Extended use of Kinesiology Tape and Balance in Participants with Chronic Ankle Instability

Plantar massage or ankle mobilization do not alter gait biomechanics in those with chronic ankle instability: a randomized controlled trial

OBJECTIVES

Chronic ankle instability (CAI) is characterized by persistent neuromechanical impairments following an initial lateral ankle sprain. Ankle joint mobilization and plantar massage have improved the range of motion and static postural control in those with CAI. This study aimed to determine the impact of two-week joint mobilization and plantar massage interventions on gait kinematics and kinetics in individuals with CAI.

METHODS

A single-blind randomized trial was conducted with 60 participants with CAI, randomized into three groups: joint mobilization (n = 20), plantar massage (n = 20), and control (n = 20). The two treatment groups received six 5-min sessions manual therapy over a 2-week, while the control group received no intervention. Gait biomechanics were assessed on an instrumented treadmill before and after the intervention using 3D kinematics and kinetics analysis. Analyses compared biomechanical outcomes from each treatment group to the control group individually using a 1-dimensional statistical parametric mapping. The alpha level was set at p < 0.05.

RESULTS

Eighteen participants per group were part of the final analysis. No significant main or interactions effects were found for ankle sagittal or frontal plane positions following either intervention (p > 0.05 for all comparisons). COP location relative to the lateral border of the foot also did not change (p > 0.05).

CONCLUSION

The findings suggest that two-week joint mobilization and plantar massage interventions do not significantly alter gait biomechanics in individuals with CAI. These results support the need for gait-specific interventions to modify biomechanics in this population.

Kinesiology taping improves balance in football players with chronic ankle instability

INTRODUCTION

There appears to be no consensus on the usefulness of kinesiological tape in athletes with chronic ankle instability, therefore the aim of this study was to examine the effects of kinesiological tape on dynamic balance in football players with chronic ankle instability.

DESIGN, SETTING AND PARTICIPANTS

Football players who were eligible for this randomized controlled study were randomly assigned (allocation ratio 1:1:1) to one of three groups: experimental group, placebo group or control.

INTERVENTIONS

The experimental group received kinesiological tape bands applied to the peroneal and tibialis anterior muscles. The tape was applied for 48 h. The placebo group received a sham kinesiological tape application for the same duration, while the control group did not receive any tape.

OUTCOME MEASURES

Balance was assessed using the Y-Balance Test at baseline and 48 h later, with the kinesiological tape still in place, either sham or control.

RESULTS

A total of 69 (23 per group) semi-professional, male, players (22.1 ± 4.3 years) completed the study. There was a significant change in test performance over time (F1,66 = 9.425; P = 0.003; ηp2 = 0.125), with a significant interaction for group × time (F2,66 = 11.154; P < 0.001; ηp2 = 0.253). The kinesiological tape group improved the overall performance in the Y-balance test (85.2 ± 8.7% to 90.3 ± 8.4%, P < 0.001), while no differences were observed for the placebo and control groups.

CONCLUSION

The application of kinesiological tape for 48 h improved overall dynamic balance performance on the Y-balance test. These findings suggest that kinesiological tape could be a beneficial strategy for addressing the consequences of chronic ankle instability.

Immediate and acute effects of Kinesio taping on back muscle endurance, low back flexibility, and balance among sedentary individuals: A randomized controlled trial

INTRODUCTION

Sedentary lifestyles is linked to a reduction in back muscle strength, endurance, and balance, consequently increasing the risk of experiencing low back pain. Kinesio taping has been shown to be effective in enhancing endurance, flexibility, and balance. This study aimed to investigate the effects of Kinesio taping on measures of lumbar function in sedentary individuals.

METHOD

Forty-four sedentary young adults were randomly assigned into intervention and control groups. The intervention group received Kinesio tape to the lumbar region while the control group received health education. The Schober's test, Single-leg stance test, Y Balance Test, and Biering-Sorensen test were performed at baseline and 30 min and 24 h after the taping intervention.

RESULTS

There was a statistically significant increase in static balance (single-leg stance test) in the intervention group compared to the control group (p ≤ 0.05). In the Y Balance Test and Biering-Sorensen test, there was no significant difference between the intervention group and control group, though there was a significant increase in both groups from baseline to 24 h after taping. Though low back flexibility (Schober's test) significantly decreased in the intervention group, there was no significant difference between the two groups.

CONCLUSION

Kinesio taping can immediately improve static balance in people with sedentary behavior. The application of Kinesio tape had no impact on dynamic balance, low back flexibility, or low back muscle endurance.

Effects of short- or long-term use of orthotic interventions on functional performance in individuals with chronic ankle instability: A systematic review

BACKGROUND

Individuals with chronic ankle instability (CAI) have problems in function. The purpose of this study was to systematically investigate the short- or long-term effects of various orthoses on function of these people.

METHODS

Randomized controlled trial (RCT) studies reporting on the short- or long-term effects of orthotic intervention on functional performance in individuals with CAI were identified through PubMed, Cochrane Library, PEDro, MEDLINE via Ovid, and Scopus databases from inception to July 2022. Two reviewers independently extracted data and assessed the risk of bias and quality of the studies using ROB tool and PEDro scale, respectively.

RESULTS

Eleven RCTs published from 2012 to 2022 were included in this review. The studies were of a fair or good quality. The risk of bias was low in 50 percent and high in 16.7 percent of the studies. The mSEBT in the posterolateral and posteromedial directions were improved both in the short- and long-term application of orthoses. Single leg hop did not change but single leg stance was improved more in the experimental group who used orthoses for 4 weeks.

CONCLUSION

Various tapes can improve dynamic balance immediately after application and their effects would last up to 2 months. Therefore, they can be used during training. Athletes with CAI who want to perform better should use the tape at least two weeks before competing to take advantage of its long-term effects. The timing of application of orthotic appliances, needs to be adjusted according to the relevant function.

Immediate effects of trunk Kinesio Taping® on functional parameters in the acute stage of patients with mild stroke: A randomized controlled trial

BACKGROUND

Improving early trunk control, balance, and sitting activity following acute stroke is critical for functional prognosis.

PURPOSE

To compare the immediate efficacy of Kinesio Taping® (KT) application on anterior and posterior trunk muscles in terms of improving trunk control, balance, and sit-to-stand performance in the acute stage of stroke.

METHODS

Sixty-nine patients with acute mild stroke were allocated to the anterior KT group (AKT) (age = 65.95 ± 9.67; 12 females, 11 males; Modified Rankin Score = 3), posterior KT group (PKT) (age = 65.39 ± 10.39; 10 females, 13 males; Modified Rankin Score = 3), and control group (CG) (age = 65.34 ± 8.91; 11 females, 12 males; Modified Rankin Score = 2). Trunk control, balance, and sit-to-stand performance were assessed at the baseline and after 45 minutes and 48 hours post-KT. Data were analyzed using repeated-measures ANOVA.

RESULTS

All outcome measures scores improved in all groups significantly after 48 hours (p < .001). A significant improvement after 45 minutes was only seen in trunk control compared to the CG (p < .001; d = 1.32 for AKT and p = .038; d = 0.75 for PKT). Trunk control, balance, and sit-to-stand performance improved in both AKT and PKT compared to the CG at 48 hours post-taping. Trunk control (p < .001; d = 0.26) and balance (p < .001; d = 0.72) results were in favor of the AKT, while sit-to-stand performance results did not make a difference between KT groups (p = .335; d = 0.47).

