Kinesiotaping for the Rehabilitation of Rotator Cuff-Related Shoulder Pain: A Randomized Clinical Trial

Group Physical Therapy Programs for Military Members With Musculoskeletal Disorders: A Pragmatic Randomized Controlled Trial

OBJECTIVE: To compare the effects of personalized, supervised group-based programs (ie, group physical therapy programs) and usual one-on-one physical therapy care (ie, usual physical therapy care) on disability for military personnel suffering from low back pain, rotator cuff-related shoulder pain, patellofemoral pain syndrome, or lateral ankle sprain. Secondary outcomes were pain severity, pain-related fear, health-related quality of life, and patients' satisfaction with their condition and care. DESIGN: Non-inferiority pragmatic randomized clinical trial. METHODS: One hundred twenty military personnel from the Canadian Armed Forces, experiencing 1 of 4 targeted musculoskeletal disorders, were consecutively recruited and randomly assigned to group physical therapy programs or usual physical therapy care. Disability, pain severity, pain-related fear, and health-related quality-of-life outcomes were measured at 6, 12, and 26 weeks after baseline. Satisfaction with treatment was evaluated at the end of the intervention. Intention-to-treat analyses using linear mixed models with random effects were used to compare the effects of interventions. Chi-square tests were used to compare satisfaction. RESULTS: There were no significant Time × Group interactions for any of the primary and secondary outcomes (Time × Group: P>.67). Satisfaction with treatment also did not differ between groups (P>.05). Statistically significant and clinically important improvements were observed in both groups for all outcomes after 12 weeks (Time effect: P<.01), except for health-related quality of life (P = .13). CONCLUSION: Group physical therapy programs were not inferior to usual physical therapy care for managing pain, functional capacity, and patients' satisfaction with care of military personnel presenting with various musculoskeletal disorders. Both interventions led to clinical and statistical improvement in pain and function in the mid and long term. Group physical therapy could be an effective strategy to enhance access to care. J Orthop Sports Phys Ther 2024;54(6):1-10. Epub 26 Mar 2024. doi:10.2519/jospt.2024.12342.

Evaluating the effects of two different kinesiology taping techniques on shoulder range of motion and proprioception in patients with hypermobile Ehlers-Danlos syndrome: a randomized controlled trial

Background

Ehlers-Danlos syndrome (EDS) is a common group of inherited connective tissue disorders with a prevalence as high as 0.75%-2% of the population. Physical manifestations include pain and decreased proprioception, especially in more mobile joints, such as the shoulder. The kinesiology tape (K-Tape) is often used to treat patients with shoulder dysfunction. The effectiveness of the K-Tape is uncertain, and there is a lack of studies specifically studying the K-Tape in an EDS population.

Purpose

The purpose of this study was to compare the short-term effects of two different K-Tape procedures on shoulder active joint reposition (AJR) and active range of motion (AROM) in patients with hypermobile EDS (hEDS) and shoulder pain.

Methods

All participants were recruited from the EDS support groups and presented with shoulder pain. Baseline demographic information was obtained for each participant, after which AROM and AJR were assessed. The participants were randomized to receive one of two K-Tape procedures. Testing was repeated immediately post-taping and 48 h post-taping.

Results

Significant improvements in shoulder external (F = 10.917, p < 0.001) and internal (F = 11.736, p < 0.001) rotations were seen from baseline to immediately post-taping and baseline to 48 h post-taping in the experimental K-Tape group. There were no significant differences in the shoulder rotation in the control K-Tape group and no significant differences in either group for shoulder flexion or AJR at any time point (p > 0.05).

Conclusion

K-Tape may offer short-term improvements in shoulder rotation AROM in patients with hEDS and shoulder pain.

