Kinesio taping was developed in the 1970s by Dr. Kenzo Kase.1 Using his knowledge and career experience as a chiropractor, Dr. Kase wanted to create another method of intervention that could help his patients even after they left his clinic and went about their daily activities. This intervention is commonly used in order to help provide support and stability to joints and muscles without negatively affecting the body’s range of motion, promote proprioceptive neuromuscular facilitation, treat edema and pain, and promote blood and lymph flow.2,3 This technique is based on the body’s natural ability to heal and relies on the body’s neurological and circulatory systems to be most effective.2 Contraindications and precautions of this intervention include but are not limited to deep vein thrombosis, kidney problems, congestive heart failure, cancer, infection, aneurysms, and open sores.
In 1988, Kinesio Tape products were made available for purchase in stores in order for other healthcare providers to practice this technique on their own patients.1 In 2001, Medicare established a code for kinesio taping that allowed it to be reimbursed nationally.1 Although Kinesio Tape has risen in popularity over the years, scientific evidence regarding the effectiveness of this intervention has been conflicting. Akbab conducted a randomized controlled trial at Istanbul University to see how patients’ expectations of a successful outcome of the application of Kinesio Tape would affect its actual effectiveness as an intervention. One-hundred and ten patients were recruited to participate in the trial; however, only 89 patients fit the criteria to participate. Out of these 89 patients, three groups were formed by using an online randomization service. In addition to the Kinesio Tape being applied in the same way on each patient, each group was given different verbal information. Group 1 was told that there was no evidence that kinesio taping was effective.
Group 2 was given the information that there was limited evidence that kinesio taping was effective, and Group 3 was told that there was evidence that kinesio taping has an excellent effect.3 In preparation of applying the intervention, several outcome measurements were assessed including a visual analog scale (VAS) for pain during rest (VAS-rest), pain during activities of daily living (VAS-activity), and pain at night (VAS-night). Goniometer measurements of “active and passive shoulder forward flexion, abduction, and scapular plane external–internal rotation range of motion were also assessed.”3 Functions of the patients were assessed by “the Disability of the Arm, Shoulder and Hand Questionnaire and the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form.”3 Before the Kinesio Tape was applied, the patients’ pain at rest and activity were recorded (first assessment) as well as recorded again 30 minutes later (second assessment). Night pain, range of motion and both questionnaires previously given were recorded again after 24 hours (third assessment) at their reevaluation. After the patients’ reevaluation, the data taken proved to be statistically insignificant between the three groups in VAS-rest and VAS-activity.
Also, there was very little difference between the three groups in VAS-night, range of motion, and the two questionnaires given. In Group 2, the only visual analog scale to improve after 30 minutes was the VAS-night (P = 0.02).3 In addition, an improvement in pain both after 30 minutes and after one day of assessment was found predominantly in the third group which had been given the positive verbal information beforehand (P = 0.001, P = 0.001, respectively).3 VAS-activity and VAS-night were improved in all groups after 24 hours. In conclusion, “this study provides evidence that expectations have an effect on short-term (24 hours) outcomes in patients with rotator cuff tears treated with kinesio taping.”3 This research would be considered level 1-b in evidence based practice due to it being a randomized controlled trial.
Simsek’s randomized, double-blind, controlled clinical trial, had the goal of determining the effectiveness of the application of Kinesio Tape (KT) in addition to the exercise treatment of subacromial impingement syndrome (SIS). This study consisted of 38 patients with SIS in an age range of 18 to 69 years old. All patients had pain that persisted for one month or longer and had positive Neer and Hawkin’s impingement test result.5 These patients were divided into two groups of 19 patients; one group received therapeutic KT, and the other group received sham KT. These patients were given VAS pain scales based on pain felt at rest, night, and during an activity as well as the DASH and Constant score for functional assessment. Active and passive range of motion of the shoulder was also measured with a standard goniometer. All of these outcome tools and measurements were taken prior to the KT being applied, 5 days after, and 12 days after it was applied. The KT was applied in conjunction with an exercise program outlined by Hughston and Riivald.
The results of the measurements and testing are as follows: “the therapeutic KT group showed more significant improvement when compared to the sham group in terms of activity, pain, and function (DASH) on the 5th day (p Nelson’s systematic review chose to look at the results of many randomized controlled trials to see the effects KT had on chronic low back pain. After many articles were examined, the systematic review focused on five trials which included 306 patients with chronic low back pain.6 These trials involved the use of KT alone compared to sham KT and KT in combination with traditional physical therapy exercise. Many measurements were taken during these various studies including pain intensity, anticipatory postural control, muscular endurance, ROM, global perceived effect, disability, and fear of movement. In Parreira et al., one inch strips of KT were applied bilaterally to the erector spinae with a 10-15% stretch.6 The control group received sham KT with no stretch applied. Both groups showed similar reductions in pain and disability; however, there were no significant differences between groups following up at 4 and 12 weeks that made one a better option than the other.
