Allergy in patients treated with kinesiology taping

Medical Rehabilitation 2010, 14 (4), 29–32

Allergy in patients treated with kinesiology taping: A case report Alergia u pacjenta po terapii metodą kinesiotapingu – opis przypadku Emilia Mikołajewska Department of Rehabilitation, 10th Military Clinical Hospital with a Polyclinic in Bydgoszcz, Poland

Key words

rehabilitation, kinesiology taping, allergy Abstract

Kinesiology taping is currently regarded as an independent or supporting method in rehabilitation, orthopaedics and sport medicine. The idea of the method lies in the effect of elastic tape applied according to the kinesiolgy taping rules. Kinesio tape, made from cotton and acrylic, has parameters (thickness, weight, extensibility, etc.) very similar to those of human skin. Glue used in kinesio tex tape is hypoallergenic. Evidence of allergy during kinesiology taping treatment (heat, rash etc.) in clinical practice is rare, there is a lack of articles in this area. The aim of the present article is to familiarize one with an interesting case of allergy during kinesiology taping treatment and to speculate on the potential implications of this possibility in kinesio taping treatment for clinical practice. Further study is recommended to determine the source(s) of the allergy. The case presented case could constitute evidence that during kinesio taping treatment apart from the possibility of allergy to the kinesiology tape itself there is equally possible: allergy to substances used for skin preparation before kinesio tape application, allergy to a combination of substances used to produce the glue on the kinesio tape and substances used in skin preparation prior to application. This is a very important area of research, because an allergy can cause severe cutaneous lesions and wounds. In patients with paralysis or a coma acute allergies can lead to serious wounds and even bedsores. Słowa kluczowe

rehabilitacja, kinesiotaping, alergia Streszczenie

Kinesiotaping jest obecnie uważany za samodzielną lub uzupełniającą metodę w rehabilitacji, ortopedii i medycynie sportowej. Historia kinesiotapingu sięga wczesnych lat 70-tych XX w. Techniki kinesiotapingu oraz plaster używany w tej metodzie zostały opracowane ponad 25 lat temu w Japonii przez chiropraktyka Kenzo Kase. Idea metody leży w oddziaływaniu specjalnego plastra zaaplikowanego zgodnie z zasadami kinesiotapingu. Plaster ten, wykonany z bawełny i akrylu, ma parametry (grubość, wagę, rozciągliwość itp.) bardzo zbliżone do ludzkiej skóry. Klej wykorzystywany w plastrach do kinesiotapingu uważany jest za hipoalergiczny. Artykuł przedstawia interesujący przypadek alergii podczas terapii metodą kinesiotapingu. Świadectwa dotyczące alergii podczas terapii metodą kinesiotapingu w praktyce klinicznej są rzadkie, brak jest publikacji w tym zakresie. Istnieje konieczność zwrócenia szczególnej uwagi na reakcję skóry na kombinację substancji używanych do produkcji kleju stosowanego w plastrach i środków używanych do przygotowania skóry do aplikacji kinesiotapingu. Niezbędne są dalsze badanie w celu określenia możliwego źródła (źródeł) alergii. Przedstawiony opis przypadku może być świadectwem, że podczas terapii metodą kinesiotapingu oprócz możliwości alergii na używane w niej plastry możliwe są również: alergia na substancje używane do przygotowania skóry przed aplikacją plastra oraz alergia na kombinację substancji używanych do produkcji kleju do plastrów do kinesiotapingu oraz substancji używanych do przygotowania skóry przed aplikacją plastra. Stanowi to bardzo ważny obszar badań, ponieważ alergia może powodować poważne uszkodzenia skóry i rany. U pacjentów z porażeniem lub w śpiączce ostre alergie mogą doprowadzić do poważnych ran, a nawet odleżyn.

Background and purpose Kinesiology taping (abbr. KT, also known as kinesio taping) is currently regarded as an independent or sup-

porting method in rehabilitation, orthopaedics and sport medicine. The history of its application began in the early 1970s. The kinesiology taping

technique and kinesio tex tape was developed by Dr. Kenzo Kase in Japan over 25 years ago. The idea behind the method lies in the effect of

