Effects of Kinesio taping in patients with quadriceps inhibition: A randomized, single-blinded study

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.

Acute Effect of Kinesiology Taping on Muscle Activation, Functionality and Proprioception in Patients With Knee Osteoarthritis: A Randomized Controlled Trial

Data on the mechanism of kinesiology taping (KT) for providing mechanical support, facilitating or inhibiting muscles, and increasing functionality in the treatment of knee osteoarthritis (OA) have been contradictory, with no study evaluating acute muscle activation. Our aim in this study was to determine the acute effect of KT applied to the rectus femoris muscle on this muscle's activation, functionality and proprioception in patients with knee osteoarthritis. We divided 40 individuals diagnosed with knee osteoarthritis into two groups: (a) KT group (taping with tension facilitation) and (b) a placebo group (taping with no tension facilitation). We applied taping to the participants' left and right side rectus femoris muscles for 30 minutes, but with muscle facilitation in the KT group and without tension in the placebo group. We assessed participants for muscle activation with surface electromyography (sEMG), for functionality with the Timed Up and Go Test (TUG), and for proprioception/joint sense with the Five Times Sit-to-Stand Test (5TSTS) before and after taping. Demographic and clinical characteristics of the groups before these interventions were similar (p > .05). Muscle activation did not change significantly in either group compared to before taping (p > .05), but there were improvements in both knees for proprioception/joint sense (p < .05). Both groups were similar in terms of functionality (5TSTS, TUG) results (p > .05). We concluded that KT applied bilaterally to the rectus femoris did not affect rectus femoris muscle activation and functionality in patients with knee OA, but it did improve proprioception.

What interventions can treat arthrogenic muscle inhibition in patients with chronic ankle instability? A systematic review with meta-analysis

PURPOSE

To identify, critically appraise, and synthesize the existing evidence regarding the effects of therapeutic interventions on arthrogenic muscle inhibition (AMI) in patients with chronic ankle instability (CAI).

MATERIALS AND METHODS

Two reviewers independently performed exhaustive database searches in Web of Science, PubMed, Medline, CINAHL, and SPORTDiscus.

RESULTS

Nine studies were finally included. Five types of disinhibitory interventions were identified: focal ankle joint cooling (FAJC), manual therapy, fibular reposition taping (FRT), whole-body vibration (WBV), and transcranial direct current stimulation (tDCS). There were moderate effects of FAJC on spinal excitability in ankle muscles (g = 0.55, 95% CI = 0.03-1.08, p = 0.040 for the soleus and g = 0.54, 95% CI = 0.01-1.07, p = 0.046 for the fibularis longus). In contrast, manual therapy, FRT, WBV were not effective. Finally, 4 weeks of tDCS combined with eccentric exercise showed large effects on corticospinal excitability in 2 weeks after the intervention (g = 0.99, 95% CI = 0.14-1.85 for the fibularis longus and g = 1.02, 95% CI = 0.16-1.87 for the tibialis anterior).

CONCLUSIONS

FAJC and tDCS may be effective in counteracting AMI. However, the current evidence of mainly short-term studies to support the use of disinhibitory interventions is too limited to draw definitive conclusions.

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 Effects of Kinesiology Taping Stretch Tensions on Soleus and Gastrocnemius H-Reflex Modulations

This study examined the acute effects of stretch tensions of kinesiology taping (KT) on the soleus (SOL), medial (MG), and lateral (LG) gastrocnemius Hoffmann-reflex (H-reflex) modulation in physically active healthy adults. A cross-over within-subject design was used in this study. Twelve physically active collegiate students voluntarily participated in the study (age = 21.3 ± 1.2 years; height = 175.6 ± 7.1 cm; body weight = 69.9 ± 7.1 kg). A standard Y-shape of KT technique was applied to the calf muscles. The KT was controlled in three tension intensities in a randomised order: paper-off, 50%, and 100% of maximal stretch tension of the tape. The peak-to-peak amplitude of maximal M-wave (M_max) and H-reflex (H_max) responses in the SOL, MG, and LG muscles were assessed before taping (pre-taping), taping, and after taping (post-taping) phases in the lying prone position. The results demonstrated significantly larger LG H_max responses in the pre-taping condition than those in the post-taping condition during paper-off KT (p = 0.002). Moreover, the ΔH_max/M_max of pre- and post-taping in the SOL muscle was significantly larger during 50%KT tension than that of paper-off (p = 0.046). In conclusion, the stretch tension of KT contributes minor influence on the spinal motoneuron excitability in the triceps surae during rest.

