Can inhibitory and facilitatory kinesiotaping techniques affect motor neuron excitability? A randomized cross-over trial

Physical Therapy Intervention Effects on Alteration of Spinal Excitability in Patients With Chronic Ankle Instability: A Systematic Review and Meta-analysis

CONTEXT

Chronic ankle instability (CAI) is a common injury in athletes. Different forms of physical therapy have been applied to the population with CAI to assess their impact on spinal excitability.

OBJECTIVE

The purpose of this systematic review and meta-analysis was to investigate the effectiveness of various physical therapy interventions on the alteration of spinal excitability in patients with CAI.

DATA SOURCES

Four databases (EMBASE, MEDLINE, Cochrane CENTRAL, and Scopus) were searched from inception to November 2022.

STUDY SELECTION

A total of 253 studies were obtained and screened; 11 studies on the effects of physical therapy intervention on the alteration of spinal excitability in patients with CAI were identified for meta-analysis.

STUDY DESIGN

Systematic review and meta-analysis.

LEVEL OF EVIDENCE

Level 3a.

DATA EXTRACTION

A total of 11 studies that included the maximal Hoffmann reflex normalized by the maximal muscle response (H/M ratio) in the peroneus longus and soleus muscles were extracted and summarized. The quality of the studies was assessed using the PEDro scale.

RESULTS

The extracted studies had an average PEDro score of 4.7 ± 1.4, indicating that most of them had fair-to-good quality. The physical therapy interventions included cryotherapy, taping, mobilization, proprioceptive training, and dry needling. The overall effects showed that the H/M ratios of the peroneus longus (P = 0.44, I2 = 0%) and soleus (P = 0.56,I2 = 22%) muscles were not changed by physical therapy in patients with CAI.

CONCLUSION

The meta-analysis indicated that physical therapy interventions such as cryotherapy, taping, mobilization, proprioceptive training, and dry needling do not alter the spinal excitability in patients with CAI. Given that only 1 study reported ineffective changes in spinal excitability with dry needling, more research is essential to establish and validate its efficacy.

PROSPERO REGISTRATION

CRD42022372998.

Inhibitory kinesiotaping has no effect on post-stroke spasticity: Prospective, randomised, controlled study

OBJECTIVE

Motor neuron pool activity is high in spasticity. The effect of inhibitory kinesiotaping (KT) on spasticity is unclear. The aim of this study is to investigate the effect of inhibitory KT on spasticity after stroke.

METHODS

Fifty stroke patients with ankle plantarflexor spasticity were randomised to intervention (27) and control (23) groups. Inhibitory KT was applied to the triceps surae muscle in the intervention group and sham KT to the Achilles tendon in the control group. Inhibitory and sham KT were applied for 72 h with a combined conventional rehabilitation programme. Spasticity was assessed at baseline and 72 h after KT using three instruments: Modified Ashworth Scale (MAS), Homosynaptic Post-Activation Depression (HPAD) reflecting the level of motor neuron pool activity, and joint torque as a measure of resistance to passive ankle dorsiflexion.

RESULTS

The baseline MAS score, HPAD levels and dorsiflexion torque of the two groups were not significantly different. The change in MAS score was -3.7 ± 17.5 (p = 0.180) in the intervention group and 3.6 ± 33.3 (p = 0.655) in the control group. The change in dorsiflexion torque was -0.3 ± 16.1 kg m (p = 0.539) in the intervention group and 8.0 ± 24.1 kg m (p = 0.167) in the control group. The change in mean HPAD was 8.7 ± 34.7 (p = 0.911) in the intervention group and 10.1 ± 41.6 (p = 0.609) in the control group.

CONCLUSIONS

The present study showed that inhibitory KT has no antispastic effect in stroke patients.

