The effect of high-Dye and low-Dye taping on rearfoot motion

For plantar taping, direction of elasticity matters

Plantar taping has been used in clinical settings as a short-term conservative treatment for plantar heel pain and related pathologies. The rise of at-home taping methods may offer patients more independence, but effectiveness has not been established. The purpose of this study was to evaluate the effects of plantar taping on foot mechanics during gait. We hypothesized that material compliance would drive mechanical effectiveness, with longitudinally inelastic tape reducing medial longitudinal arch (MLA) motion and anterior/posterior (A/P) plantar tissue spreading forces, and laterally inelastic tape reducing medial/lateral (M/L) tissue spreading. We also hypothesized that these effects would be influenced by foot structure. Fifteen healthy participants were tested in a randomized cross-over study design. Barefoot (BF) plus four taping methods were evaluated, including two inelastic tapes (Low-Dye, LD, and FasciaDerm, FD) along with longitudinally elastic kinesiology tape (KT) and a novel laterally elastic kinesiology tape (FAST, FS). Participants' arch height and flexibility were measured followed by instrumented gait analysis with a multi-segment foot model. Ankle eversion and MLA drop/rise were calculated from rearfoot and forefoot reference frames, while plantar tissue spreading was calculated from shear stresses. ANOVAs with Holm pairwise tests evaluated tape effects while correlations connected arch structure and taping effectiveness (α = 0.05). The three longitudinally inelastic tapes (LD, FD, FS) reduced MLA drop by 11-15% compared with KT and BF. In late stance, these tapes also inhibited MLA rise (LD by 29%, FD and FS by 10-15%). FS and FD reduced A/P spreading forces, while FD reduced M/L spreading forces compared with all other conditions. Arch height had a moderately strong correlation (r = -0.67) with the difference in MLA drop between BF and FS. At-home plantar taping can affect the mechanical function of the foot, but tape elasticity direction matters. Longitudinally elastic kinesiology tape has little effect on mechanics, while inelastic tapes control MLA drop but also restrict MLA rise in late stance. Lateral elasticity does not limit tissue spreading and may increase comfort without sacrificing MLA control. At-home taping has the potential to broaden conservative treatment of plantar heel pain, flat foot deformity, and related pathologies, but additional studies are needed to connect mechanics with symptom relief.

Low-dye taping may enhance physical performance and muscle activation in basketball players with overpronated feet

BACKGROUND

Low-dye taping (LTD) is widely used by athletes and medical practitioners but the research regarding its impacts on athletic performance is lacking. This study investigated the effects of using low-dye taping on plyometric performance and muscle activities in recreational basketball players with overpronated feet.

METHODS

Twelve collegiate males with at least three years basketball training experience and navicular drop (ND) value ≥10 mm performed the navicular drop, drop jump and countermovement jump tests. Surface electromyography of selected lower limb muscles were observed during bilateral free squat. All tests in non-taped (NT) and taped (TAP) conditions were counterbalanced using repeated crossover study design. Paired t-test with an alpha level of 0.05 and non-clinical magnitude-based decision (MBD) with standardized effects were used to analyze data.

RESULTS

Contact time and reactive strength index (RSI) in the TAP condition were significantly shorter (p = 0.041) and higher (p<0.01) than the NT condition respectively. No significant difference in CMJ performance between NT and TAP was observed. MBD demonstrated clear effects on both ND (standardized effect: -1.54±0.24), flight time (standardized effect: 0.24±0.30), contact time (standardized effect: -0.27±0.21), RSI (standardized effect: 0.69±0.35) and eccentric activities of inferior gluteus maximus (standardized effect: 0.23±0.35), gluteus medius (standardized effect: 0.26±0.29) and tibialis anterior (standardized effect: 0.22±0.06).

CONCLUSIONS

LDT is effective in correcting overpronated feet by increasing ND height. Meanwhile, it provides a small increase in RSI and gluteal muscle activity during the eccentric (down) phase of the bilateral squat, and without affecting CMJ performance. Conditioning coaches or therapists may use LDT to enhance gluteal activation for reducing injury occurrence and reactive strength performance in drop jump tasks.