Shoulder specific exercise therapy is effective in reducing chronic shoulder pain: A network meta-analysis

BACKGROUND

Exercise therapy (ET) is frequently an early treatment of choice when managing shoulder pain, yet evidence on its efficacy to expedite recovery is inconsistent. Moreover, the value of adding adjunct therapies (i.e. injections, manual therapy, electrotherapy) to ET is currently unclear. This study combined both direct and indirect evidence across studies on the effectiveness of ET with/without adjunct therapies compared to usual medical care for adults with chronic shoulder pain.

METHODS AND FINDINGS

Using a network meta-analysis, randomized control trials comparing ET along with adjunct therapies were identified in MEDLINE, Embase, CINAHL, Sportdiscus, CENTRAL, Conference Proceedings Citation Index-Science, clinicaltrials.gov, and association websites. Outcomes included pain, range of motion (ROM), and health-related quality of life (HRQL) measures in adult patients with chronic shoulder pain. Data analysis used a Frequentist hierarchical model. CINeMA tool assessed the confidence in the results and Cochrane Risk of Bias tool assessed quality of studies. 54 studies primarily from Europe (40.38%) included 3,893 participants who were followed up to 52 weeks. Shoulder-specific ET (Mean difference (MD) = -2.1; 95% confidence interval (CI) = -3.5 to -0.7) or in combination with electro-physical agents (MD = -2.5; 95% CI = -4.2 to -0.7), injections (MD = -2.4; 95% CI = -3.9 to-1.04) or manual therapy (MD = -2.3; 95% CI = -3.7 to -0.8) decreased pain compared to usual medical care. Trends with ROM and HRQL scores were seen; however, only Manual Therapy (MD = -12.7 and 95% CI = -24.4 to -1.0) achieved meaningfully important changes. Sensitivity analysis excluding studies with high risk of bias showed similar results, with exception of injections that did not reach significance (MD = -1.3; 95% CI = -4.3 to 1.7).

CONCLUSION(S)

Shoulder-specific ET provided pain relief up to 52 weeks. Adjunct therapies to shoulder-specific ET added little value in reducing pain. The quality of evidence varied between moderate and very low.

Cross-cultural adaptation of the Thoracic Outlet Syndrome Index for Turkish-speaking patients with thoracic outlet syndrome

Background/aim

Considering that there is no specifically designed scale to measure quality of life (QoL) and level of functioning among Turkish-speaking patients with thoracic outlet syndrome (TOS), the aim of this study was to adapt the Thoracic Outlet Syndrome Index (TOSI) to the Turkish language (TOSI-TR) and analyze its psychometric properties in patients with TOS.

Materials and methods

Thirty-nine patients with symptomatic TOS were included in the study. The participants were assessed using the following measures: the QuickDASH, the Western Ontario Rotator Cuff Index (WORC), and a visual analog scale (VAS). The psychometric properties of the TOSI-TR were examined in terms of test-retest reliability, construct validity, convergent validity, and feasibility.

Results

The ICC2,1 of the TOSI-TR was 0.949 (95% CI: 0.903-0.973). The Kaiser-Meyer-Olkin value was found to be 0.716 with a significant result for Bartlett's sphericity test (p < 0.001). The TOSI-TR had a one-factor solution explaining 74.05% of the total variance. There was a significant correlation between TOSI-TR scores and QuickDASH (r = 0.762, p < 0.001), WORC (r =0.794, p < 0.001), and VAS (r = 0.663, p < 0.001) scores. The WORC and VAS scores were significant determinants of the TOSI-TR score, explaining 65.3% of the variance. There were no floor or ceiling effects.

Conclusion

The TOSI-TR is a reliable, valid, and feasible questionnaire for the QoL and functional status in Turkish-speaking patients with TOS. We recommend this 15-item scale for optimal assessment in patients with TOS.

The influence of exercise therapy dosing on pain and functional outcomes in patients with subacromial pain syndrome: A systematic review

Background

The objective was to identify exercise therapy dosing parameters for subacromial pain syndrome (SAPS) associated with improved pain and function outcomes (via effect sizes) and determine the extent of exercise intervention reproducibility.

