Isokinetic Knee Function
in Healthy Subjects With and Without Kinesio Taping
in Healthy Subjects With and Without Kinesio Taping
Wong O., Cheung R., Li
R. Physical Therapy in Sport, 2012
R. Physical Therapy in Sport, 2012
Kinesio
Taping
(KT) has been used
by clinicians for over 30 years, but limited research has been done investigating
the mechanism behind its effectiveness. Application of the tape with the KT
Method can be used to influence muscle, tendons, ligaments and joint
biomechanics. Research is particularly limited regarding KT muscle application.
Therefore, the purpose of this study was to evaluate the effectiveness of KT quadriceps
muscle taping through isokinetic knee flexion and extension strength measures.
Thirty healthy participants were included in this study. All participants
completed maximum concentric knee extension and flexion measures on an
isokinetic dynamometer with and without KT quadriceps muscle application. The
tasks were completed at 3 different angular velocities (60, 120, 180 °/sec) with
10 repetitions each. The order of taped and untaped trials was randomized and
subjects were tested on 2 separate days with at least 7 days rest in between to
avoid any potential carryover effect. The tape was applied to the vastus medialis
muscle with the participant in a supine position and the knee flexed to 30°.
One investigator applied the tape from muscle origin to insertion with 75%
tension. This was done to promote muscle facilitation as per the KT Method. The
measures evaluated during the isokinetic testing were peak torque, total work,
and time to peak torque of both the quadriceps and hamstring musculature. The
authors found that peak torque measures and total work of knee extension and
flexion were not significantly different between taped and untaped conditions
at all angular velocities. However, there was a significant difference in time
to peak torque for knee extension measures in taped and untaped conditions for
all angular velocities. With the taped condition, the time to peak torque for
knee extension was decreased (36-101 ms) compared to the untaped condition. No
differences were found for knee flexion time to peak torque measures at all
angular velocities.
Taping
(KT) has been used
by clinicians for over 30 years, but limited research has been done investigating
the mechanism behind its effectiveness. Application of the tape with the KT
Method can be used to influence muscle, tendons, ligaments and joint
biomechanics. Research is particularly limited regarding KT muscle application.
Therefore, the purpose of this study was to evaluate the effectiveness of KT quadriceps
muscle taping through isokinetic knee flexion and extension strength measures.
Thirty healthy participants were included in this study. All participants
completed maximum concentric knee extension and flexion measures on an
isokinetic dynamometer with and without KT quadriceps muscle application. The
tasks were completed at 3 different angular velocities (60, 120, 180 °/sec) with
10 repetitions each. The order of taped and untaped trials was randomized and
subjects were tested on 2 separate days with at least 7 days rest in between to
avoid any potential carryover effect. The tape was applied to the vastus medialis
muscle with the participant in a supine position and the knee flexed to 30°.
One investigator applied the tape from muscle origin to insertion with 75%
tension. This was done to promote muscle facilitation as per the KT Method. The
measures evaluated during the isokinetic testing were peak torque, total work,
and time to peak torque of both the quadriceps and hamstring musculature. The
authors found that peak torque measures and total work of knee extension and
flexion were not significantly different between taped and untaped conditions
at all angular velocities. However, there was a significant difference in time
to peak torque for knee extension measures in taped and untaped conditions for
all angular velocities. With the taped condition, the time to peak torque for
knee extension was decreased (36-101 ms) compared to the untaped condition. No
differences were found for knee flexion time to peak torque measures at all
angular velocities.
The use of KT for
facilitation of the quadriceps muscle did not show an increase in peak torque
and total work done as measured by isokinetic testing of knee flexion and
extension. However, there was a decrease in the time to peak quadriceps muscle torque.
This supports the theoretical basis of the KT muscle facilitation application.
