Elastic Therapeutic Taping for children with Cerebral Palsy (ETT4CP)

Welcome

Tightness in the back of the thigh muscles (hamstrings) can cause changes to how we sit, stand, or walk and cause discomfort. Young people with Cerebral Palsy (CP) often have increased activity in these muscles which are generally managed with stretches, medicine or surgery. These treatments aim to maintain a child’s level of movement and minimise their pain. 

Elastic therapeutic taping is popular in the world of athletics and has been used to treat other conditions. The tape is thought to improve muscle tone and control in people with CP, but there is limited research to support its use on children with CP. This study will seek to further that research, looking at the use of tape on muscle tone in participants and how it affects the movement of the leg and functional activities such as walking. 

Here we will provide information about the study and link to resources for children and families affected by CP, which we hope you will find helpful. This study is in the early stages and the website will be updated to keep you informed of our progress.

Information about the study

ETT4CP is a two-phase study of the mechanism and effects of Elastic Therapeutic Taping (ETT) of the thigh in children with Cerebral Palsy and spastic hemiplegia or diplegia. Phase 1 looks at the mechanisms of action while Phase 2 is a more active trial investigating the effects of ETT on functional measures such as hamstring muscle length, sit to stand and walking.

We will begin data collection in the first half of 2019 and aim to complete this by the end of 2020. This gives lots of time to find a convenient time to see any children and families who wish to be involved in the study.



We hope that the study will inform us whether taping can affect muscle tone and function and help us to understand how this may occur. The results will help inform a larger clinical trial into the effects of taping in children with Cerebral Palsy.

Phase 1

Phase 1 will assess how tape changes the response to stretching the hamstring muscles (the muscle at the back of the thigh). The hamstring muscle of the most affected or dominant leg will be stretched at different speeds using a motor. The stretch will be in the child’s current range of movement and there are motor safety features to prevent over-stretching the muscle. Muscle activity will be measured using pads attached to the muscles. This will assess whether the stretch gives rise to a contraction of the muscle and how this is affected by tape applied to the back or front of the thigh. The order of these tests will vary and there will be a five-minute rest between each taping application. It will take about 60 minutes to complete the whole process.

Phase 2

Phase 2 will assess how tape changes the length of the hamstrings, stiffness in the muscle and walking, standing patterns and abilities. Measures will be taken before and after the tape is applied to the back of the leg and in two “control” conditions when no tape is applied to the leg. We will cover the thigh in an elasticated stocking so the person taking the measures does not know whether tape has been applied or not. 

In Phase 2 we will take the following measures:

  • Myotonometer. This device applies a small tap to the back of the leg 3 times and measures how much the muscle moves (this looks at muscle stiffness).
  • Clinical measure muscle stiffness- with the child lying on their front the shin will be raised and allowed to drop with gravity three times; sensors attached to the leg will record how quickly the leg drops.
  • Muscle length will be assessed using sensors attached to the legs after stretching the leg slowly.
  • Timed sit to stand, five times.
  • Speed, quality and movement of the knee while walking over 5 meters, this will be recorded on video.

Research Team

  • Samantha Payne, Clinical Researcher and Paediatric Physiotherapist – University of Plymouth
  • Dr Mary Cramp, Research Supervisor – University of West of England

Funding

Physiotherapy Research Foundation (part of the CSP Charitable Trust Registered Charity 279882), Reference Number: NP/17/01

Trial Sponsor: University of Plymouth

Ethical approval has been gained by: HRA and Health and Care Research Wales (HCRW). REC reference 18/SW/0180EC

International Registered Trial Number (ISRCTN): 35963