CONCLUSION

KT application on anterior or posterior trunk muscles was effective for improving trunk control, balance, and sit-to-stand performance in acute stage of stroke in the short term. KT application on anterior trunk muscles had the advantage of improving trunk control and balance.

Short-term effects of kinesiology taping on static and dynamic balance in healthy subjects

Background

As a therapeutic tool, kinesiology taping (KT) has become increasingly popular for musculoskeletal injuries utilized by physiotherapists. KT has been found to have effects on facilitating muscle strength by generating a concentric pull on the fascia. However, little is known about KT in the improvement of dynamic and static balance. This study aims to explore whether KT on the quadriceps muscle has any immediate effects on static and dynamic balance.

Methodology

Twenty-seven healthy individuals (13 males and 14 females, aged 22 to 29) were recruited in a crossover study with two conditions: KT and no taping. KT was applied to the quadriceps muscle for the taping group, with the control receiving no taping. Pre- and post-test measurements were taken to give an indication of the effect of the tape on balance performance. Center of Pressure Excursion (COPE) and Time to Stabilization (TTS) when landing from a hop test and Y Balance test combined score (YBTCS) were used to assess a stabilizing balance activity and a dynamic balance. The pre- and post-intervention were collected, with differences explored using repeated measures ANOVA with time and condition (tape) factor analysis.

Results

We found a significant improvement (p ≤ 0.05) with a moderate to large effect size in YBTCS between KT and no taping, indicating enhanced balance performance in the KT group. However, no significant difference (p ≥ 0.05) with small to moderate effect size was found in COPE or TTS between the two conditions during landing tests, suggesting similar balance capabilities in these specific measures.

Conclusion

The use of KT shows no significant immediate effect on static balance in healthy individuals when applied to the quadriceps muscles; however, it demonstrates a positive immediate effect on dynamic balance.

Effectiveness of functional or biomechanical bandages with athletic taping and kinesiotaping in subjects with chronic ankle instability: a systematic review and meta-analysis

Purpose

The aim of the study was to analyze the effects of functional or biomechanical bandages, whether elastic or inelastic, in Chronic Ankle Instability (CAI).

Methods

This review used PubMed, WoS, SCOPUS, and CINAHL following PRISMA and registering in Prospero. Main PICOS: (1) CAI; (2) intervention, functional/biomechanical bandages; (3) comparison, taping effect versus placebo/no taping, or another functional taping; (4) outcomes, improvement of CAI functionality (dynamic/static balance, ankle kinematic, perception, agility and motor control, endurance and strength; (5) experimental and preexperimental studies. The meta-analyses considered mean and s.d. of the results per variable; effect size (ES) of each study and for each type of intervention. Homogeneity (Q), heterogeneity (H 2 and I 2), and 95% CI were calculated.

Results

In total, 28 studies were selected. Significant differences were found for dynamic balance (66.66%) and static balance (87.5%), ankle kinematics (75.00%), perceptions (88.88%), plantar flexor strength (100%), muscle activity (66.6%), endurance (100%), functional performance (100%), and gait (66.6%). The main results of meta-analyses (eight studies) are as follows - h/M ratio soleus, ES: 0.080, 95% CI: -5.219-5.379; h/M ratio peroneus, ES: 0.070, 95% CI: -6.151-6.291; posteromedial KT, ES: 0.042 95% CI: -0.514-0.598; posteromedial-overall, ES: -0.006 95% CI: -1.071-0.819; mSEBT-KT, ES: 0.057 95% CI: -0.281-0.395; mSEBT-overall, ES: -0.035 95% CI: -0.190-0.590.

Conclusions

All biomechanical or functional bandages, whether elastic or inelastic, applied in CAI were favorable, highlighting patient perception, dynamic and static balance, kinematics and agility and motor control, for its effectiveness and evidence. Thus, bandages increase ankle functionality. The meta-analyses found no statistical significance. Clinically, soleus muscle activity, h-reflex/M-responses using fibular reposition with rigid tape, and dynamic balance with combined kinesiotaping during the modified star excursion balance test and with the posteromedial direction found improvements.

Level of evidence

Level of evidence according to Scottish Intercollegiate Guidelines Network: 1+. Level of evidence according to the Oxford Centre for Evidence-Based Medicine 2011: 1.

Effectiveness of neuromuscular taping on balance, proprioception, pain, and nerve conduction parameters in patients with diabetic peripheral neuropathy: a two-group pretest-posttest randomized sham-controlled trial study protocol

Background

The management of diabetic peripheral neuropathy (DPN) comprises a multidimensional approach. Along with pharmacological treatment, physiotherapy has gained applaudable popularity in improving the symptoms of DPN. Neuromuscular taping (NMT) is effective in improving motor, sensory, and balance impairments in many neuromuscular and musculoskeletal conditions but no research has conducted to evaluate the effect of NMT on balance, proprioception, pain, and nerve conduction parameters in patients with DPN.

Purpose

To evaluate the effectiveness of NMT on balance, proprioception, pain, and nerve conduction parameters in patients with DPN.

Methods

50 DPN patients aged 40-60 years, scored ≥ 2/13 on physical appearance and ≥ 1/10 on physical examination of Michigan Neuropathy Screening Instrument (MNSI), > 12 on Leeds Assessment of Neuropathic Symptom and Sign (LANSS) scale and < 45 on Berg Balance Scale (BBS) will be included. The experimental group (EG) will receive NMT at the tibialis anterior, tibialis posterior, and peroneus longus muscle and transverse arch of the foot and TENS at the tibial and peroneal nerves (80 Hz, 50 Amp, 0.2 ms square pulses, 2 to 3 times sensory threshold) and the control group (CG) will receive sham taping at the ankle joint and TENS with the same parameters as EG. Outcome measures will be taken at baseline, at 4 weeks, and at 8 weeks of intervention, respectively.

Conclusion

The results obtained upon completion of this study may provide a cost-effective non-invasive treatment option to improve the outcomes that will be measured in the present study in patients with DPN.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01275-5.

The immediate effect of synergistic muscles kinesio taping on function and balance of volleyball players with functional ankle instability: A randomized controlled trial

OBJECTIVES

To determine the immediate effect of synergistic muscles Kinesio taping (KT) on the function and balance of volleyball players with functional ankle instability (FAI).

DESIGN

Parallel, superiority randomized controlled trial.

METHODS

Twenty-six semi-professional volleyball players with FAI were randomly assigned to either the intervention or control group. All participants received KT of fibularis longus, gastrocnemius, and gluteus maximus muscles for one session. The intervention group received KT with 35 % tension, while the control group received KT without tension. The function was assessed using the side hop and single hop distance tests. Dynamic balance was assessed with the Y Balance test. The outcomes were measured at baseline, 20 min after KT, and 24 h after KT. Statistical analyses were performed using Mixed-model repeated measures analysis of variance (ANOVA) and one-way ANOVA.

RESULTS

The interactions of time*group for the outcomes of function using the single hop test and stability in the anterior direction of the Y Balance test were significant (p < 0.05). Within-group comparisons showed after KT, both groups experienced significant improvements in all outcomes compared to the baseline. Results of between-group comparisons revealed that the application of KT with tension compared to no tension significantly improved function and balance in the anterior of the Y Balance test.

CONCLUSIONS

Kinesio taping can be an effective treatment option to improve function and balance in FAI. Additionally, Kinesio taping with tension compared to KT without tension had superiority.