For global perceived effect (GPE), there were significant statistical differences between groups at 4 weeks in favor of the ETT group (MD 1.4 points, 95% CI 0.3 to 2.5).6 Yet, there were no significant differences in improvement in GPE between groups at the 12 week follow up. In Kachanathu et al., one-inch strips of KT were placed bilaterally on the erector spinae with slight stretch applied on the tape in combination with physical therapy exercise. The control group only received stretching for the back, iliopsoas, and hamstring muscles in combination with strengthening for the abdominal muscles. After 4 weeks, both groups had significant improvement in pain, disability, and range of motion (p < 0.05).6 In conclusion, the effect of KT on the measured parameters is small and may be most valuable used in combination with exercise for individuals with chronic low back pain. This research is level 1-a in evidence based practice due to it being a systematic review of randomized controlled trials.
Evidence-based practice is made up of three things: patient preference, clinician’s clinical experience, and best research available. In the past years, kinesio taping has risen in popularity and sparked many patients interest due to the media spotlight it was given during the Olympics. Patients see famous and successful athletes trying a trendy treatment and usually assume that intervention should work for them too. With this in mind, they may suggest the intervention to the clinician which should be taken into consideration if it is applicable to their injury and treatment plan. Patients also may not want to participate in a certain intervention due to cultural or religious beliefs which must be accommodated for. Next, the clinician must have education or experience with the intervention. For kinesio taping, a Physical Therapist Assistant (PTA) can become a Certified Kinesio Taping Practitioner (CKTP). This certification ensures that the PTA is properly educated and trained in this intervention.
The PTA can also gain new knowledge on this evolving intervention by taking Continuing Education courses to further their education. The clinician should also be using the best available research which means staying up to date on all the new studies and their outcomes looking into the effectiveness of kinesio taping. Patient X is a 28 year-old female who suffers from subacromial impingement syndrome due to rotator cuff inflammation. She is not sure how the injury occurred. The patient has previously been given three different shots of lidocaine by her physician with the goal of providing pain relief, but it has been fairly unsuccessful possibly due to her comorbidity of diabetes. Patient X is limited in her daily activities such as reaching above her head to put dishes away and picking up and putting down her 3 year-old toddler. She is also having a hard time while working as a nurse due to constant activities like transferring patients and placing IV bags on above head portable IV poles. She is also having trouble sleeping at night due to pain.
After three weeks of physical therapy exercise and electrical stimulation, some improvement have been made, but the patient is willing to try anything to meet her goals faster and to get back to doing her daily activities such as working. Without any improvement in pain relief, doctors will soon begin to look at surgical options. Moving forward in physical therapy, kinesio taping would be an appropriate intervention to try in conjunction with current and new physical therapy exercises. In conclusion, studies have shown that patients anticipating positive outcomes while using Kinesio Tape can have a positive effect within the first 24 hours after the application of the Kinesio Tape.3 Kinesio taping has also shown to be more effective in combination with physical therapy exercise. On the other hand, some studies suggest that kinesio taping has no positive effects on patients who utilize the intervention itself. This intervention has been growing in popularity; however, it requires more extensive research to identify its effectiveness on multiple patient populations.
Reference
- History and Background. Kinesio Tape. https://kinesiotaping.com/about/our-history/. Accessed September 10, 2018.
- What Does Kinesio Taping Do? Kinesio Taping in Canada. http://kinesiotape.ca/what-does-kinesio-taping-do/. Accessed September 10, 2018.
- Akbaba YA, Mutlu EK, Altun S, Celik D. Does the patients’ expectations on kinesiotape affect the outcomes of patients with a rotator cuff tear? A randomized controlled clinical trial. Clinical Rehabilitation. 2018:026921551877964. doi:10.1177/0269215518779645
- Thomas S. Understanding the Benefits & Contraindications of Taping the Geriatric Client. MASSAGE Magazine. https://www.massagemag.com/taping-technique-geriatric-client-86290/. Published August 21, 2017. Accessed September 14, 2018.
- Şimşek H, Balki S, Keklik S, Öztürk H, Elden H. Does Kinesio taping in addition to exercise therapy improve the outcomes in subacromial impingement syndrome? A randomized, double-blind, controlled clinical trial. Acta Orthopaedica Et Traumatologica Turcica [serial online]. 2013;47(2):104-110. Available from: MEDLINE with Full Text, Ipswich, MA. Accessed September 11, 2018.
- Nelson NL. Kinesio taping for chronic low back pain: A systematic review. Journal of Bodywork and Movement Therapies. 20(3):672-681. doi:doi: 10.1016/j.jbmt.2016.04.018