Methods

An electronic search of PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane Database of Systematic Reviews, and SportDiscus identified studies that used exercise therapy exclusively to treat SAPS. Exercise therapy dosing parameters were extracted and within-group effect sizes were calculated for all pain and functional outcomes. Template for Intervention Description and Replication and Consensus on Exercise Reporting were used to record intervention reporting. The risk of bias and Grading of Recommendations, Assessment, Development, and Evaluation were assessed by two reviewers.

Results

Twenty-one trials with 674 subjects were included. Effect sizes for pain and function were large in 18 studies, medium in six studies, and small or no effect in four studies, despite the type of supervision. With moderate certainty, effect sizes of pain and function were not influenced by exercise therapy dosing parameters. Intervention reporting was generally poor.

Discussion

Exercise therapy for SAPS was associated with large effect sizes for improvement in pain and function but optimal exercise therapy dosing parameters could not be identified. Strong recommendations conditionally suggest treating SAPS with a variety of exercise therapy dosing parameters.

Immediate effects of Kinesio taping and Dynamic taping on acromiohumeral distance in individuals with symptomatic rotator cuff tendinopathy

BACKGROUND

It has been suggested that the reduction in subacromial space during arm elevation is one of the potential mechanisms in the etiology of Rotator cuff tendinopathy. While it is known that Kinesio taping reduces the narrowing of the acromiohumeral distance (AHD) during arm elevation, the effect of Dynamic taping remains unknown.

PURPOSE

This study aimed to compare the immediate effects of Kinesio taping and Dynamic taping on AHD in individuals with symptomatic Rotator Cuff Tendinopathy.

STUDY DESIGN

Two group pre-post-test repeated measures design was used.

METHODS

Thirty-two participants were randomly assigned to two groups: Kinesio taping group (n = 16) and Dynamic taping group (n = 16). AHD measurements were taken via ultrasound at 0° (rest) and 60° shoulder abduction both before and immediately after taping. Repeated measures ANOVAs were used for statistical analyses.

RESULTS

The study demonstrated that both taping methods led to a significant increase in AHD at both neutral and 60° abduction. However, the increase in AHD with Dynamic taping was statistically greater than with Kinesio taping in both neutral (p < 0.05) and 60° abduction (p < 0.001).

CONCLUSIONS

The findings of this study suggest that Dynamic taping techniques may be a more effective approach for improving AHD for symptomatic patients. Therefore, Dynamic taping has the potential to be clinically beneficial before engaging in exercises.

Dexmedetomidine improves lung compliance in patients undergoing lateral decubitus position of shoulder arthroscopy: A randomized controlled trial

BACKGROUND

The improvement of oxygenation and pulmonary mechanics in patients under general anesthesia can be achieved by dexmedetomidine (DEX) infusion. However, its role in patients undergoing lateral supine shoulder arthroscopy has not been thoroughly studied. This study aimed to evaluate the effect of DEX on lung compliance in patients undergoing shoulder arthroscopic surgery in a lateral decubitus position.

METHODS

The patients who underwent lateral recumbent shoulder arthroscopy under general anesthesia were randomly divided into the DEX group (group D) and the control group (group N). At the start of the trial, group D was given 0.5 μg/kg/hours continuous pumping until 30 minutes before the end of anesthesia; Group N was injected with normal saline at the same volume. The patients were recorded at each time point after intubation: supine position for 5 minutes (T0), lateral position for 5 minutes (T1), lateral position for 1 hour (T2), lateral position for 2 hours (T3), airway peak pressure, platform pressure, dynamic lung compliance, and static lung compliance, etc.

RESULTS

At the end of the drug infusion, the DEX group showed significant improved pulmonary mechanics and higher lung compliance than the control group. Compared with group N, group D's heart rate and mean arterial pressure were lower at all time points; there was no statistical difference in Tidal volume and Pressure end-tidal carbon dioxide data at each time point in Group D.