Acute effects of kinesiology tape on dynamic balance control in chronic ankle instability: An exploratory study

OBJECTIVE

To investigate the acute effect of the four-strip kinesiology taping (KT) technique on dynamic balance control in the Y Balance Test (YBT), and to explore the relationship between the YBT and Cumberland Ankle Instability Tool (CAIT) scores in individuals with and without chronic ankle instability (CAI).

METHODS

16 CAI and 16 non-CAI participants were involved. Two groups completed the YBT in the no-tape barefoot and the KT condition at random. The CAIT was completed on the first day. Bonferroni test was used to analyze YBT scores in three directions for post hoc analysis. Spearman's correlation was used to analyze the relationship between YBT scores in the no-tape barefoot condition and CAIT scores.

RESULTS

This KT application significantly improved YBT performance. The YBT scores in the anterior direction (YBT-A), posteromedial direction (YBT-PM), and posterolateral direction (YBT-PL) for the CAI group were significantly improved after taping. However, in the non-CAI group, only YBT-PM score was significantly improved after taping. Three YBT scores were all moderately correlated with the CAIT score.

CONCLUSION

This KT technique can immediately improve dynamic balance in CAI patients. Dynamic balance performance was moderately related to the degree of self-perceived instability in individuals with and without CAI.

Effect of kinesio taping intervention on the muscle strength and balance of college basketball players with functional ankle instability

Objective: The aim of this study was to investigate the effects of acute Kinesio Taping (KT) intervention on the muscle strength and balance ability of college basketball players with functional ankle instability (FAI).

Methods: Thirty college basketball players with FAI were treated with acute KT to test the changes in their muscle strength and balance ability.

Results: After acute KT intervention, the ankle dorsiflexion moment and the ankle plantar flexion moment increased by 34% and 19.9%, respectively. The stable plane test with the subjects’ eyes open decreased by 1%, whereas that with the subjects’ eyes closed decreased by 1.1%. The swaying environment test with the subjects’ eyes open increased by 2.4%. The swaying plane test with the subjects’ eyes open increased by 5.1%, whereas that with the subjects’ eyes closed increased by 16.2%. The swaying environment test with the subjects’ eyes open plus the use of a plane increased by 12.1%.

Conclusion: KT can increase the isokinetic strength of the ankle dorsum muscle and plantar flexion of college basketball players with FAI. The effect of KT in the static balance test was weaker than that in the dynamic balance test. The findings indicate that KT can significantly improve the balance ability of college basketball players with FAI during dynamic sports.

Comparison of the Effectiveness of Kinesiology Taping and Rigid Taping on Ankle Kinematics During Drop Landing in Individuals with Lateral Ankle Injury

BACKGROUND

Lateral ankle sprain is an injury that often occurs during sports or daily life activities. Athletic tape and kinesiology tape applications are among the external support treatment options especially for athletes to support the ankle and protect it from recurrent sprains. We sought to compare the kinematic stabilization effects of different ankle taping applications on the ankle joint during drop landing in individuals with a history of unilateral lateral ankle injury.

METHODS

In this randomized controlled study, 30 volunteers with unilateral ankle injury were evaluated. The participants were asked to land on one leg on the involved side and the contralateral side from a 30-cm-high platform. The same practice was repeated after applying kinesiology tape and rigid tape to the injured foot. Kinematic analysis of the foot and ankle was performed by recording three-dimensional spatial position information at a speed of 240 frames per second using infrared cameras.

RESULTS

The highest inversion angles of the involved foot at initial contact and 150 msec after initial contact were higher than those of the uninvolved side (P = .03 and P = .04, respectively). There was no significant difference in ankle kinematic values in the involved foot among kinesiology taping, athletic taping, and no taping applications (P = .74).

CONCLUSIONS

People with lateral ankle sprains show reduced inversion during landing. There were no significant differences among kinesiology taping, athletic taping, and no taping on the injured foot in terms of ankle kinematics. Care should be taken when using taping materials as protective measures for sports activities.

Effects of Conservative Interventions on Static and Dynamic Balance in Individuals With Chronic Ankle Instability: A Systematic Review and Meta-analysis

OBJECTIVE

To determine which conservative interventions are effective for static and dynamic balance in patients with chronic ankle instability (CAI).

DATA SOURCES

PubMed, Cochrane Library, Web of Sciences, and CINAHL databases were searched up to March 20, 2022.

STUDY SELECTION

Randomized controlled trials investigating the effects of conservative interventions on static and/or dynamic balance in patients with CAI compared with those of different conservative interventions or controls were included.

DATA EXTRACTION

Two independent reviewers extracted the data. Certainty of the evidence was assessed using the GRADE approach.

DATA SYNTHESIS

Forty-eight studies (1906 participants) were included. Whole-body vibration training (WBVT) was significantly more effective than controls for both static (standardized mean difference, 1.13; 95% confidence interval [CI], 0.58-1.68; moderate-certainty evidence) and dynamic balance (0.56; CI, 0.24-0.88; low-certainty evidence). Balance training (BT) and joint mobilization were significantly more effective than controls for dynamic balance (0.77; CI, 0.41-1.14; and 0.75; CI, 0.35-1.14, respectively), but not for static balance (very low to low-certainty evidence). Adding other interventions to BT had no significant effect on either type of balance compared with that of BT alone (moderate to low-certainty evidence). Strength training (ST) and taping had no significant effect on either type of balance (very low- to low-certainty evidence). Multimodal interventions were significantly effective in improving dynamic balance (0.76; CI, 0.32-1.20; low-certainty evidence). Adding transcranial direct current stimulation to ST was significantly more effective for dynamic balance than ST (0.81; CI, 0.08-1.53; moderate-certainty evidence). The effects on balance were not significantly different among BT, ST, and WBVT (very low- to low-certainty evidence).

CONCLUSIONS

The significantly effective interventions reviewed may be treatment options for balance impairments associated with CAI. However, interventions should be chosen carefully, as much of the certainty of evidence is very low to low.

Is Kinesio Taping Effective for Sport Performance and Ankle Function of Athletes with Chronic Ankle Instability (CAI)? A Systematic Review and Meta-Analysis

Background and Objectives: Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The aim of the present review is to evaluate the effects of Kinesio Taping (or KT) on sports performances and ankle functions in athletes with CAI. Materials and Methods: This systematic review with meta-analysis was carried out following the criteria of the Prisma Statement system (registered on Open Science Framework, number: 10.17605/OSF.IO/D8QN5). For the selection of the studies, PubMed, Scopus and Web of Science were used as databases in which the following string was used: (“kinesiology tape” OR “tape” OR “taping” OR “elastic taping” OR “kinesio taping” OR “neuro taping”) AND (unstable OR instability) AND (ankle OR (ankle OR “ankle sprain” OR “injured ankle” OR “ankle injury”)). The Downs and Black Scale was used for the quality analysis. The outcomes considered were gait functions, ROM, muscle activation, postural sway, dynamic balance, lateral landing from a monopodalic drop and agility. Effect sizes (ESs) were synthesised as standardized mean differences between the control and intervention groups. Calculation of the 95% confidence interval (CI) for each ES was conducted according to Hedges and Olkin. Results: In total, 1448 articles were identified and 8 studies were included, with a total of 270 athletes. The application of the tape had a significant effect size on gait functions, ROM, muscle activation and postural sway. Conclusions: The meta-analysis showed a significant improvement in gait functions (step velocity, step and stride length and reduction in the base of support in dynamics), reduction in the joint ROM in inversion and eversion, decrease in the muscle activation of the long peroneus and decrease in the postural sway in movement in the mid-lateral direction. It is possible to conclude that KT provides a moderate stabilising effect on the ankles of the athletes of most popular contact sports with CAI.