The effects of foot orthosis and low-dye tape on lower limb joint angles and moments during running in individuals with pes planus

BACKGROUND

Pes Planus or Flat feet is one of the most common lower limb abnormalities. When runners with this abnormality participate in recreational running, interventional therapies could help in pain alleviation and enhance performance. To determine the most effective treatment, however, a biomechanical examination of the effects of each treatment modality is required.

RESEARCH QUESTION

The aim of the present study was to investigate the effects of Foot Orthoses (FOs) and Low-Dye Tape (LDT) on lower limb joint angles and moments during running in individuals with pes planus.

METHODS

kinematic and kinetic data of 20 young people with pes planus were measured during running in three conditions: (1) SHOD (2) with shoes and FOs (3) with shoes and LDT. One-way repeated measure ANOVA was used to investigate the impacts of the FOs and LDT on the lower limb joint angles and moments throughout the stance phase of the running cycle.

RESULTS

The results showed that FOs reduced ankle eversion compared to SHOD and LDT (P < 0.001) and decreased the dorsiflexion angle (P = 0.005) and the plantarflexor moment compared to the SHOD (P < 0.001). FOs increased knee adduction angle (P = 0.021) and knee external rotator moment (P < 0.001) compared to both conditions and increased knee extensor and abductor moments compared to SHOD (P < 0.001). At the hip joint, FOs only increased hip external rotation compared with the LDT condition (P = 0.031); and LDT increased hip extensor moment compared to SHOD and FOs (P = 0.037) and also increased hip adduction angle compared to SHOD (P = 0.037).

SIGNIFICANCE

FOs with a medial wedge appears to increase the external knee adduction moment and knee adduction angles, which are risk factors for the development and progression of knee osteoarthritis. Further, usage of FOs seems to reduce the ankle joint role in propulsion as it impacts the ankle sagittal angles and moments.

Prediction on the plantar fascia strain offload upon Fascia taping and Low-Dye taping during running

Background

Taping is commonly prescribed to treat plantar fasciitis for runners by virtue of its alleged ability to offload the plantar fascia and facilitate positive injury prognosis. Our study aimed to investigate how different taping methods could change the loading on the plantar fascia during running using computational simulations.

Methods

A finite element foot model was modified from a previous version to fit the study's purpose. The model featured twenty bones, bulk soft tissue, foot muscles, ligaments/tendons, and a solid part representing the plantar fascia. A runner performed several running trials under one untaped condition and two taped conditions—Low-Dye taping and Fascia taping, which were implemented by a physiotherapist using the Kinesio tapes. The captured motion data were processed to drive a scaled musculoskeletal model and calculate segmental kinematics, foot muscle force, and joint reaction force. These variables were then input as the boundary/loading conditions for finite element analyses of running. The principal tensile strain on the plantar fascia, subtalar eversion, and navicular height during the stance phase were averaged across five trials of each condition and compared using Friedman's test.

Results

Maximal subtalar eversion did not differ among conditions (p = 0.449). Fascia taping significantly reduced maximal strains on the fascia band (p = 0.034, Kendall's W = 0.64–0.76) and increased the navicular height (p = 0.013, Kendall's W = 0.84) compared with nontaping. There were no significant differences in all outcome variables between Low-Dye taping and nontaping (p = 0.173–0.618).

Conclusion

From a mechanical point of view, our study provided quantitative evidence to support the application of taping treatments for overstrained plantar fascia. The untensed fascia band by Fascia taping could be a potential indicator of pain relief for the runners. However, a prospective study targeting the patient population would be needed to address the point.

The Translational Potential of this Article

The study quantified the loading status of the plantar fascia during running and provided mechanical evidence to support the usage of taping as a mean to reduce fascial strain, thus possibly controlling injury risks for the runners. The results of the study also highlighted the importance of selecting specific taping methods based on individuals' needs.

Development of a clinical prediction rule to identify patients with plantar heel pain likely to benefit from biomechanical anti-pronation taping: A prospective cohort study

OBJECTIVES

To develop a clinical prediction rule (CPR) to identify patients with plantar heel pain (PHP) likely to benefit from biomechanical anti-pronation taping (BAPT).

DESIGN

A prospective cohort study.

SETTING

An outpatient rehabilitation department in a general hospital.

PARTICIPANTS

Seventy-five patients with PHP.