CONCLUSION

DEX can improve lung compliance and reduce airway pressure and platform pressure of patients undergoing shoulder arthroscopy in the lateral position under general anesthesia.

Evaluating the effects of two different kinesiology taping techniques on shoulder pain and function in patients with hypermobile Ehlers-Danlos syndrome

Background

Ehlers-Danlos Syndrome (EDS) is a group of inherited connective tissue disorders which predominantly affects women and has a prevalence as high as 1 in 5,000 individuals. Hypermobile EDS (hEDS) is the most common subtype of EDS and is characterized by multi-joint pain, particularly in large joints such as the shoulder. Physical therapy is often utilized to address the pain, physical impairments, and functional loss in patients with EDS. Kinesiology Tape (KT) is an intervention commonly used by physical therapists for treating shoulder pain and dysfunction. Studies related to the effectiveness of KT in patients with shoulder pain is equivocal and there are a lack of studies specifically studying the effects of KT in an EDS population.

Purpose

The purpose of this study was to assess the efficacy and short-term effects of two different KT techniques on shoulder pain and function in individuals with hEDS and shoulder pain.

Methods

Participants were recruited from EDS support groups in the New England area of the United States; were diagnosed with hEDS by their physician; and had shoulder pain. Baseline demographic information was obtained for each participant followed by completion of 4 patient reported outcome (PRO) measures: the Upper Extremity Functional Index, QuickDASH (Disabilities of the Arm, Shoulder, & Hand), Shoulder Pain and Disability Index, and the Western Ontario Shoulder Instability Index. Current pain level, average pain over the past 24 h, and worst pain over the past 24 h were recorded using the numeric pain rating scale (NPRS). Subjects were randomly assigned to receive either an experimental shoulder KT procedure or a control shoulder taping. Immediately after taping, the NPRS was reassessed. Subjects then returned 48 h later to repeat the NPRS and PRO measures.

Results

There was no significant difference between the experimental and control tape groups for any outcome measure. There was a significant improvement from pre-taping to 48-hours post taping for each of the 4 PRO measures with large effect sizes (p < 0.001; ƞ _p ² = .517-.719). Likewise, average, and worst pain over the last 24 h significantly improved with large effect sizes over the same period (p = 0.005; ƞ _p ² = .225 and p < 0.001; ƞ _p ² = .382, respectively). Current NPRS levels significantly improved from pre-tape to immediately post-tape (p = .023, ƞ _p ² = .131) and was maintained through the 48-hour follow up, although no further improvement was seen.

Conclusion

KT is an inexpensive and relatively safe intervention that is easy to apply and can offer temporary improvements in pain and function for patients with EDS and shoulder pain.

Effects of Kinesio Taping and Rigid Taping on Gluteus Medius Muscle Activation in Healthy Individuals: A Randomized Controlled Study

BACKGROUND

Gluteus medius muscle (GMed) dysfunctions may be associated with pain and functional problems in the lumbar spine and lower limbs. The study sought to assess the effects of applying kinesio taping (KT) and rigid taping (RT) on GMed in the dominant leg of healthy individuals. Furthermore, an attempt was made to indicate which of the applied exercises brought about the greatest activation of GMed.

METHODS

The study included 90 individuals, with an average age of 21.79. The participants were randomly assigned to one of three groups: kinesio tape (KT), rigid tape (RT) and placebo tape (C). GMed activation was assessed using sEMG during the performance of such exercises as glute bridge, unilateral glute bridge, clamshell, pelvic drop and lunge. Each of the participants was examined three times-before taping, immediately after and 48 h after taping.