Effect of Short-Term Kinesiology Taping on Knee Proprioception and Quadriceps Performance in Healthy Individuals

Background: Kinesiology taping (KT) is well known measure for preventing musculoskeletal injuries. Our study aims to explore the actual effects of KT on healthy participants’ knee proprioception and quadriceps performance within 1 h.

Methods: A total of 35 healthy male amateur runners were recruited in our study. Four taping sequences were randomly allocated to four different weeks, namely, no taping, placebo taping, KT with tension, and KT with no tension. A CON-TREX isokinetic dynamometer was used in assessing the participants’ knee proprioception and muscle strength of knee extension and flexion at 60°/s. The electromyography (EMG) signals of medial oblique muscle and vastus lateralis were collected using Myon EMG system synchronously. Two-way repeated measures ANOVA was used in exploring the difference between taping and time effects, and the significance was set to alpha <0.05.

Results: Significant interaction effect was found between the taping groups and time effect [F (3.32) = 2.389, p = 0.029, η² = 0.050] in the peak torque during the concentric contraction of quadriceps. No significant interaction and no significant differences between groups and time effects in knee proprioception and muscle activation.

Conclusion: The effect of KT seems insufficiently large to impose a positive effect on healthy people within short periods. Health participants may not necessarily use KT to increase muscle activation and proprioception of knee.

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.

THE EFFECT of KINESIO TAPE® on STATIC FOOT POSTURE, PLANTAR PRESSURE, and REARFOOT MOTION in INDIVIDUALS with PRONATED FEET

Background

Kinesio Tape® (KT) is an elastic therapeutic tape that is applied to the skin for treatment of sport-related injuries. Its application has been purported to facilitate the neuromuscular system, thus altering skeletal muscle activity to increase joint range of motion and improve performance. Due to its proposed therapeutic effect, KT may benefit individuals with excess foot pronation in order to decrease pain and improve function. Unfortunately, current research regarding the ability of KT to alter foot biomechanics is limited.

Purpose

The purpose of this study was to determine if the application of KT to the ankle and lower leg would alter static foot posture, plantar pressure, and foot motion during walking in individuals with foot pronation.

Study Design

Prospective Cohort Study.

Methods

Thirty participants (10M/20F) were recruited for this study. Each participant had their dorsal arch height and midfoot width measured prior to the application of the KT. In addition, their dynamic rearfoot eversion and plantar pressure was recorded during walking using an electrogoniometer and plantar pressure system. After these measurements were collected, KT was applied to their right foot and lower leg in order to attempt to facilitate activity in the posterior tibialis muscle. After applying the tape, the above measurements were repeated.

Results

None of the variables measured were statistically significantly different between the pre-test and post-test.

Conclusion

Application of KT did not result in a change in static foot posture, plantar pressure, and frontal plane rearfoot motion during walking. As such, KT cannot be recommended as a treatment for reducing excessive foot pronation where such a goal would be beneficial.

Level of Evidence

Level 3.

Effects of Kinesio tape on lower limb muscle strength, hop test, and vertical jump performances: a meta-analysis

BACKGROUND

To date, published systematic reviews concerning the effects of Kinesio Taping (KT) on muscle strength have not analysed facilitatory and inhibitory applications separately. As a result, their results could be substantially affected by clinical heterogeneity. This meta-analysis was conducted to determine the effectiveness of using a facilitatory application of KT for lower limb muscle strength and functional performance (distance in a single-leg hop and vertical jump height) in individuals without disabilities and in those with musculoskeletal conditions (muscle fatigue, chronic musculoskeletal diseases, and post-operative orthopaedic conditions).

METHODS

Searches were conducted on six major electronic databases. Randomised controlled trials that used facilitatory KT were included. Standardised mean differences (SMDs) were calculated and random-effects models were used for analysis.

RESULTS

Thirty-seven randomised controlled trials were included. KT was superior to controls for improving lower limb muscle strength in individuals with muscle fatigue (short-term effect, pooled SMD = 0.53, 95% CI = 0.09 to 0.96; long-term effect, pooled SMD = 0.61, 95% CI = 0.12 to 1.11) and in individuals with chronic musculoskeletal diseases (pooled SMD = 1.24, 95% CI = 0.33 to 2.16) with large effect sizes. The use of KT in populations without disabilities was not supported. There is insufficient evidence for the effect of KT on functional performance in individuals with musculoskeletal conditions.

CONCLUSIONS

Contrary to prior research, the existing evidence shows that KT can improve lower limb muscle strength in individuals with muscle fatigue and chronic musculoskeletal diseases. The effect sizes produced in this meta-analysis show that KT may be superior to some existing treatments for these conditions. In addition, this study suggests that practitioners may wish to avoid the use of KT in individuals without disabilities.

TRIAL REGISTRATION

PROSPERO registration number CRD42017075490 , registered on 21 November 2017.

Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions

OBJECTIVE

To determine whether reported therapeutic interventions for arthrogenic muscle inhibition (AMI) in patients with ACL injuries, following ACL reconstruction, or in laboratory studies of AMI, are effective in improving quadriceps activation failure when compared with standard therapy in control groups.

DESIGN

A scoping review of the efficacy of interventions was conducted in accordance with the methodological framework of Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Search terms included 'arthrogenic muscle inhibition', 'quadriceps activation following knee injuries', 'anterior cruciate' or 'knee' combined with 'quadriceps activation', 'quadriceps inhibition', 'corticomotor', 'arthrogenic', 'brain activation' and 'neuroplasticity'. Articles were evaluated for risk of bias using the PEDro (Physiotherapy Evidence Database) criteria. The overall quality of evidence for each intervention was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).

DATA SOURCES

PubMed, EMBASE and Cumulative Index to Nursing and Allied Health Literature databases.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Isolated case reports and articles reporting outcomes in patients with chronic disease or major trauma were excluded. All other original research articles were included.

RESULTS

780 potential articles were identified. 20 met the inclusion criteria. These studies provided a moderate quality of evidence to support the efficacy of cryotherapy and physical exercises in the management of AMI. There was low-quality evidence for efficacy of neuromuscular electrical stimulation and transcutaneous electrical nerve stimulation, and very low-quality evidence for efficacy of ultrasound and vibration.

CONCLUSIONS

This scoping review demonstrated moderate-quality evidence for the efficacy of cryotherapy and physical exercises in improving quadriceps activation failure after ACL injury and reconstruction. These therapeutic modalities are therefore recommended in the management of AMI.

Kinesio taping is superior to other taping methods in ankle functional performance improvement: a systematic review and meta-analysis

OBJECTIVE:

To compare the effect of Kinesio taping on ankle functional performance with that of other taping methods (non-elastic taping) in healthy individuals and patients with ankle sprain.

METHODS:

A search was performed in electronic databases (MEDLINE, Embase, Cochrane Library, and China National Knowledge Infrastructure) for studies published up to 31 March 2018 using the following keywords: ankle, Kinesio taping, KT, and tape. Studies on ankle functional performance were selected, and data on Star Excursion Balance Test results, vertical jump height, and range of motion were extracted. Meta-analyses (where appropriate and possible) using either fixed or random effects model, standardized mean differences, and tests of heterogeneity were performed.

RESULTS:

Ten studies fulfilled the inclusion criteria. The Star Excursion Balance Test results indicated that Kinesio taping was superior to other taping methods (placebo taping or tension-free taping). The mean difference was 3.2 (95% confidence interval (CI): 0.84-5.59, I² = 5%, P = 0.008). In studies in which vertical jump height was measured, a negative effect was observed for other taping methods (athletic taping or placebo taping), but not for Kinesio taping (mean difference = 1.06, 95% CI: 0.19-0.93, I² = 15%, P = 0.02). Both Kinesio taping and common taping had no significant effect on range of motion, with no differences between these methods ( I² = 0%, P = 0.80).

CONCLUSION:

Kinesio taping is superior to other taping methods (athletic taping) in ankle functional performance improvement.

Kinesio Taping effects with different directions and tensions on strength and range of movement of the knee: a randomized controlled trial

OBJECTIVE

To evaluate the Kinesio Taping effects with different directions and tensions on the strength of rectus femoris and range of movement of the knee in healthy individuals, but with a muscle imbalance caused by exposure to a continuous vibration.

METHODS

This is a randomized controlled trial. The subjects were randomly allocated into two groups: Group application of the Kinesio Taping using origin to insertion and Group application of the Kinesio Taping using insertion to origin. In both groups the dominant limb received the application of Kinesio Taping on rectus femoris (experimental limb) while the non-dominant limb was used as control of the study (control limb). Three assessments were carried out with each subject at different time-points (baseline, post-application, 24h later). These evaluations were performed with 0%, 10% and 75% of tension. The continuous vibration was conducted on the patella tendon for 20min before the first evaluation on each subject. A handheld dynamometer and a digital goniometer were used to evaluate the strength of the rectus femoris and the range of movement of the knee.

RESULTS

The sample consisted of 42 subjects, 79% women and 21% men, mean age 20.5 (SD=4.6), body mass index average of 18.7 (SD=2.34). There were no between-group differences for all outcomes.

CONCLUSION

This study suggests that the use of Kinesio Taping in healthy individuals did not change muscle strength or increase range of movement. Future clinical trials are recommended for symptomatic patients.

TRIAL REGISTRATION

NCT02501915 (https://clinicaltrials.gov/ct2/show/NCT025019150).