ArticlePDF AvailableLiterature Review

Kinesio taping for sports injuries

Authors:

Abstract

This section features a recent systematic review that is indexed on PEDro, the Physiotherapy Evidence Database (http://www.pedro.org.au). PEDro is a free, web-based database of evidence relevant to physiotherapy.
This section features a recent systematic review that is indexed on
PEDro, the Physiotherapy Evidence Database (www.pedro.org.au).
PEDro is a free, web-based database of evidence relevant to
physiotherapy.
Kinesio taping for sports
injuries
Williams S, Whatman C, Hume PA, et al. Kinesio taping in treatment and prevention
of sports injuries. A meta-analysis of the evidence for its effectiveness. Sports Med
2012;42:153164.
BACKGROUND
Kinesio tape is a proprietary product that purports to offer a
range of benets in the treatment and prevention of various
musculoskeletal conditions. Kinesio taping involves the applica-
tion of elastic adhesive tape to areas of pain or dysfunction.
Theorised mechanisms of action are diverse, including reduction
of pain through stimulation of sensory afferents
1
and increased
range of motion (ROM) due to enhanced local circulation.
2
Despite a recent increase in public prole due to use of kinesio
taping by athletes at major sporting events, the clinical benets
of the intervention remain unclear.
AIM
To review the evidence for the effectiveness of kinesio taping
for the prevention and treatment of sports injuries.
SEARCHES AND INCLUSION CRITERIA
Biomedical and sports-related databases including MEDLINE,
Scopus, ScienceDirect and SPORTDiscus along with sports
medicine websites were searched for potentially eligible articles.
Only the search term: kinesio taping/tapewas used. Studies
were eligible for inclusion if they reported a musculoskeletal
outcome (eg, pain, ROM, strength or proprioception); com-
pared a kinesio tape condition with comparison condition and
had full-text published in English. Methodological quality was
assessed in the included studies based on three items: random-
isation, subject blinding and assessor blinding.
INTERVENTIONS
Any study that reported the application of kinesio tape as the
index intervention was eligible for inclusion. Comparator
groups included no treatment, placebo taping and sham treat-
ments. Description of the sham interventions is not provided in
the review.
MAIN OUTCOME MEASURES
Outcome measures extracted from the included studies were:
pain, ROM, strength, proprioception and muscle activity. The
authors extracted and reported only the results in the included
studies that showed a statistically signicant difference between
the kinesio taping and control groups.
STATISTICAL METHODS
Despite the title of the review, the authors do not report a
meta-analysis of the included studies. Individual comparisons
from the included studies (only statistically signicant results)
are evaluated using a metric designed to facilitate clinical
interpretation.
3
The authors determined thresholds for clinical beneton
each outcome based on existing literature. Where no previously
validated thresholds for an outcome measure existed, one-fth
of the baseline SD of the measure was used as the threshold. If
no baseline data were provided in the included studies, a thresh-
old for clinical benet was agreed on by the authors. The
authors then used these thresholds to infer the likelihood that
each effect was benecial, trivial or substantially harmful.
RESULTS
Ten controlled studies were included in the review, with sample
sizes ranging from 14 to 65. Only two randomised studies
blinded participants as well as assessors. Three of the ten studies
included patients with a musculoskeletal condition, two of
which were sports-related. Seven studies that recruited healthy
individuals were included on the basis that kinesio taping may
have a preventative action, however none of these studies pro-
vided a direct measure of injury prevention.
Kinesio taping was compared with sham treatment for pain
relief in one study (n=41), no clinically benecial results were
found. There were inconsistent results for ROM outcomes, with
small clinically benecial results seen in two studies, but trivial
results in two other studies. In one study of 21 healthy athletes,
there was a likely benecial intervention effect for propriocep-
tion regarding grip force sense error, but no positive impact on
ankle proprioception.
While intervention appeared to be benecial for a number of
outcomes relating to strength, there were also numerous trivial
ndings and the majority of results were non-signicant. These
studies were also conducted mostly in healthy populations.
Reported effects on muscle activity included a mix of substan-
tial, trivial, unclear and non-signicant ndings.
All the results and subsequent conclusions of the review are
based only on comparisons that showed a signicant difference
between treatment and comparison groups in the included
studies.
LIMITATIONS
The review has several aws, the most serious of which is select-
ive reporting of outcomes. As only positive (signicant) results
are reported it is not possible to assess the entirety of the evi-
dence for effectiveness of kinesio taping.
In addition, while the authors report to have followed
the methodological guidelines of the Cochrane Collaboration
this does not appear to be the case. Recommended methods
of presenting between group comparisons (eg, mean differ-
ences), extraction of all relevant data, complete assessment of
risk of bias and adoption of the Grading of Recommendations
Assessment, Development and Evaluation (GRADE) approach
to describe quality of the evidence would make interpretation
more straightforward.