Effects of facilitatory and inhibitory Kinesio taping on lateral gastrocnemius muscle activity, motor neuron excitability, and countermovement jump height in university athletes from multiple sports: A randomized controlled trial

Objectives

This study aims to investigate the temporal effects of two Kinesio Taping (KT) techniques on lateral gastrocnemius muscle activity, motor neuron excitability, and countermovement jump height in university athletes from hockey, football, basketball, and volleyball. Additionally, it investigates whether the athletes' playing positions-either attacker or defender-influence these outcomes following the KT application.

Methods

Forty-eight subjects were randomly assigned to one of three groups: Group A (n = 16), Group B (n = 16), and Group C (n = 16). All groups were further subdivided into attackers and defenders. Adhesive Kinesio tape was applied to the lateral gastrocnemius using the Y-shaped technique for three days. Facilitatory KT was applied from the origin to the insertion of the lateral gastrocnemius, while inhibitory KT was applied from the insertion to the origin. Motor neuron excitability, electromyographic activity, and countermovement jump height were tested at baseline, as well as after KT application, to evaluate if the dependent variables had changed. One-way ANOVA was used for baseline comparison, and mixed ANOVA was applied to assess post-interventional effects on the outcome measures.

Results

Significant group effects for lateral gastrocnemius activation were found, measured using percentage of maximum voluntary isometric contraction (% MVIC) average root mean square (RMS). In motor neuron excitability, maximal M-wave (Mmax) was significantly improved in group comparison. Further, there was also a significant increase in countermovement jump height. There was no significant difference in outcome measures based on playing position (attacker and defender).

Conclusion

Both KT techniques effectively influenced the lateral gastrocnemius muscle's activity, motor neuron excitability, and jump height when compared with the control group. Additionally, there is no effect of playing position, specifically attacker or defender, on the examined variables following KT application.

The Effects of Kinesio Taping® on Muscle Interplay within the Lumbo–Pelvic–Hip Complex: A Randomized Placebo-Controlled Trial

Coordination of muscle activity is determined by the recruitment order of agonists and synergists that results from their onset times. Motor recruitment deficits are possible. This study examined the acute and prolonged effects of three different techniques of the kinesio taping method in optimizing the intermuscular coordination within the lumbo–pelvic–hip complex. The sample consisted of 56 healthy participants of both genders, randomly divided into equal groups by kinesio taping muscle facilitation, muscle inhibition and functional correction technique, and placebo kinesio taping condition. The onsets of the ipsilateral and contralateral erector spinae muscles, in relation to the semitendinosus muscle of the tested leg, were measured using the surface electromyography, during the active performance of the prone hip extension test. Time span was also determined. Measurements were performed at baseline, 60 min, and 48 h post-intervention. For the control group, we did not find statistically significant differences in the onset between the measurement points (p > 0.05), while in the experimental groups, there was a significant delay in the onset of the contralateral erector spinae (p < 0.001) in the second and third measurement points. These results indicate that the kinesio taping method can optimize the intermuscular coordination, with the potential for primary injury prevention.

The effects of facilitatory and inhibitory kinesiotaping of Vastus Medialis on the activation and fatigue of superficial quadriceps muscles

This study aimed to investigate how facilitatory and inhibitory KT of the Vastus Medialis affected the activation and the fatigue indices of VM, Vastus Lateralis (VL) and Rectus Femoris (RF) throughout a dynamic fatigue protocol. Seventeen collegiate athletes (Ten males, seven females, age: 24.76 ± 3.99 years, height: 1.73 ± 0.10 m, mass: 68.11 ± 8.54 kg) voluntarily participated in four dynamic fatigue protocol sessions in which no-tape (control condition), inhibitory, facilitatory and sham KTs were applied to the Vastus Medialis in each session. The protocol included 100 dynamic maximum concentric knee extensions at 90°/s using an isokinetic dynamometry device. The knee extensor muscle activities were recorded using wireless surface electromyography. The average muscle activity (Root mean square) during the first three repetitions and the repetitions number of 51-100, respectively, were used to calculate the before and after exhaustion muscle activity. Furthermore, median frequency slope during all repetitions was reported as the fatigue rate of muscles during different KT conditions and for the control condition (no-tape). The results showed neither muscle activation (significance for the main effect of KT; VM = 0.82, VL = 0.72, RF = 0.19) nor fatigue rate (significance for the main effect of KT; VM = 0.11 VL = 0.71, RF = 0.53) of the superficial knee extensor muscles were affected in all four conditions. These findings suggest that the direction of KT cannot reduce, enhance muscle activity or cause changes in muscle exhaustion. Future studies should investigate the generalizability of current findings to other populations.