MAIN OUTCOME MEASURES

After completing a series of physical examinations, all patients received BAPT and were evaluated with a numeric rating scale for pain intensity, the patient-specific functional scale and foot function index (FFI) for function, and the global rating of change for perceived improvement.

RESULTS

Twenty-eight patients achieved a successful outcome. A CPR with 6 significant variables was identified by a multivariate logistic regression: FFI score less than 33.3, hip adduction angle of the most affected side was greater than the contralateral side, ankle plantarflexors and hip abductors on the most affected side were not weaker than those on the contralateral side, ankle invertors on the most affected side were weaker than the contralateral side, and having more than 2 painful sites in the low back and lower extremity regions. If 5 or more of the 6 predictors were presented, the probability of success increased from 37% to 80%.

CONCLUSIONS

A CPR has been developed to identify patients with PHP likely to benefit from BAPT.

Multidimensional impact of low-Dye taping on low-load hopping in individuals with and without plantar fasciitis

OBJECTIVES

Evaluate the acute effect of low-Dye, placebo and no tape on motor behaviour in individuals with plantar fasciitis (PF).

DESIGN

Prospective, experimental.

SETTING

Motion analysis laboratory.

PARTICIPANTS

Ten participants with PF and ten matched controls.

MAIN OUTCOME MEASURES

Hopping behaviour (lower-limb stiffness and ankle angle at peak loading) were evaluated during low-load sleigh hopping, during three taping conditions. Stiffness and ankle angle were determined using three-dimensional motion analysis. Pain during submaximal loading was assessed with a numeric pain rating scale.

RESULTS

The lower-limb stiffness response to therapeutic taping was modulated by the presence of PF (interaction, F = 4.48, p = 0.018). Matched controls demonstrated a significant increase in stiffness post application of low-Dye taping (p = 0.001), stiffness was unchanged in the PF group. In the PF group, low-Dye taping decreased hopping pain in comparison to placebo (p = 0.037) and no-tape (p = 0.024). There was no difference in ankle angle at peak loading between the groups or across taping conditions.

CONCLUSIONS

Low-Dye taping reduces nociceptive inputs more than placebo in the presence of PF pain. Low-Dye tape alters stiffness in the control group but not the PF group. The motor behavioural outputs such as stiffness, during low-load hopping is modulated by both pathology and therapeutic taping.

The effects of the application of low-dye taping on paretic side plantar pressure among patients with plantar fasciitis

[Purpose] This study aimed to examine the effects of low-dye taping on paretic side plantar pressure in patients with plantar fasciitis. [Subjects] The 30 patients in this study were randomly allocated to a low-dye taping group (n = 15) or a conservative treatment group (n =15). [Methods] Both groups received treatment thrice a week for six weeks. BioRescue was used to measure the weight distribution of the patients’ paretic side. [Results] Within-group comparison showed that the posterior weight distribution significantly increased among patients in both groups. However, comparison between the two groups showed that the low-dye taping group’s posterior weight distribution was significantly higher than that of the conservative treatment group. [Conclusion] These findings show that the application of low-dye taping is an effective intervention for paretic-side plantar pressure among patients with plantar fasciitis.

Effects of the application of Low-Dye taping on the pain and stability of patients with plantar fasciitis

[Purpose] This study examined how the application of Low-Dye (LD) taping affected the pain and stability of patients with plantar fasciitis. [Subjects] The subjects were 30 patients with plantar fasciitis who were divided into two groups: a Low-Dye taping group (LTG, n=15) and a conservative treatment group (CTG, n=15). [Methods] The treatments were performed three times a week for six weeks in both groups. A visual analog scale (VAS) was used to evaluate the pain and stability of patients with plantar fasciitis, and the transfer area of the center of gravity (TAOCOG) was measured to evaluate stability using a BioRescue device. [Results] In the within-group comparison of the VAS, the LTG and CTG values significantly decreased. In the post-test between-group comparison, the VAS pain decreased more significantly in LTG than in CTG. In the within-group comparison of the TAOCOG, the LTG value significantly increased. In the post-test between-group comparison, the TAOCOG value increased more significantly than in LTG than in CTG. [Conclusion] Utilizing Low-Dye taping for patients with plantar fasciitis appears to be an effective intervention method for reducing pain and enhancing stability.