CLINICAL IMPLICATIONS
Kinesio taping does not appear to have a benecial effect on
pain when compared with sham treatment. Based mostly on
studies of healthy populations, there are inconsistent results for
other outcome measures such as ROM, strength, muscle activity
and proprioception. This systematic review has serious meth-
odological limitations that compromise the reliability of the con-
clusions. Clinicians should look to other sources of information
in determining whether or not to apply this intervention. At
present there appears to be little high quality evidence on which
to assess the effectiveness of kinesio taping, it is hoped that
future research will clarify the situation.
1128 Kamper SJ, et al.Br J Sports Med November 2013 Vol 47 No 17
PEDro systematic review update
Steven J Kamper,
1,2
Nicholas Henschke
3
1
EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands
2
Musculoskeletal Division, The George Institute for Global Health, Sydney,
New South Wales, Australia
3
Institute of Public Health, University of Heidelberg, Heidelberg, Germany
Correspondence to Dr Steven Kamper, The George Institute for Global Health,
University of Sydney PO Box M201, Missenden Rd, Camperdown, NSW 2050,
Australia; skamper@george.org.au
Contributors SJK and NH interpreted the systematic review, wrote and reviewed
drafts. Both authors accepted the nal version.
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.
To cite Kamper SJ, Henschke N. Br J Sports Med 2013;47:11281129.
Accepted 3 September 2013
Br J Sports Med 2013;47:11281129. doi:10.1136/bjsports-2013-093027
REFERENCES
1 Thelen MD, Dauber JA, Stoneman PD. The clinical efcacy of kinesio tape for
shoulder pain: a randomized, double blinded, clinical trial. J Orthop Sports Phys Ther
2008;38:38995.
2 Yoshida A, Kahanov L. The effect of kinesio taping on lower trunk range of motions.
Res Sports Med 2007;15:10312.
3 Batterham AM, Hopkins WG. Making meaningful inferences about magnitudes. Int J
Sports Physiol Perform 2006;1:507.
Kamper SJ, et al.Br J Sports Med November 2013 Vol 47 No 17 1129
PEDro systematic review update
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Background: Kinesio Taping (KT) is one of the conservative treatments proposed for rotator cuff disease. KT is an elastic, adhesive, latex-free taping made from cotton, without active pharmacological agents. Clinicians have adopted it in the rehabilitation treatment of painful conditions, however, there is no firm evidence on its benefits. Objectives: To determine the benefits and harms of KT in adults with rotator cuff disease. Search methods: We searched the Cochrane Library, MEDLINE, Embase, PEDro, CINAHL, Clinicaltrials.gov and WHO ICRTP registry to July 27 2020, unrestricted by date and language. Selection criteria: We included randomised and quasi-randomised controlled trials (RCTs) including adults with rotator cuff disease. Major outcomes were overall pain, function, pain on motion, active range of motion, global assessment of treatment success, quality of life, and adverse events. Data collection and analysis: We used standard methodologic procedures expected by Cochrane. 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Mean overall pain (0 to 10 scale, 0 no pain) was 2.96 points with sham taping and 3.03 points with KT (3 RCTs,106 participants), with an absolute difference of 0.7% worse, (95% CI 7.7% better to 9% worse) and a relative difference of 2% worse (95% CI 21% better to 24% worse) at four weeks. Mean function (0 to 100 scale, 0 better function) was 47.1 points with sham taping and 39.05 points with KT (6 RCTs, 214 participants), with an absolute improvement of 8% (95% CI 21% better to 5% worse)and a relative improvement of 15% (95% CI 40% better to 9% worse) at four weeks. Mean pain on motion (0 to 10 scale, 0 no pain) was 4.39 points with sham taping and 2.91 points with KT even though not clinically important (4 RCTs, 153 participants), with an absolute improvement of 14.8% (95% CI 22.5% better to 7.1% better) and a relative improvement of 30% (95% CI 45% better to 14% better) at four weeks. Mean active range of motion (shoulder abduction) without pain was 174.2 degrees with sham taping and 184.43 degrees with KT (2 RCTs, 68 participants), with an absolute improvement of 5.7% (95% CI 8.9% worse to 20.3% better) and a relative improvement of 6% (95% CI 10% worse to 22% better) at two weeks. No studies reported global assessment of treatment success. Quality of life was reported by one study but data were disaggregated in subscales. No reliable estimates for adverse events (4 studies; very low-certainty) could be provided due to the heterogeneous description of events in the sample. Comparison with conservative treatments Due to very low-certainty evidence, we are uncertain if KT improves overall pain, function, pain on motion and active range of motion compared with conservative treatments. However, KT may improve quality of life (low certainty of evidence). Mean overall pain (0 to 10 scale, 0 no pain) was 0.9 points with conservative treatment and 0.46 points with KT (5 RCTs, 266 participants), with an absolute improvement of 4.4% (95% CI 13% better to 4.6% worse) and a relative improvement of 15% (95% CI 46% better to 16% worse) at six weeks. Mean function (0 to 100 scale, 0 better function) was 46.6 points with conservative treatment and 33.47 points with KT (14 RCTs, 499 participants), with an absolute improvement of 13% (95% CI 24% better to 2% better) and a relative improvement of 18% (95% CI 32% better to 3% better) at four weeks. Mean pain on motion (0 to 10 scale, 0 no pain) was 4 points with conservative treatment and 3.94 points with KT (6 RCTs, 225 participants), with an absolute improvement of 0.6% (95% CI 7% better to 8% worse) and a relative improvement of 1% (95% CI 12% better to 10% worse) at four weeks. Mean active range of motion (shoulder abduction) without pain was 156.6 degrees