Systematic Review of Lumbar Elastic Tape on Trunk Mobility: A Debatable Issue

Objectives

To systematically review the literature to analyze the effect of lumbar elastic tape application on trunk mobility, surpassing the minimal detectable change of the used outcome measurement tool, and to analyze the additional effect of applied tension and direction of elastic tape application in low back pain and participants without low back pain.

Data Sources

Four databases were used: PubMed, Web of Science, Physiotherapy Evidence Database (PEDro), and Google Scholar.

Study Selection

The inclusion criteria were randomized and clinical controlled trials evaluating the effectiveness of lumbar elastic tape application on trunk mobility.

Data Extraction

Two researchers executed the search and a third author was consulted to resolve disagreements. The methodological quality was scored using the PEDro scale, with studies scoring ≤5 being excluded.

Data Synthesis

Eight out of 6799 studies were included; 5 studied individuals with low back pain, and 3 studied participants without low back pain. Two studies scored low on the PEDro scale and were excluded. None of the reported significant changes in trunk mobility due to elastic tape application exceeded the indicated minimal detectable change. No conclusions can be drawn from the direction and applied tension of elastic tape application.

Conclusions

Based on the results of this systematic review, there is no evidence supporting the effect of lumbar elastic tape application. We recommend consensus in the use of more reliable and valid instruments in future studies.

Kinesiology Tape: A Descriptive Survey of Healthcare Professionals in the United States

BACKGROUND

The existing body of kinesiology tape (KT) research reveals inconsistent results which challenges the efficacy of the intervention. Understanding professional beliefs and KT clinical application might provide insight for future research and development of evidence-based guidelines.

PURPOSE

The purpose of this study was to survey and document the beliefs and clinical application methods of KT among healthcare professionals in the United States.

DESIGN

Cross-sectional survey study.

METHODS

A 30-question online survey was emailed to members of the National Athletic Trainers Association, Academy of Orthopedic Physical Therapy, and American Academy of Sports Physical Therapy. Professionals were also informed through a recruitment post in different private healthcare Facebook groups.

RESULTS

One thousand and eighty-three respondents completed the survey. Most respondents used KT for post-injury treatment (74%), pain modulation (67%), and neuro-sensory feedback (60%). Most believed that KT stimulates skin mechanoreceptors (77%), improve local circulation (69%), and modulates pain (60%). Some respondents believed KT only created a placebo effect (40%) and use it for such therapeutic purposes (58%). Most used a standard uncut roll (67%) in black (71%) or beige (66%). Most respondents did not use any specialty pre-cut tape (83%), infused tape (99.54%), or a topical analgesic with tape (65%). The most common tape tension lengths used by respondents were 50% tension (47%) and 25% (25%) tension. Patient reported outcomes (80%) were the most common clinical measures. Most respondents provided skin prep (64%) and tape removal (77%) instructions. Some did not provide any skin prep (36%) or tape removal (23%) instruction. The average recommended times to wear KT were two to three days (60%). The maximum times ranged from two to five days (81%).

CONCLUSION

This survey provides insight into how professionals use KT and highlights the gap between research and practice. Future research should address these gaps to better determine evidence-based guidelines.

LEVEL OF EVIDENCE

3.

