 minutes post-application of placebo ou elastic tape||Yes|