In Patients with Grade I and II Ankle Sprains, Dynamic Taping Seems to Be Helpful during Certain Tasks, Exercises and Tests in Selected Phases of the Rehabilitation Process: A Preliminary Report

We aimed to investigate changes in postural stability on a stable surface after the application of dynamic tape for patients with inversion ankle sprains. This study enrolled 30 patients (age 25.5 ± 8.0 years) with grade I and II ankle sprains, which occurred 7−21 days before enrolment. Postural stability (balance, coordination, feedback) was assessed before and after the application of dynamic tape using a stabilographic platform. Three 32-s exercises were performed on the stabilographic platform, one with eyes open, one with eyes closed and one with visual feedback. After the application of dynamic tape, an improvement was observed in terms of the mean radius of sway (4.2 ± 1.3 mm vs. 3.4 ± 0.9 mm; p = 0.012) and coordination (48.8 ± 19.2% vs. 59.3 ± 5.8%; p = 0.021). Selected balance parameters did not improve significantly in the tests with open and closed eyes. Asymmetric load improved for all tests, but significant differences were only observed with eyes closed (34.9 ± 24.4 vs. 41.7 ± 30.5; p < 0.01). We concluded that the use of dynamic tape after an ankle sprain significantly improved balance and coordination on a stable surface. The benefits were shown in terms of a significant improvement in the asymmetric load of the injured limb in comparison to the healthy limb during the test with closed eyes and a considerable improvement in the asymmetric load that was evaluated with visual feedback on a stable surface.

The effects of gluteus medius and tibialis anterior kinesio taping on postural control, knee kinematics, and knee proprioception in female athletes with dynamic knee valgus

OBJECTIVES

This study aimed to investigate the effects of Kinesio taping on postural control, kinematics, and knee proprioception in female athletes with dynamic knee valgus (DKV).

DESIGN

a single-blind randomized clinical trial.

PARTICIPANTS

40 female athletes between the age of 18 and 28 years with DKV in single-leg drop landing (>13°) participated in this study. They were randomly classified into the Kinesio taping (KT) and placebo control (PC) groups.

MAIN OUTCOME MEASURES

All the evaluations and measurements were performed on each subject in the pre-test and post-test stages (with an interval of 72 h). The dynamic balance (Y balance test), proprioception (Knee position sense error), and knee kinematics (flexion and DKV angles) of the subjects were measured, prior and post gluteus medius and tibialis anterior KT.

RESULTS

The results of study demonstrate that the DKV angle and knee position sense error significantly decreased and YBT increased in the KT group from pre-test to post-test (p < 0.05). Nevertheless, there was no significant difference in knee flexion angle (p > 0.05).

CONCLUSION

The results of the present study indicated that KT improves dynamic balance and proprioception and reduces the DKV angle. Therefore, KT is recommended for female athletes with DKV.

Effects of Kinesiology Taping on Muscle Strength, Dynamic balance, and Functional Movement in Wrestlers with Chronic Ankle Instability

OBJECTIVES This study aimed to investigate the effect of the Kinesio taping on ankle strength, Dynamic balance and, functional movement in wrestlers with chronic ankle instability.METHODS Twenty wrestlers who registered in the Korea Wrestling Association were participated in this study. They were divided into two groups (chronic ankle instability group [n=10] or control group [n=10]) based on Cumberland’s ankle instability questionnaire. Ankle strength (dorsiflexion, plantarflexion, inversion, and eversion) were measured using manual muscle tester, and the dynamic balance was measured using Y-Balance test (anterior, postero-medial, postero-lateral, and composite). Functional movement hop test (side hop, square hop, and figure-of-8 hop) were used to evaluate functional movement.RESULTS The significant interaction was observed between group and time on the Y-balance test (composite score), and functional movement hop test (figure-of-8 hop) (group × time, all P for interaction < 0.05).CONCLUSIONS These results suggest that Kinesio taping has a positive effect on dynamic balance and functional movement. Also, Kinesio taping may be able to use an alternative and effective methods to maintain ankle stability and performance in the wrestlers with chronic ankle instability.

Examining the Use of Kinesiology Tape During Weight Bearing Exercises on Proprioception in Participants With Functional Ankle Instability

The aim of this study was to examine the effect of tape worn during weight bearing exercises on proprioception (i.e., ankle angle repositioning error) in participants with functional ankle instability. We employed a randomized, controlled clinical study in a laboratory setting, with 56 participants with functional ankle instability. Participants were randomly assigned to three groups: (a) weight bearing exercises without tape (n = 18), (b) weight bearing exercises with tape (n = 19) and controls not engaged in weight bearing exercises (n = 19). Weight bearing exercises included six weeks of bilateral squats in partial form with up to 45 degrees of knee flexion, and unilateral partial squats with full heel raise, and with full toe raise. In the taped condition, participants wore tape for six weeks with up to three tape replacements per week. Proprioception was measured as ankle repositioning error. Results showed that the mean angle repositioning error among participants in the active weight bearing groups was decreased by the taping intervention, relative to the control group's performance (p = 0.042). There were no significant differences between weight bearing exercise groups and control groups. The addition of kinesiology tape in weight bearing exercises can improve proprioception in active conditions.

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.

Kinesiology tape length and ankle inversion proprioception at step-down landing in individuals with chronic ankle instability

OBJECTIVES

To determine the effect of different lengths of kinesiology tape (KT) on ankle inversion proprioceptive performance in individuals with or without chronic ankle instability (CAI).

DESIGN

A repeated measures study.

METHODS

Fifteen participants with unilateral CAI and fifteen participants with no CAI volunteered. The Ankle Inversion Discrimination Apparatus for Landing (AIDAL) was used to measure ankle proprioceptive acuity. All participants were tested under four KT conditions: no tape (baseline), short tape length (only foot and ankle complex involved), mid length (below the knee) and long length (above the knee) taping. After the baseline test, participants underwent the 3 different taping tests in a random order.

RESULTS

Repeated measures ANOVA indicated that, compared to those without CAI, individuals with CAI performed significantly worse across the 4 different conditions (F = 8.196, p = 0.008). There was a significant KT main effect (F = 7.489, p < 0.001) and a significant linear effect (F = 17.083, p < 0.001), suggesting that KT significantly improved ankle proprioceptive performance in landing, and with longer tape length there was greater proprioceptive enhancement. Post-hoc analysis showed that for the CAI group, both mid length (p = 0.013, 95%CI = -0.063, -0.009) and long length (p = 0.010, 95%CI = -0.067, -0.011) taping can significantly improve ankle proprioceptive performance compared to no tape, whereas for the non-CAI group, ankle proprioceptive acuity was significantly improved only with long length taping (p = 0.007, 95%CI = -0.080, -0.015).

CONCLUSIONS

KT can be used to improve ankle inversion proprioceptive performance during landing in both individuals with and without CAI and increasing tape length may achieve greater proprioceptive improvement.