Acute effect of inhibitory kinesio-tape of the upper trapezius on lower trapezius muscle excitation in healthy shoulders

INTRODUCTION

Shoulder pain increases excitation of the upper trapezius (UT) and reduces excitation in the lower trapezius (LT). Despite inconclusive evidence, kinesio-tape (KT) is often used to modify muscular excitation within the UT and/or LT to help correct alterations in scapular position and motion associated with shoulder pain/injury. The objective of the current study was to determine if inhibitory KT to the UT acutely increases LT excitation and if load alters the magnitude of change in the excitation observed.

METHODS

Twenty-two (N = 22, 11 female) individuals with healthy shoulders (24 ± 3 years) completed 10 repetitions of an arm elevation task during 3 taping conditions (no-tape, experimental KT, sham KT) and 2 loading conditions (no load and loaded). Whole-muscle (mean grid) and spatial distribution (grid row) of LT excitation (root mean squared; RMS) was measured using a single high-density surface electromyography 32-electrode grid.

RESULTS

There was a main effect for loading condition on whole-muscle LT RMS, F (1, 19) = 38.038, p < .001, partial η² = 0.667. Whole-muscle LT RMS was significantly higher in the loaded condition (0.055 V ±0 .005) compared to the no-load condition (0.038 V ±0 .004). No effect of tape condition was observed on whole-muscle or spatial distribution of RMS.

CONCLUSION

Our findings suggest that inhibitory KT to the UT does not alter whole-muscle excitation or shift the distribution of excitation within the LT during a repeated arm elevation task in healthy shoulders.

Kinesiotape on quadriceps and gluteus in counter movement jump and sprint in soccer players

BACKGROUND

Kinesiotape (KT) is a technique commonly used in sports practice. It may be beneficial in enhancing muscle function by additional cutaneous afferent stimulation. The objective of this study was to analyse the effect of KT on countermovement jump (CMJ) and 20-m sprints (sp) immediately and 24 h after its application on the quadriceps and gluteus maximus.

METHODS

37 male soccer players (19.7 ± 0.9 years old) were randomly assigned to one of 3 groups: experimental group: KT activation (KTact), placebo group: sham tape (KTst), and control group (CG). Participants performed a 30-min preliminary warm-up, after which they conducted CMJ and 20-m sp tests. These tests were repeated later (with KT application or not) and after 24 h.

RESULTS

Intergroup results found no significant differences either post-test (CMJ, p = 0.115; sp, p = 0.307) or after 24 h (p = 0.053). Intragroup results showed no significant results for CMJ, although 20-m sp seemed to display significant differences in the (KTst) (p = 0.002, post-hoc: 0.015 in pre_sp vs post_sp) and the (KTact) (0.021, in post-hoc: 0.007 in pre_sp vs post_sp), with a moderate effect in pre_sp vs post_sp (0.66) in the (KTact) after KT was applied.

CONCLUSION

KT application on the gluteus maximus and quadriceps in young soccer players increases the sprint execution time immediately and 24 h after application, even that the sprint execution time had not been grater that one tenth of the second (0.08 s). It also has no effect on CMJ.

Therapeutic Elastic Tapes Applied in Different Directions Over the Triceps Surae Do Not Modulate Reflex Excitability of the Soleus Muscle

CONTEXT

Elastic taping has been widely used for either to facilitate or to inhibit muscle contraction. The efficacy of elastic taping is allegedly ascribed to physiological mechanisms related to subcutaneous tissue and muscle stimulation as a result of tape tension and direction. However, the underlying mechanisms that support the use of elastic taping are still unclear.

OBJECTIVE

To investigate changes in electrophysiological responses after 48 hours of tape application in different directions on the calf muscles of healthy individuals.

DESIGN

Within-subjects design.

SETTING

Research laboratory.

PARTICIPANTS

Twenty-seven physically active males (age 18.0 [4.2] y, height 1.65 [0.07] m, body mass 62.3 [10.3] kg) participated.