Article received 22.07.2010; accepted: 31.01.2011

Medical Rehabilitation e ISSN 1896-3250 © ELIPSA-JAIM & WSA Bielsko-Biała

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elastic tape (special kinesio tex tape) applied according to the kinesiology taping rules. Kinesio tex tape, made from cotton and acrylic, has parameters (thickness, weight, extensibility etc.) very similar to those of human skin. Glue used in kinesio tex tape is hypoallergenic. Various research projects have been undertaken to investigate the effect of kinesiology taping on different musculoskeletal conditions1,2,3,4,5,6,7,8. Depending on the method of application, kinesiology taping has proven efficacy e.g. as an analgesic or antihydropic method and has been used for stabilization or correction3,8,9,10. Thanks to its efficacy, simplicity, cheapness and low requirements in the time consuming area kinesiology taping is widely used in rehabilitation. It is used in a lot of functional problems, like ligament instability, lymphoedema, pain in the spinal column or joints, increased muscle tone (on a fascial base), muscle paralysis and paresis, joint deformity etc. Evidence of allergy during kinesiology taping treatment (heat, rash etc.) in clinical practice is rare, there is a noticeable lack of articles in this research area. A critical appraisal of publications based on the Pubmed database has been carried (Figure 1). Areview of other data bases, both foreign and Polish, has given the same or similar resultsA. Only one article by the author of the present work has dealt with a similar topic to date, but here in a different area: using kinesio tape in very hot and wet conditions11. The aim of the article is to familiarize the reader with an interesting case of allergy during kinesiology taping treatment and to speculate on the potential implications of this possibility in kinesio taping treatment for clinical practice. Patient history and examination A patient, 23 years old, hospitalized on a rehabilitation ward, originally with tetraplegia. As a result of the previous therapy there had been achieved recovery in the area of paresis with A

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Figure 1 Results of investigation in the Pubmed database (U.S. National Library of Medicine)

assymetry in muscle tone in the area of the trunk muscles. The patient had become adapted to a wheelchair (sitting position) and was in the process of undergoing gait re-education. The majority of the day he spent sitting in his wheelchair. This caused (together with the above mentioned asymmetry in muscle tone in the area of the trunk muscles) scoliosis – spinal curvature in the frontal plane. The clinically diagnosed scoliosis was being treated with kinesiotherapy. Treatment using physiotherapy had been ruled out due to a cancerous base. Kinesiology taping constituted a supporting treatment method. Intervention Kinesiology taping was provided by a therapist experienced in kinesiology taping, K-Active Association certified. The patient received an application of

kinesiology taping, applied with the appropriate tension, in a corrective way. Black kinesiology tape, 5 cm (2 inches) in width, produced by Nitto Denko was used. Te length of the tape was adjusted to the application. It was applied in the area of the extended muscles (on the side of the curvature protuberance – see Foto 1 a, b). Before application the skin was prepared using neutral spirit. This was done to remove fat from the skin and to increase the adhesive force of the tape. After 5 days during the changing of the tape, an allergy was observed: heat and rash (Foto 2). The patient had not felt itching because of the initial illness i.e. damage to the spinal cord. The proper way of application, after the healing of the wound was another application of the tape . This was conducted without spirit, after a very exact and thorough washing and wiping dry of the area in ques-

The total number of articles (incl. proceedings from conferences etc.) in the area, both Polish and foreign, is 36, and books: 5.


Figure 1 a, b Means of kinesio tape application

Figure 2 Stated allergy

tion. After 5 days during the change of the tape, there was not noted any allergy whatsoever. Discussion and conclusions The observed allergy can be associated with the use of spirit. The subsequent

B

application with the self same kinesiology tape, without the use of spirit, resulted in an absence in allergy. The assumption that kinesiology tape is hypoallergenic can be true. But there is a need to pay particular attention to a response caused by a combination of substances used to produce the glue on the kinesio tex tape and the substances used in skin preparation. The manufacturer of applied kinesiology tape has merely informed one that warm activated acrylic glue was used. There is lack of detailed information as to which adhesive substance(s) are used in these tapes, making it subsequently hard to investigate. Acryl and acrylates can be in selected patients a source of contact allergy (contact reaction)12. Because of the polyvalence of allergy to acrylates, difficulties are caused in the interpretation of results. There are a lot of kinds of acrylates, and new chemical compounds in this area, maybe allergy-producing, are developed each year. According to European Standards 26 main allergens are defined as the most frequent pos-

sible causes of contact allergy or allergic contact dermititis (ACD) in European countries13. But for now this list may be viewed as incomplete13, and these allergens are important especially in Europe, not necessarily in the whole world. What is more – this can be combined with the rare, but even so known in medical circles, syndromes of angry back or excited skin syndrome13. Individuals may develop contact allergy to many external medications while the sensitivity to topical preparations may change14. According to current accessible references, kinesiology tape used in kinesio taping is hypoallergenic. There is lack of articles in the area of allergies resulting during kinesiology taping treatment. This case report can constitute evidence that during �� kinesio tapingtreatment apart from the possibility of allergy to the kinesiology tape itself there exists the possibility of e: – allergy to substances used to skin preparation before the kinesio tex tape applicationB,

Because of regular shape of the heat and rash in the presented patient it is rather improbable, but as an element of further therapy using kinesiology tape there is a need to provide a test of neutral spirit as an allergen (on a small part of the patient’s skin).

