Sports Medicine Research: In the Lab & In the Field: Kinesiotaping with Exercise Versus Manual Therapy with Exercise in Patients with Subacromial Impingement Syndrome (Sports Med Res)
Tuesday, November 25, 2014

Kinesiotaping with Exercise Versus Manual Therapy with Exercise in Patients with Subacromial Impingement Syndrome

The clinical and sonographic effects of kinesiotaping and exercise in comparison with manual therapy and exercise for patients with subacromial impingement syndrome: a preliminary trial
Kaya DO, Baltaci G, Toprak U, Atay AO. J Manipulative Physiol Ther. 2014;37(6):422-432. DOI: 10.1016/j.jmpt.2014.03.004

Take Home Message: This study shows that the use of kinesiotaping with exercise and manual therapy with exercise are both effective in decreasing pain and disability in patients with subacromial impingement syndrome. The kinesiotaping with exercise intervention was more effective in decreasing pain at night than the manual therapy with exercise treatment group.
The shoulder complex is one of the most commonly injured body parts, with subacromial impingement syndrome being one of the most common shoulder conditions. Because subacromial impingement syndrome has such a high prevalence, it is important to find an effective treatment for the condition. Subacromial impingement syndrome has a high prevalence, so it is important to find an effective treatment protocol.  As an adjunct to traditional therapeutic exercises, some clinicians use manual therapy or kinesiotaping. However, it is unclear if one of these additional therapies is more beneficial than the other. Kaya and colleagues conducted a 6-week randomized control trial to examine the effectiveness of 2 treatment protocols for individuals with subacromial impingement syndrome: kinesiotaping with exercise and manual therapy with exercise.  The authors compared the effectiveness of the treatments based on decreasing shoulder pain, improving function, or altering the supraspinatus tendon thickness.  The kinesiotaping group consisted of 28 patients that received a taping application once per week for rotator cuff tendinitis/impingement syndrome that met their specific needs.  The tape was kept on for 4 to 5 days.  The manual therapy group included 26 participants who received treatment once per week, including soft tissue and deep friction massage of the supraspinatus muscle and mobilizations of the neck, glenohumeral joint, thoracic region, and elbow. Both treatment groups performed the same six-week progressive exercise rehabilitation program that included flexibility, strengthening, and muscle re-education exercises for the scapular stabilizers and rotator cuff muscles.  Pain was assessed with a visual analog scale and disability was assessed with the Disability of the Arm, Hand, and Shoulder Questionnaire (DASH).  The authors assessed the supraspinatus thickness with diagnostic ultrasound.  All outcomes were assessed at baseline and after the 6 weeks of treatment.  The authors found improvement in pain and function in both groups after the treatment program.  The kinesiotaping group had a greater decrease in pain at night than the manual therapy group. Both groups lacked any alterations to the thickness of the supraspinatus tendon after the treatment programs. 
These findings are significant because previous research has not compared these two treatment options, which are both commonly used in sports medicine clinics.  Also, the quality of evidence for research conducted on manual therapy used in shoulder rehabilitation is less than optimal and there is limited research on the effectiveness of kinesiotape since it’s a relatively new modality. Both treatment protocols cause improvements in shoulder pain and disability, and these improvements were found to be clinically meaningful conservative therapies.  Clinicians can implement these findings by using either manual therapy or kinesiotaping in conjunction with exercise to treat subacromial impingement syndrome.  It will be interesting to see if a future study determines if adding these adjunct therapies is more advantageous than just doing the exercise program.  As clinicians, kinesiotaping can prove to be more ideal since it is a quicker alternative than manual therapy.  Kinesiotaping with exercise may also be preferred for patients with night pain.  In conclusion, both treatment protocols prove to be effective, kinesiotaping with exercise may provide more benefits to the patient and clinician.
Questions for Discussion: Do you think kinesiotaping and/or the manual therapy could decrease pain and improve function if they weren’t combined with the exercise therapy program? Do you use patient-reported outcomes (like a pain visual analog scale) as part of your evaluation?

Written by: Lauren Hankle, Kayla Green
Reviewed by: Kim Pritchard

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Kaya, D., Baltaci, G., Toprak, U., & Atay, A. (2014). The Clinical and Sonographic Effects of Kinesiotaping and Exercise in Comparison With Manual Therapy and Exercise for Patients With Subacromial Impingement Syndrome: A Preliminary Trial Journal of Manipulative and Physiological Therapeutics, 37 (6), 422-432 DOI: 10.1016/j.jmpt.2014.03.004

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