Gait Biomechanics Following Taping and Bracing in Patients With Chronic Ankle Instability: A Critically Appraised Topic

Clinical Scenario: Approximately 30% of all first-time patients with LAS develop chronic ankle instability (CAI). CAI-associated impairments are thought to contribute to aberrant gait biomechanics, which increase the risk of subsequent ankle sprains and the development of posttraumatic osteoarthritis. Alternative modalities should be considered to improve gait biomechanics as impairment-based rehabilitation does not impact gait. Taping and bracing have been shown to reduce the risk of recurrent ankle sprains; however, their effects on CAI-associated gait biomechanics remain unknown. Clinical Question: Do ankle taping and bracing modify gait biomechanics in those with CAI? Summary of Key Findings: Three case-control studies assessed taping and bracing applications including kinesiotape, athletic tape, a flexible brace, and a semirigid brace. Kinesiotape decreased excessive inversion in early stance, whereas athletic taping decreased excessive inversion and plantar flexion in the swing phase and limited tibial external rotation in terminal stance. The flexible and semirigid brace increased dorsiflexion range of motion, and the semirigid brace limited plantar flexion range of motion at toe-off. Clinical Bottom Line: Taping and bracing acutely alter gait biomechanics in those with CAI. Strength of Recommendation: There is limited quality evidence (grade B) that taping and bracing can immediately alter gait biomechanics in patients with CAI.

Effectiveness of Kinesio Taping for Dynamic Postural Stability in Adolescent Athletes with Chronic Ankle Instability: A Pilot Study

OBJECTIVES To determine the effectiveness of K-tape on dynamic postural stability of the injured limb in adolescent athletes with chronic ankle instability (CAI) by measuring reach distance with the modified Star Excursion Balance Test (mSEBT).METHODS Twenty volunteers (20 females [17.78 ± 1.22 yrs], height [163.89 ± 7.69 cm], mass [62.51 ± 9.81 kg]) with CAI. Four strips of K-tape were applied to the injured limb. Participants completed 4 trials of testing (2 with tape, 2 without tape) using the mSEBT as the assessment tool. We applied 4 strips of K-tape to the injured limb and then tested postural stability using the mSEBT to see if there was an increase of reach distance in the mSEBT. Measuring reach distance in Anterior (AN), Posteromedial (PM), Posterolateral (PL) on the injured limb with K-tape and without K-tape condition. We measured the reach distances and then normalized the distance to account for height differences. A repeated measures t-test was used for this study.RESULTS There is no statistically significant different between the condition with K-tape and without K-tape in the reach distances on the mSEBT in adolescent athletes with CAI.CONCLUSIONS Based on the results, there appears to be no improvement of reach distance using the mSEBT in adolescent athletes with CAI. Therefore, clinicians need their thoughtful consideration for applying K-tape to improve dynamic postural stability in adolescent athletes with CAI.

Acute Effect of Ankle Kinesio™ Taping on Lower-Limb Biomechanics During Single-Legged Drop Landing

CONTEXT

Chronic ankle instability is documented to be followed by a recurrence of giving away episodes due to impairments in mechanical support. The application of ankle Kinesiotaping (KT) as a therapeutic intervention has been increasingly raised among athletes and physiotherapists.

OBJECTIVES

This study aimed to investigate the impacts of ankle KT on the lower-limb kinematics, kinetics, dynamic balance, and muscle activity of college athletes with chronic ankle instability.

DESIGN

A crossover study design.

PARTICIPANTS

Twenty-eight college athletes with chronic ankle sprain (11 females and 17 males, 23.46 [2.65] y, 175.36 [11.49] cm, 70.12 [14.11] kg) participated in this study.

SETTING

The participants executed 3 single-leg drop landings under nontaped and ankle Kinesio-taped conditions. Ankle, knee, and hip kinematics, kinetics, and dynamic balance status and the lateral gastrocnemius, medial gastrocnemius, tibialis anterior, and peroneus longus muscle activity were recorded and analyzed.

RESULTS

The application of ankle KT decreased ankle joint range of motion (P = .039) and angular velocities (P = .044) in the sagittal plane, ground reaction force rate of loading (P = .019), and mediolateral time to stability (P = .035). The lateral gastrocnemius (0.002) and peroneus longus (0.046) activity amplitudes also experienced a significant decrease after initial ground contact when the participants' ankles were taped, while the application of ankle KT resulted in an increase in the peroneus longus (0.014) activity amplitudes before initial ground contact.

CONCLUSIONS

Ankle lateral supports provided by KT potentially decreases mechanical stresses applied to the lower limbs, aids in dynamic balance, and lowers calf muscle energy consumption; therefore, it could be offered as a suitable supportive means for acute usage in athletes with chronic ankle instability.

Immediate Effects of Limb Rotational Kinesio Tape Application on Upper Quarter Y-Balance Test Scores

CONTEXT

Rounded shoulder posture is a common problem in the athletic population. Recently Kinesio tape has been utilized to improve balance, proprioception, and posture. However, the literature has been unable to provide definitive answers on the efficacy of Kinesio tape use.

OBJECTIVE

To determine the immediate effect of the limb rotational Kinesio tape application on the dynamic balance and proprioception of the shoulder measured by the Y-Balance Upper Quarter Test (YBT-UQ) in male collegiate athletes.

DESIGN

Cross-sectional.

SETTING

Sports medicine research laboratory.

PARTICIPANTS

Nineteen healthy male collegiate National Association of Intercollegiate Athletics athletes (including rodeo, baseball, football, and soccer) with a mean age of 19.8 (1.4) years.

INTERVENTIONS

Subjects were randomized into Kinesio tape and non-Kinesio tape groups. The limb rotational Kinesio tape application was applied to the Kinesio tape group, while the non-Kinesio tape group received no intervention. Each group performed the YBT-UQ, which requires reaching in 3 directions in a push-up position, before and after the randomized intervention on a single day.

MAIN OUTCOME MEASURES

The variables of interest included the maximum reach distance in each of the 3 directions and the composite score for both trials between the Kinesio tape and non-Kinesio tape groups. Each score was normalized against the subject's limb length.

RESULTS

No statistically significant improvements in any YBT-UQ scores were observed following either the Kinesio tape or non-Kinesio tape intervention.

CONCLUSIONS

Applying the limb rotational Kinesio tape technique did not improve immediate YBT-UQ scores in a male collegiate athletic population with rounded shoulder posture. The use of Kinesio tape to improve immediate closed kinetic chain function in male collegiate athletes with rounded shoulder posture cannot be supported.

THE RELATIONSHIP BETWEEN SINGLE LEG BALANCE AND ISOMETRIC ANKLE AND HIP STRENGTH IN A HEALTHY POPULATION

Background

Impaired balance and strength commonly affect athletes with conditions like chronic ankle instability (CAI). Yet, clinical research surrounding the relationship between balance, strength, and CAI is still growing. Deeper investigation of these relationships is warranted to better inform clinical practice patterns when managing athletes with balance deficits.

Purpose

To investigate the relationship between single leg balance, ankle strength, and hip strength in healthy, active adults.

Study Design

Observational study.

Methods

Forty healthy participants (age 23.7 ± 4.9 years) were assessed for static balance, using a modified version of the Balance Error Scoring System (mBESS), as well as isometric strength of ankle and hip musculature via handheld dynamometry. Pearson's correlations were used to analyze relationships between balance and strength measures. Paired t-tests were utilized to compare dominant and non-dominant limb performance.

Results

Negligible to low, negative correlations were found between balance scores and hip extension strength (r = -0.24 to -0.38, p<0.05). High, positive correlations were found between ankle and hip strength measures (r = 0.75 to 0.84, p<0.05). When comparing dominant to non-dominant limbs, only minimal differences were noted in ankle eversion strength (mean difference = 6.0%, p<0.01) and hip extension strength (mean difference = 5.5%, p<0.01).

Conclusions

Minimal relationships were identified between static balance and isometric ankle and hip strength. Comparison of dominant and non-dominant limbs suggests that clinicians should expect relative symmetry in balance and strength in healthy adults. Thus, asymmetries found during clinical examination should raise suspicion of specific impairments that may lead to dysfunction.