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– allergy to a combination of substances used in the production of the glue on kinesio tex tape and the substances used in skin preparation before kinesio tex tape application. Further study is recommended to determine the source(s) of the allergy. This is a very important area of research, because an allergy can cause severe cutaneous lesions and wounds. In patients with paralysis or in a coma, acute allergies can lead to severe wounds, and even to bedsores. Piśmiennictwo / References 1.

2.

3.

4.

5. 6.

7.

8.

9.

10.

11.

12.

13. 14.

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González-Iglesias J., Fernández-de-LasPeñas C., Cleland J.A., Huijbregts P., Del Rosario Gutiérrez-Vega M.: Short-term effects of cervical kinesio taping on pain and cervical range of motion in patients with acute whiplash injury: a randomized clinical trial. J. Orthop. Sports Phys. Ther., 2009; 39(7): 51521 Hsu Y.H., Chen W.Y., Lin H.C., Wang W.T., Shih Y.F.: The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome. J. Electromyogr. Kinesiol., 2009; 19(6): 1092-9 Słupik A., Dwornik M., Białoszewski D., Zych E.: Effect of Kinesio Taping on bioelectrical activity of vastus medialis muscle. Preliminary report. Ortop. Traumatol. Rehabil., 2007; 9(6): 644-51 Fu T.C., Wong A.M., Pei Y.C., Wu KP, Chou SW, Lin YC.: Effect of Kinesio taping on muscle strength in athletes-a pilot study. J. Sci Med. Sport, 2008; 11(2): 198-201 Yoshida A., Kahanov L.: The effect of kinesio taping on lower trunk range of motions. Res. Sports Med., 2007; 15(2): 103-12 Jaraczewska E., Long C.; Kinesio taping in stroke: improving functional use of the upper extremity in hemiplegia. Top Stroke Rehabil, 2006; 13(3): 31-42 Yasukawa A., Patel P., Sisung C.: Pilot study: investigating the effects of Kinesio Taping in an acute pediatric rehabilitation setting. Am. J. Occup. Ther., 2006; 60(1): 104-10 Białoszewski D., Woźniak W., Zarek S.: Clinical efficacy of kinesiology taping in reducing edema of the lower limbs in patients treated with the ilizarov method--preliminary report. Ortop. Traumatol. Rehabil., 2009; 11(1): 4654 Żuk B., Księżopolska-Orłowska K.: Przydatność metody Kinesio Taping w chorobach zapalnych układu ruchu u dzieci. Reumatologia, 2008; 46(6): 340–347 Kuciel-Lewandowska J., Paprocka-Borowicz M., Kierzek A., Pozowski A., Boerner E.: Zastosowanie kinesiotapingu w usprawnianiu pourazowego uszkodzenia nerwu strzałkowego – opis przypadku. Acta Bio-Opt. Inform. Med., 2008; 3: 224–225 Mikołajewska E.: Hipoalergiczność plastrów do kinesiotapingu – opis przypadku. Praktyczna Fizjoterapia i Rehabilitacja, 2010; 6: 48-49 Zaremba J., Kieć-Świerczyńska M., Kręcisz B., Swierczyńska-Machura D.: Acrylates as a significant source of occupational and non-occupational contact allergy. Medycyna Pracy, 2004, 55(4): 357-361 Śpiewak R.: Contact allergy – diagnosing and treatment. Alergia Astma Immunologia, 2007; 12(3): 1-6 Rudzki E. Eczema. IV Contact dermatits reaction to topical drugs. Alergia, 2003; 17(2): 18-20, 30

Address for correspondence Emilia Mikołajewska PT PhD Klinika Rehabilitacji, 10 Wojskowy Szpital Kliniczny z Polikliniką SP ZOZ ul. Powstańców Warszawy 5, 85-681 Bydgoszcz, Poland e-mail: [email protected]

Translated from the Polish by Guy Torr