Effect of Elastic Taping on Shock Attenuation Capacity in Individuals with Poor-rebound Heel Pad

• Main Authors: Jui-Chi Hsu, 許瑞祈
• Other Authors: 柴惠敏
• Format: Others
• Language: en_US
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/9wu75q

碩士 === 國立臺灣大學 === 物理治療學研究所 === 99 === The function of the heel pad is mainly composed of the adipocytes, separated by fibrous septa, whose function is to decrease and absorb the shock as the foot contacts on the ground during walking. If the heel pad becomes atrophy, its shock attenuation capacity decreased which may cause inflammation or pain of the heel pad. The heel pad taping had been reported to be effective in the treatment of heel pad pain syndrome through improving the shock attenuation capacity of the heel pad. However, some people present poor rebound capacity of the heel pad as compression loaded even though they do not have the heel pad pain. There were no evidences to identify the taping effect among them. The purpose of this research was to explore the confinement effect of the heel pad taping on shock attenuation capacity in individuals with poor-rebound heel pad. Prior to the main study, the intrarater reliability of the weight shifting test and loading-unloading test were all tested. This research was convenience sampling, prospective, experiment, and pretest/ posttest study design. Twenty individuals with poor-rebound heel pad and 20 matched controls participated in the main study. Each participant received both weight shifting test and the loading-unloading test under the taping and non-taping conditions. For the weight shifting test, the participants were asked to stand with fully weight bearing on the non-dominant leg, and then shift the weight to the dominant leg and back to the non-dominant leg as soon as possible. The strain and stress data were collected using ultrasonography and load cell synchronously. The mechanical properties variables, including thickness, compressibility index, and energy dissipation ratio of the heel pad were analyzed. For the loading-unloading test, the participants were asked to sit on the floor with knee fully extended. The ultrasound probe with a stepping motor driver compressed the heel pad in a fixed speed and fixed displacement and unload in the same way. The maximum strain at the macrochamber and microchamber layers were collected by elastography. The 2×2 ANOVA with mixed model was used to examine the differences between taping conditions and groups. The significant level was set at α=0.05, and the power was at 0.8. Another 8 and 10 healthy adults separately received 3-session weight shifting test and 2-session loading-unloading test to examine the intrarater reliability. The averaged data were used for statistical analyses, including ICC3,5 and SEM. The results revealed that the heel pad taping increased thickness (16.2 ± 1.9mm vs. 18.3 ± 1.9 mm, p<0.05) and decrease CI (62.4 ±8.1% vs. 54.5 ± 10.5%, p<0.05) of the heel pad for the participants with poor-rebound heel pad. EDR significantly decreased only in the participants with mild poor-rebound heel pad (68.3± 11.2 % vs. 62.1 ± 12.6%, p<0.05); however, it was not the case for those with severe poor-rebound heel pad. There was no significant difference in εcompression and εrecoil in both macrochamber and microchamber layers of the heel pad between taping conditions for both participants with poor-rebound heel pad and healthy adults. Higher εcompression of the microchamber layer in the participants with poor-rebound heel pad than in the healthy adults was found in this study (16.0 ± 4.8% vs. 15.5 ± 3.6%, p<0.05). Additionally, both the weight shifting and loading-unloading tests were highly reliable (ICC3,5=0.782-0.979). It was concluded that the confinement effect of the heel pad taping changed the mechanical properties of the heel pad through increase in thickness rather than alteration of the mechanical properties of the tissue itself for both participants with poor-rebound heel pad and healthy adults. This taping method may be helpful in the clinic. Since the weight shifting and loading-unloading tests were reliable, these tests were able to be used to measure the mechanical properties of the heel pad.