RESULTS

Before taping, the greatest GMed activation on the dominant side was noted in clamshell (54.12 %MVIC), whereas the lowest GMed activation was observed in glute bridge (36.35 %MVIC). The comparison of results obtained before and immediately after taping in all the groups revealed a statistically significant increase in GMed activation (p < 0.05), while the comparison of results achieved before and 48 h after taping showed significant differences in glute bridge in groups KT and RT. In all the groups, the differences in results obtained in the other exercises were not significant. Taking into account each of the applied exercises, at none of the three stages of examination were the differences between the groups significant.

CONCLUSIONS

Regardless of the type of taping applied (KT, RT, C), a significant increase in GMed activation was noted in all the exercises immediately after taping. At none of the stages of examination were the differences between the groups significant.

Group-based exercice training programs for military members presenting musculoskeletal disorders - protocol for a pragmatic randomized controlled trial

BACKGROUND

Musculoskeletal disorders are a leading cause of morbidity and the most prevalent source of disability among soldiers. Their high prevalence in armed forces and limited ressources have led to problems related to access to physical rehabilitation care. To increase access, supervised group-based exercise programs for the most prevalent musculoskeletal disorders (low back pain, patellofemoral pain, rotator cuff-related shoulder pain or lateral ankle sprain) have been developed at a Canadian Armed forces (CAF) base, but their effectiveness has not been evaluated. The primary objective of this randomized controlled trial is to evaluate the mid- and long-term effects of these group-based training programs on pain severity and functional limitations, in comparison with usual individual physiotherapy care. Secondary objectives include comparing both interventions in terms of health-related quality of life, pain-related fear, and patients' satisfaction.

METHODS

One hundred and twenty soldiers with a new medical referral for physiotherapy services for one of the four targeted musculoskeletal disorders will be consecutively recruited. They will be randomly assigned to either group-based training program or usual individual physiotherapy care, and will take part in the assigned 12-week intervention. There will be four evaluation sessions over 26 weeks (baseline, week 6, 12 and 26). At each follow-up, functional limitations, pain severity, health-related quality of life and pain-related fears will be assessed. Patients satisfaction with treatment will also be evaluated at the end of the intervention period. Either two-way repeated measures ANOVA will be used to analyse and compare the effects of the interventions.

DISCUSSION

This RCT will determine the effectiveness of group-based training programs compared to usual individual physiotherapy care. This new intervention model could represent an efficient, and more pro-active approach to manage a higher number of soldiers with musculoskeletal disorders. It could improve access to physical rehabilitation care and improve the health of soldiers.

TRIAL REGISTRATION

ClinicalTrials.gov ( NCT05235152 ), February 11th 2022.

Co-creation of an exercise inventory to improve scapular stabilization and control among individuals with rotator cuff-related shoulder pain: a survey-based study amongst physiotherapists

Background

Scapular stabilization exercises (SSE) are often included in the treatment of individuals with rotator cuff-related shoulder pain (RCRSP) to decrease pain and improve function. These SSE typically aim to strengthen the scapular muscles and optimize dynamic neuromuscular control of the scapula, which may improve overall shoulder stability and movement quality. No consensus of the recommended SSE for the management of RCRSP is available. Hence, this study aimed to consult physiotherapists to co-create an inventory of recommended SSE based on the exercise’s relevance and frequency of prescriptions for the rehabilitation of individuals with RCRSP.

Methods

A group of 16 physiotherapists with experience in treating shoulder pain participated in a sequential consultation incorporating two distinct rounds of consultation focusing on SSE (modified Delphi design). In round 1, physiotherapists identified and demonstrated up to 10 SSE that they commonly recommend or use among individuals with RCRSP. The description and performance of all SSE were audio and video recorded. All SSE suggested by more than one participant in round 1 advanced to round 2. In round 2, physiotherapists rated these SSE on a 4-point Likert scale according to their perceived relevance and frequency of prescription for this population.