The effects of custom-made foot orthosis using the Central Stabilizer Element on foot pain

BACKGROUND

Foot orthoses have been applied for the management of lower limb disorders, mainly for those who develop foot pain. The Central Stabilizer Element (CSE) is a new element that contains the midfoot laterally when a plantar insole is manufactured.

OBJECTIVES

To determine the effect on foot pain of adding the Central Stabilizer Element during the manufacturing process of foot orthosis, and to describe the proportions of Central Stabilizer Element in terms of width and length of this element.

STUDY DESIGN

A clinical study.

METHODS

A sample comprising 130 patients (57 males and 73 females) with foot pain was recruited for this study, with the patients having supinated, neutral, pronated and overpronated feet. All the patients received a custom-made foot orthosis with the Central Stabilizer Element. The Central Stabilizer Element was made of resins of polyvinyl chloride, and is a device insert in foot orthosis that contains the midfoot laterally to control pronation and supination movements. Perceived patient's foot pain was collected using a Visual Analog Scale at baseline, 15, 60 and 90 days after treatment.

RESULTS

A statistically significant decrease was found after foot orthosis application at all times in all foot types. There was a statistically significant correlation between all the ratio proportions according to foot posture (Foot Posture Index scores), except for heel length proportion.

CONCLUSIONS

The Central Stabilizer Element, applied at midfoot level of a custom-made foot orthoses through a directly mould technique, can reduce foot pain, when a previous foot posture status is considered.

CLINICAL RELEVANCE

The Central Stabilizer Element can be of interest for those professionals who are involved in the manufacturing process of foot orthosis, throughout the control of an excesive pronated or a supinated foot condition that is provoking foot pain.

Cohesive taping and short-leg casting in acute low-type ankle sprains in physically active patients

BACKGROUND

Cohesive taping is commonly used for the prevention or treatment of ankle sprain injuries. Short-leg cast immobilization or splinting is another treatment option in such cases. To determine the clinical efficacy and antiedema effects of cohesive taping and short-leg cast immobilization in acute low-type ankle sprains of physically active patients, we performed a preliminary clinical study to assess objective evidence for edema and functional patient American Orthopaedic Foot and Ankle Society (AOFAS) scores with these alternative treatments.

METHODS

Fifty-nine physically active patients were included: 32 in the taping group and 27 in the short-leg cast group within a year. If a sprain was moderate (grade II) or mild (grade I), we used functional taping or short-leg cast immobilization for 10 days. We evaluated the edema and the functional scores of the injured ankle using the AOFAS Clinical Rating System on days 1, 10, and 100.

RESULTS

In each group, edema significantly decreased and AOFAS scores increased indicating that both treatment methods were effective. With the numbers available, no statistically significant difference could be detected.

CONCLUSIONS

Each treatment method was effective in decreasing the edema and increasing the functional scores of the ankle. At the beginning of treatment, not only the level of edema but also the initial functional scores of the ankle and examinations are important in making decisions regarding the optimal treatment option.

Arch-Taping Techniques for Altering Navicular Height and Plantar Pressures During Activity

CONTEXT

Arch tapings have been used to support the arch by increasing navicular height. Few researchers have studied navicular height and plantar pressures after physical activity.

OBJECTIVE

To determine if taping techniques effectively support the arch during exercise.

DESIGN

Crossover study.

SETTING

Athletic training research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Twenty-five individuals (13 men, 12 women; age = 20.0 ± 1.0 years, height = 172.3 ± 6.6 cm, mass = 70.1 ± 10.2 kg) with a navicular drop of more than 8 mm (12.9 ± 3.3 mm) volunteered.

INTERVENTION(S)

All individuals participated in 3 days of testing, with 1 day for each tape condition: no tape, low dye, and navicular sling. On each testing day, navicular height and plantar pressures were measured at 5 intervals: baseline; posttape; and after 5, 10, and 15 minutes of running. The order of tape condition was counterbalanced.

MAIN OUTCOME MEASURE(S)

The dependent variables were navicular height in millimeters and plantar pressures in kilopascals. Plantar pressures were divided into 5 regions: medial forefoot, lateral forefoot, lateral midfoot, lateral rearfoot, and medial rearfoot. Separate repeated-measures analyses of variance were conducted for each dependent variable.