Level of Evidence

2c.

Kinesio taping does not improve ankle functional or performance in people with or without ankle injuries: Systematic review and meta-analysis

OBJECTIVE

To investigate whether Kinesio taping technique, applied to ankles of healthy people as a preventive intervention and people with ankle injuries, is superior to sham or alternative interventions on ankle function.

DATA SOURCES

Medline, Embase, Amed, CINAHL, SPORTDiscus, Cochrane Library and Web of Science, from inception to August 2020.

REVIEW METHODS

The terms "ankle" and "kinesio taping" were used in the search strategy. Included studies were randomized controlled trials (including crossover design) investigating Kinesio taping effects on ankle functional performance compared to any alternative or control/sham technique.

RESULTS

From 5,572 studies, 84 met the eligibility criteria which evaluated 2,684 people. Fifty-eight meta-analyses from 44 studies were performed (participants in meta-analyses ranging from 27 to 179). Fifty-one meta-analyses reported ineffectiveness of Kinesio taping: moderate evidence for star excursion balance test (anterior direction), jump distance, dorsiflexion range of motion, and plantar flexion torque for healthy people (effect size = 0.08-0.13); low to very-low evidence for balance, jump performance, range of motion, proprioception, muscle capacity and EMG for healthy people; balance for older people; and balance and jump performance for people with chronic instability. Seven meta-analyses reported results favoring Kinesio taping (effect size[95% CI]): low to very-low evidence for balance (stabilometry, ranging from 0.42[0.07-0.77] to 0.65[0.29-1.02]) and ankle inversion (0.84[0.28-1.40]) for healthy people; balance for older people (COP velocity, 0.90[0.01-1.78]); and balance for people with chronic instability (errors, 0.55[0.06-1.04]).

CONCLUSIONS

Current evidence does not support or encourage the use of Kinesio taping applied to the ankle for improvements in functional performance, regardless the population.

The effect of ankle Kinesio™ taping on ankle joint biomechanics during unilateral balance status among collegiate athletes with chronic ankle sprain

OBJECTIVES

To determine the effects of ankle Kinesio-taping (KT) on postural sway, lower limb ROM, and muscle activity during a unilateral balance tasks.

DESIGN

Case control study design.

SETTING

Data were collected at the human movement analysis laboratory.

PARTICIPANTS

30 collegiate athletes with chronic ankle sprain (11 females and 19 males, 23.91 ± 2.58 years).

MAIN OUTCOME MEASURE

Hip, knee and ankle joints ranges of motion (ROMs); postural sway area and velocities in both anteroposterior and mediolateral directions; and muscular activity amplitudes (% peak) of lateral and medial gastrocnemius, tibialis anterior and peroneus longus in a 20s single leg balance test in two non-taped (control) and KT (intervention) conditions.

RESULTS

Significant decrease observed in ankle lateral ROM (p = 0.048, d = 0.52), mediolateral postural sway velocity (p = 0.029, d = 1.25), and peroneus longus activity amplitudes (p = 0.042, d = 0.55) after KT application.

CONCLUSION

Acute application of KT among athletes with chronic ankle instability could provide lateral mechanical support to the ankle, potentially decreasing the velocity of frontal plane sway, and decreasing the magnitude of muscle activation. These data suggest that KT may be beneficial for improving static joint stability among individuals with chronic ankle sprain, and thus could be considered an option to allow safe return-to-activity.

Effects of Kinesiotape vs Soft and Semirigid Ankle Orthoses on Balance in Patients With Chronic Ankle Instability: A Randomized Controlled Trial

BACKGROUND

Chronic ankle instability (CAI) is a frequent complication of ankle sprain that may be associated with long-term consequences. Although taping and bracing are common interventions that are widely used by clinicians and athletic trainers for patients with CAI, no studies have compared the effects of kinesiotaping and bracing on balance performance in these patients. The present study aimed to compare the effects of ankle kinesiotaping, a soft ankle orthosis, and a semirigid ankle orthosis on balance performance in patients with CAI.

METHODS

Sixty patients with CAI were randomly assigned to 4 groups that received kinesiotaping, a soft orthosis, a semirigid orthosis, or no treatment (control group). Dynamic and static balance were measured with the modified Star Excursion Balance Test, single leg hop test, and single leg stance test before and after a 4-week intervention period.

RESULTS

Significant between-group differences were seen in all evaluated outcomes (P ≤ .003). The lowest reach distances in all directions in the modified Star Excursion Balance Test were found in the control group, and these patients also had a significantly shorter measured distance in the single leg hop test, and more errors in the single leg stance test compared with the 3 intervention groups. No significant differences were found among the 3 intervention groups.

CONCLUSION

Use of kinesiotaping and a soft or a semirigid ankle brace for 4 weeks were all beneficial in improving static and dynamic balance in individuals with CAI. None of the interventions was superior to the other 2.

LEVEL OF EVIDENCE

Level I, randomized controlled trial.

Can fibular reposition taping improve balance performance in individuals with chronic ankle instability? A randomized controlled trial

BACKGROUND

Lateral ankle sprain results in positional faults in the fibula which are thought to limit accessory motion in the ankle, leading to hypomobility and negatively influencing sensorimotor function and postural control. Although it has been shown that fibular reposition taping (FRT) is effective in the prevention of recurrent lateral ankle sprain, its ability to produce significant changes in balance measures in patients with chronic ankle instability is inconclusive.

OBJECTIVE

This study aimed to determine whether a FRT intervention affects balance performance in patients with chronic ankle instability.

DESIGN

Randomized controlled trial.

METHODS

Sixty individuals with chronic ankle instability were randomly allocated to three groups: FRT, sham taping, or no intervention (control group). Kinesiotape was applied and then re-applied on 3 occasions per week for 2 weeks. Static and dynamic balance were measured with three functional tests before and 1 day after the last session of intervention with the tape removed: single-leg stance test, single-leg hop test for distance, and modified Star Excursion Balance Test (mSEBT).

RESULTS

The results of ANCOVA showed that there were no significant differences between the three groups except for mSEBT reach distance in the posterolateral direction, which was significantly greater in the FRT group than the control group (p = 0.03).

CONCLUSION

Applying FRT for 2 weeks did not significantly affect static or dynamic balance measures in individuals with chronic ankle instability, hence its clinical efficacy to influence balance remains uncertain in this population.

CLINICAL TRIAL REGISTRATION NUMBER

IRCT20171122037576N2.

Acute Effect of Kinesiology Taping on Postural Stability in Individuals With Unilateral Chronic Ankle Instability

Background

Chronic ankle instability (CAI), which is characterized by deficient postural control, could be improved through kinesiology taping (KT). However, the effect of KT on postural control in CAI individuals is controversial. Therefore, this study aimed to investigate the acute effect of KT on postural control through computerized dynamic posturography (CDP) and self-perceived sensation in CAI individuals.

Methods

Participants with CAI received four different ankle treatments randomly, including KT, athletic taping (AT), sham taping (ST), and no taping (NT). A series of postural stability measurements was performed using CDP subsequently. The measurements included sensory organization test (SOT), unilateral stance (US), limit of stability (LOS), motor control test (MCT), and adaption test (ADT). In addition, self-perceived sensation was measured through visual analog scaling. Repeated measures analysis of variance was conducted to determine whether the difference among KT, AT, ST, and NT was significant; Bonferroni test was used for post hoc analysis.