Results

In round 1, out of the 25 SSE recommended by participants, 19 SSE (76.0%) were recommended by more than one physiotherapist and advanced to round 2. In round 2, 13 SSE were consensually classified (agreement ≥75%) as being relevant for the rehabilitation of individuals with RCRSP. SSE targeting the recruitment of the serratus anterior and lower trapezius muscles were considered the most relevant for the management of RCRSP, whereas SSE targeting neuromuscular scapular control were the most prescribed SSE for the management of RCRSP.

Conclusions

An inventory composed of 13 SSE was co-created by physiotherapists based on their relevance and frequency of prescription for the rehabilitation of individuals with RCRSP. When designing an exercise program, physiotherapists can use this SSE inventory to inform their exercise selection, in combination with their current knowledge on shoulder rehabilitation, as well as patients’ preferences.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40945-022-00132-7.

Effectiveness of kinesiotaping in patients with subacromial impingement syndrome: A systematic review with meta-analysis

OBJECTIVE

To determine the effectiveness of kinesiotaping (KT) with or without co-interventions for clinical outcomes in patients with subacromial impingement syndrome (SIS).

DESIGN

Systematic review with meta-analysis of randomized clinical trials.

DATA SOURCES

Eight databases (MEDLINE, CENTRAL, EMBASE, PEDro, LILACS, CINAHL, SPORTDiscus, and Web of Science) were searched from inception until March 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Clinical trials that determine the effectiveness of KT with or without co-interventions for clinical outcomes in patients with SIS who are older than 18 years of age.

RESULTS

Ten trials for the quantitative analysis were included. For pain intensity at 1-3 weeks, the overall pooled MD was -0.73 cm, 95% CI = -1.50 to 0.04 (p = 0.06), and at 3-6 weeks, it was -0.13 cm, 95% CI = -1.37 to 0.36 (p = 0.25). For shoulder function, the MD was -0.02, 95%CI = -0.30 to 0.26 (p = 0.89). For shoulder Range of Motion (ROM) flexion, the MD was -16.70, 95% CI = -0.52 to 33.92 (p = 0.06). Additionally, there was a low to moderate quality of evidence according to the GRADE rating.

CONCLUSION

Kinesiotaping with or without co-interventions was not superior to other interventions for improving shoulder pain intensity, function and ROM flexion in patients with SIS.

Kinesio taping for rotator cuff disease

BACKGROUND

Kinesio Taping (KT) is one of the conservative treatments proposed for rotator cuff disease. KT is an elastic, adhesive, latex-free taping made from cotton, without active pharmacological agents. Clinicians have adopted it in the rehabilitation treatment of painful conditions, however, there is no firm evidence on its benefits.

OBJECTIVES

To determine the benefits and harms of KT in adults with rotator cuff disease.

SEARCH METHODS

We searched the Cochrane Library, MEDLINE, Embase, PEDro, CINAHL, Clinicaltrials.gov and WHO ICRTP registry to July 27 2020, unrestricted by date and language.

SELECTION CRITERIA

We included randomised and quasi-randomised controlled trials (RCTs) including adults with rotator cuff disease. Major outcomes were overall pain, function, pain on motion, active range of motion, global assessment of treatment success, quality of life, and adverse events.

DATA COLLECTION AND ANALYSIS

We used standard methodologic procedures expected by Cochrane.