RESULTS

Navicular height was higher immediately after application of the navicular-sling condition (P = .004) but was reduced after 5 minutes of treadmill running (P = .12). We observed no differences from baseline to posttape for navicular height for the low-dye (P = .30) and no-tape conditions (P = .25). Both the low-dye and navicular-sling conditions increased plantar pressures in the lateral midfoot region compared with the no-tape condition. The low-dye condition created decreased pressure in the medial and lateral forefoot regions compared with the no-tape condition. All changes were identified immediately after application and were maintained during running. No changes were noted in plantar pressures for the no-tape condition (P > .05).

CONCLUSIONS

Both taping techniques effectively changed plantar pressures in the lateral midfoot, and these changes were sustained throughout the 15 minutes of exercise.

A biomechanical analysis of the effects of low-Dye taping on arch deformation during gait

BACKGROUND

The low-Dye technique serves to limit hindfoot pronation and medial arch collapse. Few studies exist that investigate the effects on medial arch deformation from a biomechanical perspective.

METHODS

Kinematic data was collected using a Motion Analysis System. Foot function of 21 healthy adults was assessed during the stance phase of gait. Subjects were evaluated prior to and immediately following the low-Dye tape application, as well as at 48 h. Foot deformation was assessed during the stance phase of gait using the calcaneus, navicular and 1st metatarsal head markers to calculate the medial longitudinal arch angle (MLA) and the dynamic arch height index (dAHI). Paired t-tests were used to assess low-Dye tape effectiveness.

RESULTS

There was a significant 19.3% reduction in MLA immediately after application of the tape. However only 4.01% reduction remained in deformation after 48 h. The MLA deformation findings were consistent with the AHI change, showing a significant change in the arch deformation between Pre and Post0 low-Dye taping. The effects were short-lived.

CONCLUSIONS

There are measurable changes to medial arch height and amount of arch height deformation during gait following low-Dye taping. Although changes were present immediately after application, results were diminished 48 h after application.

Duration of strength retention of ankle taping during activities of daily living

BACKGROUND AND PURPOSE

Taping has been used for the prevention and treatment of ankle injuries. The change in tape strength has not been specifically quantified during activities of daily living (ADL) by any investigation so far. Therefore the primary aim of this study was to investigate the change in ankle tape strength over a 24-h period, while subjects performed their ADL.

SUBJECTS

Twenty-four healthy subjects (mean age: 24.3+/-7.4) participated in this study.

METHODS

Ankle taping was applied to all subjects for a 24-h period. Outcome measures were recorded at six different time intervals and are as follows: before and immediately after taping, 15, 30, 60 min, and 24h post taping. Strength of tape was quantified as the moment required to rotate the foot passively into inversion, measured using a handheld dynamometer. The range of motion (ROM) was also measured using a goniometer. The muscle activity of the ankle evertors were monitored while recording the outcome measures to ensure that the passive rotation of the ankle into inversion by the investigator was not impeded by their contraction.

RESULTS

A significant change in the moment required to rotate the foot into inversion and ROM was found between all time intervals tested (p<0.001). There was a 58% reduction in MOM and a 155% increase in ROM after 24h.

DISCUSSION AND CONCLUSION

This study has quantified for the first time the reduction in the support provided by ankle taping while subjects performed their ADL. This can assist clinicians on deciding the frequency of tape reapplication that may required to provide adequate support to the ankle.

Tape that increases medial longitudinal arch height also reduces leg muscle activity: a preliminary study

PURPOSE

: To evaluate the initial effects of antipronation taping (APT) on foot posture and electromyographic (EMG) activity of tibialis anterior (TA), tibialis posterior (TP), and peroneus longus (PL) muscles during walking.

METHODS

: Five asymptomatic individuals who exhibited lower medial longitudinal arch height on a clinical assessment of gait walked on a treadmill for 10 min before and after the application of an APT technique-specifically, the augmented low-Dye. Arch height (AH) in standing as well as peak and average amplitude, duration, time of onset, and time of offset of recorded EMG activity during walking were analyzed for each condition.