Results

No significant difference was observed for parameters in SOT, US, and LOS in four different taping treatments. In MCT, the amplitude scaling scores of KT were 35.87% significantly lower than that of NT [p < 0.001, 95% confidence interval (CI) = 0.548–1.795] in forward-small slip and 21.58% significantly lower than that of ST (p = 0.035, 95% CI = 0.089–3.683) in backward-large slip. In ADT, sway energy scores were 7.59% significantly greater in ST than in AT (p = 0.028, 95% CI = −8.343 to −0.320). For perceived stability, KT was significantly greater than ST (p < 0.001, 95% CI = 0.552–1.899) and NT (p < 0.001, 95% CI = 0.797–2.534), and AT was significantly greater than ST (p = 0.001, 95% CI = 0.423–2.246) and NT (p < 0.001, 95% CI = 0.696–2.852). For perceived comfort, KT was significantly greater than AT (p = 0.001, 95% CI = 0.666–3.196) and NT (p = 0.031, 95% CI = 0.074–2.332), and ST was significantly greater than AT (p = 0.007, 95% CI = 0.349–2.931).

Conclusion

KT and AT have limited effect to facilitate postural control for CAI individuals during SOT, US, and LOS. However, KT and AT could provide effective support to cope with sudden perturbation in MCT and ADT. Moreover, KT provided excellent perceived stability and comfort, whereas AT provided excellent perceived stability but least comfort.

Add-on effect of kinesiotape in patients with acute lateral ankle sprain: a randomized controlled trial

Background

Evidence for the add-on effect of kinesiotape (KT) with acupuncture for treating ankle sprains remains insufficient. We assessed the add-on effect of KT on ankle sprains by comparing acupuncture combined with KT (AcuKT) with acupuncture alone in patients with acute lateral ankle sprain (ALAS).

Methods

This study was a multicenter, randomized controlled clinical trial that included a per-protocol analysis of the add-on effect of KT on ALAS. The randomization was software based and only the assessors were blinded. Sixty participants (20 each from three centers) with grade I or II ALAS were randomly assigned to acupuncture (n = 30) or AcuKT (n = 30) groups. Both groups received acupuncture treatment once daily, 5 days per week for 1 week. The AcuKT group received additional KT treatment. Visual analog scale (VAS) scores for pain and the Foot and Ankle Outcome Score (FAOS) were obtained, and edema measurements were performed at baseline (week 0), at the end of the intervention (week 1), and at 4 weeks after intervention (week 5). The European Quality of Life Five Dimension-Five Level Scale (EQ-5D-5 L) measurements were conducted at week 0, week 1, week 5, and week 26 after the intervention. The number of recurrent ankle sprains was determined at 4, 8, 12 and 26 weeks after the intervention.

Results

Fifty-six patients with ALAS completed the trial (AcuKT group, n = 27; acupuncture group, n = 29). There were significant changes in visual analog scale score (AcuKT, P < 0.001; acupuncture, P < 0.001), the FAOS (AcuKT, P < 0.001; acupuncture, P < 0.001), and EQ-5D-5 L measurements (AcuKT, P < 0.001; acupuncture, P < 0.001) within both groups. There were no significant differences between groups in terms of any outcome or in a subanalysis based on symptom severity.

Conclusions

These results indicate that AcuKT did not show a positive add-on effect of KT with acupuncture in terms of pain reduction, edema, recovery of function, activities of daily living, quality of life or relapse of ALAS.

Trial registration

Clinical Research Information Service (cris.nih.go.kr), KCT0002257. Registered on 27 February 2017.

Do External Supports Improve Dynamic Balance in Patients with Chronic Ankle Instability? A Network Meta-analysis

BACKGROUND

To improve ankle stability in patients who have experienced an ankle sprain with residual symptoms of instability and/or objective joint laxity, external supports (such as taping, bracing, and orthotic insoles) are used sometimes. However, available randomized trials have disagreed on whether restraints improve balance in those individuals. In this situation, a network meta-analysis can help because it allows for comparing multiple treatments simultaneously, taking advantage not only of direct but also indirect evidence synthesis.

QUESTIONS/PURPOSES

The aim of this network meta-analysis was to assess (1) the impact of taping and orthotic devices on dynamic postural control in individuals with ankle instability and (2) the presence of a placebo effect in participants treated with sham taping and complications resulting from the administered treatments.

METHODS

We searched the PubMed, Scopus, and CENTRAL databases up to February 13, 2019 for completed studies. Randomized trials assessing the results of real and/or sham taping, wait-and-see protocols, ankle bracing, and foot orthotics for ankle instability as determined by one or more ankle sprains followed by ongoing subjective symptoms and/or mechanical laxity were included. We evaluated dynamic postural control in terms of the Star Excursion Balance Test in the posteromedial direction (SEBT-PM), which is considered the most representative of balance deficits in patients with ankle instability. Standardized mean differences were re-expressed to percentage differences in SEBT-PM, with higher scores representing possible improvement. Subsequently, those data were checked against the established minimal detectable change of 14% for this scale to make judgements on clinical importance. We also assessed the presence of a placebo effect by comparing the results of sham taping with no treatment and complications resulting from the administered treatments. Additionally, we judged the quality of trials using the Cochrane risk of bias tool and quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. A total of 22 trials met our inclusion criteria, 18 of which were deemed to be at a low risk of bias. A network of treatments consisting of 13 studies was created, and the level of evidence was judged to be high. As far as participants' allocation to treatment arms, 85 patients followed a wait-and-see protocol, 29 received placebo taping, 99 were treated with taping, 16 were treated with bracing, 27 were administered insoles, and six individuals were offered a combination of insoles with bracing. Of note, with statistical power set at 80%, a minimum of 16 patients per treatment group was required to provide sufficient statistical power and detect a SEBT-PM percentage difference of 14%.

RESULTS

A network meta-analysis did not demonstrate a benefit of taping or bracing over no treatment (percentage difference in SEBT-PM between taping and bracing versus control: -2.4 [95% CI -6 to 1.1]; p = 0.18, and -7.5 [95% CI -15.9 to 1]; p = 0.08, respectively). This was also the case for sham taping because the measurement increase failed to exceed the minimal detectable change (percentage difference in SEBT-PM between sham taping and untreated control: -1.1 [95% CI -6.9 to 4.7]; p = 0.72). Importantly, there were no reported adverse events after treatment application.

CONCLUSIONS

Evidence of moderate strength indicated that external supports of any type were no more effective than controls in improving dynamic postural control in patients with at least one ankle sprain and residual functional or mechanical deficits. Therefore, implementing those tools as a standalone treatment does not appear to be a viable strategy for the primary management of ankle instability. It is conceivable that combinations of rehabilitation and external supports could be more effective than external supports alone, and future trials should evaluate the potential of such combinations in enhancing not only clinician-reported but also patient-oriented outcomes using long-term follow-up measurements.

LEVEL OF EVIDENCE

Level I, therapeutic study.

Improvements in strength and functional performance after Kinesio taping in semi-professional male soccer players with and without functional ankle instability

OBJECTIVE

The objectives of this study were to compare the immediate effects of two methods of Kinesio taping on muscle strength, functional performance, and balance in athletes with and without functional ankle instability (FAI).

METHODS

The present study investigated the effects of distal taping (muscle application over peroneus longus) and proximal- distal taping (muscle application over gluteus medius and peroneus longus) on the strength of evertor and hip abductor muscles, side hop test, figure of 8 hop test, and star excursion balance test in semi-professional male soccer players with and without FAI (n=15 in each group). A Multifactorial repeated measure ANOVA was used for comparison.