with conservative treatment and 159.64 degrees with KT (3 RCTs, 143 participants), with an absolute improvement of 3% (95% CI 11% worse to 17 % better) and a relative improvement of 3% (95% CI 9% worse to 14% better) at six weeks. Mean of quality of life (0 to 100, 100 better quality of life) was 37.94 points with conservative treatment and 56.64 points with KT (1 RCTs, 30 participants), with an absolute improvement of 18.7% (95% CI 14.48% better to 22.92% better) and a relative improvement of 53% (95% CI 41% better to 65% better) at four weeks. No studies were found for global assessment of treatment success. No reliable estimates for adverse events (7 studies, very low certainty of evidence) could be provided due to the heterogeneous description of events in the whole sample. Authors' conclusions: Kinesio taping for rotator cuff disease has uncertain effects in terms of self-reported pain, function, pain on motion and active range of motion when compared to sham taping or other conservative treatments as the certainty of evidence was very low. Low-certainty evidence shows that kinesio taping may improve quality of life when compared to conservative treatment. We downgraded the evidence for indirectness due to differences among co-interventions, imprecision due to small number of participants across trials as well as selection bias, performance and detection bias. Evidence on adverse events was scarce and uncertain. Based upon the data in this review, the evidence for the efficacy of KT seems to demonstrate little or no benefit.
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A study of a sample provides only an estimate of the true (population) value of an outcome statistic. A report of the study therefore usually includes an inference about the true value. Traditionally, a researcher makes an inference by declaring the value of the statistic statistically significant or nonsignificant on the basis of a P value derived from a null-hypothesis test. This approach is confusing and can be misleading, depending on the magnitude of the statistic, error of measurement, and sample size. The authors use a more intuitive and practical approach based directly on uncertainty in the true value of the statistic. First they express the uncertainty as confidence limits, which define the likely range of the true value. They then deal with the real-world relevance of this uncertainty by taking into account values of the statistic that are substantial in some positive and negative sense, such as beneficial or harmful. If the likely range overlaps substantially positive and negative values, they infer that the outcome is unclear; otherwise, they infer that the true value has the magnitude of the observed value: substantially positive, trivial, or substantially negative. They refine this crude inference by stating qualitatively the likelihood that the true value will have the observed magnitude (eg, very likely beneficial). Quantitative or qualitative probabilities that the true value has the other 2 magnitudes or more finely graded magnitudes (such as trivial, small, moderate, and large) can also be estimated to guide a decision about the utility of the outcome.
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The purpose of the study was to determine the effects of kinesio taping (KT) on trunk flexion, extension, and lateral flexion. Thirty healthy subjects with no history of lower trunk or back issues participated in the study. Subjects performed two experimental measurements of range of motion (with and without the application of KT) in trunk flexion, extension, and right lateral flexion. A dependent t test was used to compare the range of motion measurements before and after the application of KT. Through evaluation of the sum of all scores, KT in flexion produced a gain of 17.8 cm compared with the non-kinesiotape group (t(29)=2.51, p<0.05). No significant difference was identified for extension (-2.9 cm; t(29)=-0.55, p>0.05) or lateral flexion (3 cm; t(29)=-1.25, p>0.05). Based on the findings, we determined that KT applied over the lower trunk may increase active lower trunk flexion range of motion. Further investigation on the effects of KT is warranted.
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Prospective, randomized, double-blinded, clinical trial using a repeated-measures design. To determine the short-term clinical efficacy of Kinesio Tape (KT) when applied to college students with shoulder pain, as compared to a sham tape application. Tape is commonly used as an adjunct for treatment and prevention of musculoskeletal injuries. A majority of tape applications that are reported in the literature involve nonstretch tape. The KT method has gained significant popularity in recent years, but there is a paucity of evidence on its use. Forty-two subjects clinically diagnosed with rotator cuff tendonitis/impingement were randomly assigned to 1 of 2 groups: therapeutic KT group or sham KT group. Subjects wore the tape for 2 consecutive 3-day intervals. Self-reported pain and disability and pain-free active ranges of motion (ROM) were measured at multiple intervals to assess for differences between groups. The therapeutic KT group showed immediate improvement in pain-free shoulder abduction (mean +/- SD increase, 16.9 degrees +/- 23.2 degrees ; P = .005) after tape application. No other differences between groups regarding ROM, pain, or disability scores at any time interval were found. KT may be of some assistance to clinicians in improving pain-free active ROM immediately after tape application for patients with shoulder pain. Utilization of KT for decreasing pain intensity or disability for young patients with suspected shoulder tendonitis/impingement is not supported. Therapy, level 1b-.
PEDro systematic review update
  • Sj Kamper
Kamper SJ, et al. Br J Sports Med November 2013 Vol 47 No 171129 PEDro systematic review update