RESULTS

: APT produced a mean (95% confidence interval (CI)) increase in AH of 12.9% (6.5-19.3; P = 0.005). Mean (95% CI) reductions in peak and average EMG activation of TA (peak: -23.9% (-34.0 to -13.9); average: -7.8% (-13.6 to -2.0)) and TP (peak: -45.5% (-77.3 to -13.7); average: -21.1% (-41.6 to -0.6)) were observed when walking with APT (P < 0.05). The APT also produced a small increase in duration of TA EMG activity of 3.7% (0.9-6.5) of the stride cycle duration, largely because of an earlier onset of EMG activity (4.4%; -8.1 to -0.8 of a stride cycle; P < 0.05).

CONCLUSION

: APT reduces activity of the TA and TP muscles during walking while increasing AH, which provides preliminary evidence of its role in reducing the load of these key extrinsic muscles of the ankle and the foot. Follow-up study is required to evaluate these findings.

Randomized controlled trial of calcaneal taping, sham taping, and plantar fascia stretching for the short-term management of plantar heel pain

STUDY DESIGN

Prospective, experimental, randomized, single-factor, pretest/posttest design.

OBJECTIVES

To examine the effects of a calcaneal and Achilles-tendon-taping technique, utilizing only 4 pieces of tape and not involving the medial arch, on the symptoms of plantar heel pain.

BACKGROUND

Plantar fasciitis is one of the most common causes of heel and foot pain. Physical therapists have applied many techniques in an attempt to relieve the symptoms of plantar heel pain, including various taping methods for which there is little existing evidence.

METHODS AND MEASURES

Subjects (n=41) were randomly assigned into 4 groups: (1) stretching of the plantar fascia, (2) calcaneal taping, (3) control (no treatment), and (4) sham taping. A visual analog scale (VAS) for pain and a patient-specific functional scale (PSFS) for functional activities were measured pretreatment and after 1 week of treatment (posttreatment).

RESULTS

A significant difference was found posttreatment among the groups for the VAS (P < .001). Specifically, significant differences were found between stretching and calcaneal taping (mean + SD, 4.6 +/- 0.7 versus 2.7 +/- 1.8; P = .006), stretching and control (mean +/- SD, 4.6 +/- 0.7 versus 6.2 +/- 1.0; P = .026), calcaneal taping and control (mean +/- SD, 2.7 +/- 1.8 versus 6.2 +/- 1.0; P < .001), and calcaneal taping and sham taping (mean +/- SD, 2.7 +/- 1.8 versus 6.0 +/- 0.9; P < .001). No significant difference among groups was found for posttreatment PSFS (P = .078).

CONCLUSIONS

Calcaneal taping was shown to be a more effective tool for the relief of plantar heel pain than stretching, sham taping, or no treatment.

The effect of low-Dye taping on kinematic, kinetic, and electromyographic variables: a systematic review

STUDY DESIGN

A systematic review.

OBJECTIVE

To determine the strength of evidence of the effect of low-Dye taping on lower limb kinematic, kinetic, and electromyographic variables.

BACKGROUND

Low-Dye taping is a foot-taping technique that aims to limit foot pronation and is commonly used to treat a number of foot disorders.

METHODS AND MEASURES

Systematic review of randomized or quasi-randomized trials examining the effect of low-Dye taping compared with no taping on kinematic, kinetic, and electromyographic variables. Trials were identified by searching CINAHL, EMBASE, MEDLINE, SPORTDiscus, and CENTRAL, and by recursive checking of bibliographies. Data were extracted from published trials and from mail contact with authors for further information as necessary. Meta-analyses were planned for all outcomes using the generic inverse variance method. Sensitivity analyses were planned by pooling data from nonrandomized trials. Statistical heterogeneity was assessed using the quantity I2.

RESULTS

Six trials met inclusion criteria and, of these, 5 trials reported sufficient data on kinematic and kinetic variables to be included in the analysis. Results from the 5 randomized trials were considered robust when pooled with data from 7 nonrandomized trials in a sensitivity analysis. When compared to no taping, low-Dye taping increased navicular height immediately after application (weighted mean difference [WMD], 5.90 mm; 95% confidence interval [CI], 0.41 to 11.39; P = .04) and had no effect on navicular height post exercise (WMD, 4.70 mm; 95% CI, -0.61 to 10.01; P = .08), maximum rearfoot eversion while walking (WMD, -0.59 degrees; 95% CI, -2.53 to 1.35; P = .55), and total rearfoot range of motion while walking (WMD, 2.3 degrees; 95% CI, -0.64 to 5.24; P = .13).