RESULTS

There were significant differences for factor effect in all outcome measures (P<0.05), except for the figure of 8 hop test. No significant differences for group effects and group by factor interaction effects (P>0.05) was observed except for the side hop test.

CONCLUSION

Kinesio taping had immediate effects on improving strength, performance and balance. However, there were no differences on the method of application. Clinicians can consider the application Kinesio taping during the rehabilitation process of athletes with FAI, to improve balance and strength. The long-term impacts of taping on the functional, balance and strength measures should be investigated in future studies.

Effective Treatment for Chronic Ankle Instability During Lateral Step-Down-Kinesiology Tape, Resistance Exercise, or Both Accompanied With Heel Raise-Lower Exercise?

CONTEXT

Kinesiology tape (KT), multidirectional resistance exercise, and interventions for decreased ankle dorsiflexion range of motion are gaining popularity in the treatment of patients with chronic ankle instability (CAI). However, there is limited evidence of the effectiveness of combined interventions in patients with CAI.

OBJECTIVES

To compare the effects of KT alone, KT with resistance exercise (KT + resistance), and KT with resistance and heel raise-lower exercise (KT + resistance + heel) on the results of the dynamic balance test (star excursion balance test [SEBT]), functional performance (lateral step-down test), and ankle muscle activation in patients with CAI.

DESIGN AND SETTING

This study used a repeated-measures design in a laboratory setting.

MAIN OUTCOME MEASURES

The participants completed 3 different interventions with a 24-hour rest period between interventions. The SEBT, lateral step-down test, and ankle muscle activation results were used as the outcome measures. All outcomes were assessed before and immediately after the 3 interventions.

RESULTS

The results of the SEBT-anteromedial direction significantly increased with KT + resistance (78.61 [16.11] cm, P = .01, ES = 0.50) and KT + resistance + heel (76.94 [16.00] cm, P = .03, ES = 0.33) in comparison with the baseline values (73.68 [12.84] cm). Additionally, the result of the SEBT-anteromedial direction was significantly greater with KT + resistance (78.61 [16.11] cm) than with KT alone (76.00 [14.90] cm, P = .05, ES = 0.18). The number of errors during the lateral step-down test was significantly lower for the KT alone (2.16 [0.90] errors, P = .02, ES = 0.46), KT + resistance (2.10 [0.79] errors, P = .01, ES = 0.54), and KT + resistance + heel (2.03 [0.75] errors, P = .003, ES = 0.61) interventions than the baseline values (2.55 [0.85] errors).

CONCLUSIONS

Patients with CAI should be encouraged to perform KT + resistance to improve balance.

Effects of Kinesiology Tape on Non-linear Center of Mass Dispersion During the Y Balance Test

Static taping of the ankle or knee joint is a common method of reducing risk of injury by providing mechanical stability. An alternative taping technique employs kinesiology tape, which has the additional benefit of improving functionality by stimulating proprioception. There is substantial disagreement whether kinesiology tape shows significant differences in proprioception and postural stability as compared to rigid/static tape when applied at the lower limb. The current study investigated the effects of kinesiology tape and static tape during a Y Balance Test on center of mass as an indicator for postural stability. Forty-one individuals, free of injury, performed the Y Balance Test under the three conditions; no tape, kinesiology tape, and static tape applied at the lower limb to the quadriceps, triceps surae and ankle joint. All participants completed the Y Balance Test to determine whether any significant differences could be observed using center of mass movement as a surrogate measure for balance and proprioception. The Minkowski-Bouligand and box-counting fractal dimension analyses were used as measures of the dynamic changes in the center of mass whilst undertaking the Y Balance Test. Statistical analyses included the Kruskal Wallis test to allow for non-normally distributed data and a Bonferroni corrected pairwise T-test as a post hoc test to ascertain pairwise differences between the three taping conditions. Significance was set at 0.05. The fractal analyses of the dynamic changes in center of mass showed significant differences between the control and both the static tape and kinesiology tape groups (p = 0.021 and 0.009, respectively). The current study developed a novel measure of dynamic changes in the center of mass during a set movement that indicated real-time processing effects during a balance task associated with the type of taping used to enhance postural stability.

Nonelastic and Kinesio Tex Tapes Improve Perceived Stability But Not Postural Control in Participants With Chronic Ankle Instability

The development of chronic ankle instability (CAI) is common following a lateral ankle sprain. Taping using nonelastic and Kinesio Tex (KT) tapes remain popular treatment strategies. The purpose of this investigation was to determine if KT tape improves static and dynamic postural control relative to nonelastic tape and a control condition. Twenty-four participants completed all three conditions. No immediate improvements in postural control were noted in either taping condition. Both nonelastic and KT tape improved perceived stability relative to the control condition. In conclusion, nonelastic and KT tape should not be used to immediately improve postural control in CAI participants.

[The application of kinesiotaping for the rehabilitation of the post-stroke patients]

This review of the scientific literature was designed to consider the prospects for the application of kinesiotaping for the rehabilitation of the post-stroke patients. The relevance of the work arises from the absence of a systemic analysis of the large number of investigations that have been carried out during the past two years. The objective of the present review article was to evaluate the influence of kinesiotaping on the health status of the post-stroke patients and the course of their rehabilitative treatment based on the results of analysis of the scientific reports published during the period from 2015 to 2017. The analysis has demonstrated that the method under consideration makes it possible to effectively reduce spasticity, increase the paretic limb power, improve the static and dynamic balance, and alleviate the pain syndrome by virtue of the ability to improve the articulation proprioception and to regulate the muscle tone. Such effects are known to promote the reduction of muscle tone asymmetry in the patients suffering from hemiparesis and articulation instability which in its turn improves the patients' gait and walking ability, hightens their living standards, and allows to tolerate enhanced physical exertion. Kinesiotaping actually improves the locomotor function in the post-stroke patients Taken together, the advantages of the approach in question give reason to recommend kinesiotaping for the wide application for the combined rehabilitative treatment of the post-stroke patients.

Short-term effect of spiral taping on the pain and walking performance of individuals with chronic ankle instability

[Purpose] This study was designed to investigate the effects of spiral taping (ST) on the pain and walking performance of individual with chronic ankle instability (CAI). [Subjects and Methods] 12 men and 13 women (mean: 21.52 years; range: 20–31 years) with unilateral CAI (Cumberland ankle instability score: ≤24) were included. All the participants received 3 mm-wide ST. The latter was applied in a 3 × 4 cross shape onto the medial malleolus, the lateral malleolus, and the anterior talotibial joint of the unstable ankle. The pain and walking performance were measured on the visual analogue scale (VAS) and with a timed up and go test (TUGT) at the baseline and 30 minutes after the intervention. [Results] VAS and TUGT scores were significantly improved after application of the ST. [Conclusion] The results indicated that ST can improve the pain and walking performance of CAI individuals.

Effects of spiral taping on proprioception in subjects with unilateral functional ankle instability

[Purpose] The Purpose of this study was to investigate the effects of spiral taping on proprioception in functional ankle instability. [Subjects and Methods] Thirty-five participants in this study had discomfort in only one ankle and Cumberland ankle instability score of ≤23. ST was applied to the unstable ankle, and proprioception was measured baseline and 30 min later. Proprioception was measured using the active joint angle reproduction test. [Results] Plantar flexions of 10° (ES, 0.303) and 20° (ES, 1.369) and inversion 20° (ES, 0.998) showed a significant improvement. [Conclusion] Spiral taping improved on proprioception. Therefore, spiral taping may be an effective method for functional ankle instability.