Upload
handfun
View
485
Download
5
Embed Size (px)
DESCRIPTION
Elisabeth Ortuño
Citation preview
Clinical utility and some myths
Neuromuscular bandage in the children hand
Elisabeth Ortuño Cano Pediatric Physiotherapist
ICF- CY
Health Condition (disorder/disease)
Activities Body
funcion&structure Participation
Enviromental Factors
Personal Factors
Evidence
• Absence of randomized controlled trials or systematic reviews
• Differences in skin and tensions
• No placebo effect, but... What about parents placebo?
NB in children versus adults
• Effects attributed to bandaje: No evidence
• Neuromuscular bandage as material for mechanical restraint and alignement. Forget about the technique.
• Hypothesis: NB produces changes in activity in cases of minor motor and cognitive impairments.
• AHA as tool for assessment
Truths and Myths
Real effect?
• How we can measure it? Do we have tools?
• Could neuromuscular bandaje influence hand configuration before reaching the object?
Differences between several materials
NB DMO DS(neoprene)
Evidence - + ++
Versatility +++ ++ ++
Difficulty in manufacturing or using + ++ +++
Child & family’s acceptance +++ ++ ++
Cost ++ - +
Advantages of NB
• It is possible to change and try different placements in the same session (tension, direction, positioning...)
• It is a comfortable material for the child (neoprene)
• It allows to test different possibilities before making a hand splint
• Usually NB is better received than splints as first aid choice
Combination with DMO and Dynamic Splints
• NB DMO DS
• NB/DMO/DS: Structural involvement (night splints, serial casting...) + activity needs, depending on the priority of correction/assistance
Questions
• Is the continued use of a material that replaces/changes propioceptive information the better option? Could its effect cause “fatigue” to propioceptive system?
• Does its effect expire?
• Gain/Cost
I don’t have a conclusion, it’s just my experience...
...And many questions
@eliockinesio [email protected]