The intention of the muscle facilitation taping is not to increase muscle strength,
but to assist the muscle by stimulating cutaneous mechanoreceptors which may
alter the firing rate of motor units [Ridding, 2000;
Hsu, 2009; MacGregor, 2005]. The superficial effect of the tape
alone is not enough to increase muscle force output, but enough to improve
activation. These findings are consistent with other studies that have found
early activation of the vastus medialis oblique (VMO) musculature during a
stepping task [Chen, 2007]. The authors of this study have
suggested that this early onset of quadriceps muscle facilitation may
contribute to injury prevention and improve rehabilitation. This technique may
also be an additional treatment modality to use while strengthening the
quadriceps musculature, but I struggle to see how this taping could prevent
injury during athletic play. Further evaluation of a strengthening protocol
with and without KT may be beneficial to better understand of the mechanism
behind this taping. Do you think that this taping technique would be beneficial
in rehabilitation? Are you surprised that the taping did not influence total
work done?
facilitation of the quadriceps muscle did not show an increase in peak torque
and total work done as measured by isokinetic testing of knee flexion and
extension. However, there was a decrease in the time to peak quadriceps muscle torque.
This supports the theoretical basis of the KT muscle facilitation application.
The intention of the muscle facilitation taping is not to increase muscle strength,
but to assist the muscle by stimulating cutaneous mechanoreceptors which may
alter the firing rate of motor units [Ridding, 2000;
Hsu, 2009; MacGregor, 2005]. The superficial effect of the tape
alone is not enough to increase muscle force output, but enough to improve
activation. These findings are consistent with other studies that have found
early activation of the vastus medialis oblique (VMO) musculature during a
stepping task [Chen, 2007]. The authors of this study have
suggested that this early onset of quadriceps muscle facilitation may
contribute to injury prevention and improve rehabilitation. This technique may
also be an additional treatment modality to use while strengthening the
quadriceps musculature, but I struggle to see how this taping could prevent
injury during athletic play. Further evaluation of a strengthening protocol
with and without KT may be beneficial to better understand of the mechanism
behind this taping. Do you think that this taping technique would be beneficial
in rehabilitation? Are you surprised that the taping did not influence total
work done?
Written By: Kathleen
White
White
Reviewed By: Jeffrey Driban
Related Posts:
Wong, O., Cheung, R., & Li, R. (2012). Isokinetic knee function in healthy subjects with and without Kinesio taping Physical Therapy in Sport DOI: 10.1016/j.ptsp.2012.01.004
Is there any evidence that applying standard athletic taps is any less effective in improving time to peak torque (at a fraction of the cost)?
Thank you for your question Andrew. I am not aware of any athletic taping techniques that are done specifically to affect muscle. The athletic taping techniques that I am familiar with are utilized primarily to provide increased stability to a joint such as substituting for a brace.
Many have noted that cost of Kinesio Tape is often a limitation of its implementation.
Interesting article, thanks for posting. I haven't gotten on the KT bandwagon yet. We never used it in undergrad, and the time it was explained to us and the taping procedures demonstrated, the tape came right off. I'm not surprised that it didn't increase the strength of the muscle(no other tape does that, right?). However, if it does indeed decrease time to peak torque and increase muscle activation as studies have shown, it would be a good rehabilitation tool, especially post-op patients. Also, I'd like to see a similar study done with with an injured population, to see if the increased activation affects them in a positive way. Is there any research on KT with chronic ankle instability patients?
You raise a great point Chip. There is indeed very limited research on the effects of KT on injured patients. I believe that there are 2 reasons for this. First, the research on KT itself is limited that we are only beginning to understand the type of effects it may produce; and second, when discussing patients such as those with ankle instability, research still hasn't established a clear deficit existent in the majority of these patients.
While I believe patterns are emerging supporting the use of KT for improving mechanical support and EMG activation, not many studies have supported its use on proprioception and balance. Which brings us to the tricky question of how we can take these results and apply it to an injured population, such as our ankle instability patients (whose deficits may be largely proprioceptive and very individualized)?
This is one question that our lab is currently attempting to answer, as results from our lab to date have not supported the use of KT for targeting balance deficits in ankle instability patients. However, there are clearly more populations and variables for which we may see this effective. For instance, our data has supported improvements in patients with medial tibial stress syndrome.
I am very excited to see this increase in KT research increasing and am looking forward to seeing more clinical trials emerging in the next few years. Kat, thank you for the great write-up of this article.