MAIN RESULTS

We included 23 trials with 1054 participants. Nine studies (312 participants) assessed the effectiveness of KT versus sham therapy and fourteen studies (742 participants) assessed the effectiveness of KT versus conservative treatment. Most participants were aged between 18 and 50 years. Females comprised 52% of the sample. For the meta-analysis, we considered the last available measurement within 30 days from the end of the intervention. All trials were at risk of performance, selection, reporting, attrition, and other biases.  Comparison with sham taping Due to very low-certainty evidence, we are uncertain whether KT improves overall pain, function, pain on motion and active range of motion compared with sham taping. Mean overall pain (0 to 10 scale, 0 no pain) was 2.96 points with sham taping and 3.03 points with KT (3 RCTs,106 participants), with an absolute difference of 0.7% worse, (95% CI 7.7% better to 9% worse) and a relative difference of 2% worse (95% CI 21% better to 24% worse) at four weeks. Mean function (0 to 100 scale, 0 better function) was 47.1 points with sham taping and 39.05 points with KT (6 RCTs, 214 participants), with an absolute improvement of 8% (95% CI 21% better to 5% worse)and a relative improvement of 15% (95% CI 40% better to 9% worse) at four weeks. Mean pain on motion (0 to 10 scale, 0 no pain) was 4.39 points with sham taping and 2.91 points with KT even though not clinically important (4 RCTs, 153 participants), with an absolute improvement of 14.8% (95% CI 22.5% better to 7.1% better) and a relative improvement of 30% (95% CI 45% better to 14% better) at four weeks. Mean active range of motion (shoulder abduction) without pain was 174.2 degrees with sham taping and 184.43 degrees with KT (2 RCTs, 68 participants), with an absolute improvement of 5.7% (95% CI 8.9% worse to 20.3% better) and a relative improvement of 6% (95% CI 10% worse to 22% better) at two weeks. No studies reported global assessment of treatment success. Quality of life was reported by one study but data were disaggregated in subscales. No reliable estimates for adverse events (4 studies; very low-certainty) could be provided due to the heterogeneous description of events in the sample. Comparison with conservative treatments Due to very low-certainty evidence, we are uncertain if KT improves overall pain, function, pain on motion and active range of motion compared with conservative treatments. However, KT may improve quality of life (low certainty of evidence).  Mean overall pain (0 to 10 scale, 0 no pain) was 0.9 points with conservative treatment and 0.46 points with KT (5 RCTs, 266 participants), with an absolute improvement of 4.4% (95% CI 13% better to 4.6% worse) and a relative improvement of 15% (95% CI 46% better to 16% worse) at six weeks. Mean function (0 to 100 scale, 0 better function) was 46.6 points with conservative treatment and 33.47 points with KT (14 RCTs, 499 participants), with an absolute improvement of 13% (95% CI 24% better to 2% better) and a relative improvement of 18% (95% CI 32% better to 3% better) at four weeks. Mean pain on motion (0 to 10 scale, 0 no pain) was 4 points with conservative treatment and 3.94 points with KT (6 RCTs, 225 participants), with an absolute improvement of 0.6% (95% CI 7% better to 8% worse) and a relative improvement of 1% (95% CI 12% better to 10% worse) at four weeks. Mean active range of motion (shoulder abduction) without pain was 156.6 degrees with conservative treatment and 159.64 degrees with KT (3 RCTs, 143 participants), with an absolute improvement of 3% (95% CI 11% worse to 17 % better) and a relative improvement of 3% (95% CI 9% worse to 14% better) at six weeks.  Mean of quality of life (0 to 100, 100 better quality of life) was 37.94 points with conservative treatment and 56.64 points with KT (1 RCTs, 30 participants), with an absolute improvement of 18.7% (95% CI 14.48% better to 22.92% better) and a relative improvement of 53% (95% CI 41% better to 65% better) at four weeks.  No studies were found for global assessment of treatment success. No reliable estimates for adverse events (7 studies, very low certainty of evidence) could be provided due to the heterogeneous description of events in the whole sample.

AUTHORS' CONCLUSIONS

Kinesio taping for rotator cuff disease has uncertain effects in terms of self-reported pain, function, pain on motion and active range of motion when compared to sham taping or other conservative treatments as the certainty of evidence was very low. Low-certainty evidence shows that kinesio taping may improve quality of life when compared to conservative treatment. We downgraded the evidence for indirectness due to differences among co-interventions, imprecision due to small number of participants across trials as well as selection bias, performance and detection bias. Evidence on adverse events was scarce and uncertain. Based upon the data in this review, the evidence for the efficacy of KT seems to demonstrate little or no benefit.