INTERVENTIONS

Soleus H-reflex responses were evoked through stimulation of the tibial posterior nerve with 2- to 4-second interval between stimuli (32 sweeps) for each condition (baseline: without tape; facilitation: tape applied from muscle origin to insertion; inhibition: tape applied from muscle insertion to origin).

MAIN OUTCOME MEASURES

The H-reflex amplitude values were normalized by the maximal direct response (Mmax). Parameters were estimated from a sigmoidal fit of the H-reflex recruitment curve (ascending limb).

RESULTS

No significant differences were found for the parameters derived from the recruitment curve of the H-reflex among the conditions (P > .05).

CONCLUSIONS

The authors' findings showed that, irrespective of the direction of tape application, the elastic tape applied over the triceps surae does not generate any significant alteration on the excitability of the reflex pathway for different subpopulations of motor units. The authors therefore suggest a re-examination of the current recommendations on taping direction in clinical and sports activities.

Acute effect of elastic bandage technique on middle deltoid muscle force and activation in healthy men

Abstract Introduction: Elastic bandages (EB), such as Kinesio taping, have been widely used in sports or daily life activities with the aim of preventing or reducing musculoskeletal injuries. It has been suggested that Kinesio Taping is capable of altering muscle activation through neurophysiological mechanisms, but the evidences about this are controversial. Objective: To verify the acute effect of EB on maximum voluntary isometric force (MVIF) and muscle activation of the middle deltoid muscle during muscle contraction. Method: Twenty-four healthy male (24 ± 4 years, 73.2 ± 13.9kg, 1.80 ± 0.10m) were randomly assigned to a group with elastic bandage activated at 100% (AEB n = 8); with tensionless elastic bandage (NEB n = 8), and the control group (CG n = 9). The volunteers were instructed to perform 5s of maximal isometric contraction at 90° of shoulder abduction while the MIVF and EMGrms records were registered. Results: One-way ANOVA was unable to identify significant difference (α = 0.05) in MIVF and EMGrms of the middle deltoid at 90° of shoulder abduction. Conclusion: The application of elastic bandage was not able to alter the production of maximal isometric voluntary contraction and activation of the middle deltoid muscle of healthy individuals and, therefore, its use is not justified for these purposes.

What is the effect and mechanism of kinesiology tape on muscle activity?

OBJECTIVE

This study aimed to evaluate the effects of kinesiology tape, anesthesia, and kinesiology tape along with anesthesia, on motor neuron excitability.

PARTICIPANTS

Participants included 20 healthy men aged 20-35 years, who were examined over 5 sessions.

INTERVENTION

The five experimental sessions included: control without applying the kinesiology tape or Eutectic Mixture of Local Anesthetics (EMLA); treatment only with EMLA; only kinesiology tape application; only sham tape application; and treatment with kinesiology tape and EMLA.

MAIN OUTCOME MEASURES

The H-reflex recruitment curve of the soleus and lateral gastrocnemius was recorded by a blinded assessor in the 5 separate sessions randomly assigned with 48 h washout periods. The major H-reflex parameters include: the H_max/M_max ratio, the H-reflex threshold stimulation intensity (H_th), the intensity of maximum H-reflex (Intensity_Hmax), the H-reflex ascending slope (H_slp), and the H-reflex ascending slope fixed into the first three points (first H_slp).

RESULTS

The H-reflex parameters (H slope, first H_slp, H_th, and Intensity_Hmax) were facilitated by application of the kinesiology tape with and without EMLA; however, EMLA inhibited the H-reflex parameters (H_max/M_max ratio, H_slp, first H_slp, and H_th) in both the soleus and lateral gastrocnemius. The sham tape did not alter the H-reflex recruitment curve parameters. The statistical model revealed a significant difference between the kinesiology tape and the sham tape and control sessions, between kinesiology tape-EMLA and EMLA, and between kinesiology tape-EMLA and control session.

CONCLUSIONS

Results suggest that the kinesiology tape facilitates the muscle activity and the underlying mechanism on the gastrosoleus motor neuron pool involves the cutaneous receptors.