CONCLUSIONS

Low-Dye taping provides a small change in navicular height post application, although it is unclear whether this change is clinically important. There was high heterogeneity between some trials examining other variables, indicating that more research is needed to confirm the results of previous trials.

Treatment of plantar fasciitis by LowDye taping and iontophoresis: short term results of a double blinded, randomised, placebo controlled clinical trial of dexamethasone and acetic acid

OBJECTIVES

To determine if, in the short term, acetic acid and dexamethasone iontophoresis combined with LowDye (low-Dye) taping are effective in treating the symptoms of plantar fasciitis.

METHODS

A double blinded, randomised, placebo controlled trial of 31 patients with medial calcaneal origin plantar fasciitis recruited from three sports medicine clinics. All subjects received six treatments of iontophoresis to the site of maximum tenderness on the plantar aspect of the foot over a period of two weeks, continuous LowDye taping during this time, and instructions on stretching exercises for the gastrocnemius/soleus. They received 0.4% dexamethasone, placebo (0.9% NaCl), or 5% acetic acid. Stiffness and pain were recorded at the initial session, the end of six treatments, and the follow up at four weeks.

RESULTS

Data for 42 feet from 31 subjects were used in the study. After the treatment phase, all groups showed significant improvements in morning pain, average pain, and morning stiffness. However for morning pain, the acetic acid/taping group showed a significantly greater improvement than the dexamethasone/taping intervention. At the follow up, the treatment effect of acetic acid/taping and dexamethasone/taping remained significant for symptoms of pain. In contrast, only acetic acid maintained treatment effect for stiffness symptoms compared with placebo (p = 0.031) and dexamethasone.

CONCLUSIONS

Six treatments of acetic acid iontophoresis combined with taping gave greater relief from stiffness symptoms than, and equivalent relief from pain symptoms to, treatment with dexamethasone/taping. For the best clinical results at four weeks, taping combined with acetic acid is the preferred treatment option compared with taping combined with dexamethasone or saline iontophoresis.

The effect of low-Dye taping on plantar pressures, during gait, in subjects with navicular drop exceeding 10 mm

STUDY DESIGN

A preintervention and postintervention, repeated-measures experimental design.

OBJECTIVES

To investigate the immediate effect of low-Dye taping on peak and mean plantar pressures during gait in subjects with navicular drop exceeding 10 mm.

BACKGROUND

Low-Dye taping is commonly used to support the longitudinal and transverse arches of the foot in an attempt to reduce the effects of symptoms associated with excessive pronation. Plantar pressure measurement has been used as an indirect indicator of pronation during gait. METHOD AND MEASURES: The right foot of 60 subjects was tested using the Emed-AT system to obtain plantar pressure values. Subjects performed 6 barefoot walks over the Emed pressure platform while taped and a further 6 walks while untaped. Plantar pressures were recorded. Each footprint obtained was divided into 10 sections or 'masks.' Average peak and mean plantar pressure values (N/cm2) were calculated for both taped and untaped walks for each mask.

RESULTS

Paired t tests demonstrated significant changes in peak plantar pressure in 8 of the 10 areas of the foot and significant changes in mean plantar pressure in 9 of the 10 areas of the foot. Low-Dye taping significantly decreased pressure under the heel and the medial and middle forefoot, while increasing pressure under the lateral midfoot and under the toes. A significant decrease in mean plantar pressure was observed under the lateral forefoot, while no significant difference was demonstrated in peak plantar pressure under this area. The area under the medial midfoot demonstrated no significant change in either peak or mean pressure.

CONCLUSIONS

Low-Dye taping significantly altered peak and mean plantar pressure values in subjects with navicular drop exceeding 10 mm. In particular, peak and mean plantar pressure increased under the lateral midfoot and under the toes, and decreased under the heel and forefoot, suggesting that a decrease in the amount of pronation occurred.