Gluteal taping improves hip extension during stance phase of walking following stroke

Sharon L. Kilbreath, Stacey Perkins, Jack Crosbie and Jenny McConnell

The aim of this study was to determine whether gluteal taping on the affected side improved hip extension during stance phase of walking for persons following stroke. Fifteen subjects who had suffered a stroke months to years previously resulting in mild to moderate gait impairments participated in the study. Their gait was measured under control, sham, and gluteal taping conditions, in random order. For each condition, subjects walked at a self-selected and a fast speed. Hip angle relative to that obtained during quiet standing, step length, stride length and walking velocity were measured. Hip extension increased significantly with gluteal taping (p < 0.05) for both walking speeds at late stance phase of walk compared to sham taping and control. The mean absolute difference between gluteal and control conditions for self-selected velocity was 14.2 degrees (95% CI 8.6 to 19.8) whereas the difference between sham and control conditions was 2.0 degrees (95% CI –2.0 to 6.0). Also, for both speeds, step length on the unaffected side increased significantly with gluteal taping compared with either the control or placebo conditions. The absolute difference between gluteal taping and control conditions at self-selected velocity was 3.3 cm (95% CI 2.2 to 4.3) and between sham and control conditions was 0.6 cm (95% CI –0.8 to 1.9). Affected step length and walking velocity, however, remained unchanged. Lastly, there was no significant difference between the control and sham taping condition for any of the measured variables. Gluteal taping may be a useful adjunct to current rehabilitation gait training strategies. [Kilbreath SL, Perkins S, Crosbie J and McConnell J (2006): Gluteal taping improves hip extension during stance phase of walking following stroke. Australian Journal of Physiotherapy 52 1: 53-56]

Key words: Rehabilitation, Gait, Locomotion, Tape, Kinematics, Brain Injury

Introduction

Decreased hip extension of the affected leg is a common impairment after stroke (Huitema et al 2004, Olney and Richards 1996) with significant consequences for gait. For example, Lehmann et al (1987) reported that peak hip extension could be reduced by 14 degrees during late stance, attributable to insufficient active extensor muscle moments (Kim and Eng 2003). Restricted hip extension on the affected side leads to a reduction in contralateral step length, temporospatial asymmetry, and reduced walking speed (Hsu et al 2003).

Taping over the gluteus maximus has been described by McConnell (McConnell 2002) as a strategy to improve hip and pelvis mechanics in chronic low back pain. The taping may reduce the effective length of the muscle, placing it at a more mechanically advantageous length. The taping may also mechanically restrict flexion or improve proprioception at the hip joint.

The aim of this study was to determine whether gluteal taping improved hip extension in chronic stroke subjects during late stance, and, if so, whether it changed temporospatial gait parameters.