Short-Term Effect of Kinesio Taping
Versus Cervical Thrust Manipulation in Patients with Mechanical Neck Pain: A
Randomized Clinical Trial.
Versus Cervical Thrust Manipulation in Patients with Mechanical Neck Pain: A
Randomized Clinical Trial.
Saavedra-Hernández M, Castro-Sánchez AM, Arroyo-Morales M,
Cleland JA, Lara-Palomo IC, and Fernández-de-las-Penas. J Orthop Sports Phys
Ther. 2012;42(8):724-730.
Cleland JA, Lara-Palomo IC, and Fernández-de-las-Penas. J Orthop Sports Phys
Ther. 2012;42(8):724-730.
Mechanical
neck pain is a common ailment which can affect as much as 33% of the
population. While manual therapy is often performed, a gold standard for
managing mechanical neck pain has yet to be determined. Also supported for
managing mechanical neck pain is the use of Kinesio Tape, although there is
limited evidence to support this. Therefore, Saavedra-Hernández and colleagues completed a randomized
clinical trial comparing manual therapy to Kinesio Taping. The primary outcomes
measured were neck pain intensity, disability, and cervical range of motion. A
total of 93 patients were screened for eligibility. Participants were excluded
if the following criteria were met: a) contraindication to neck manipulation,
b) history of whiplash, c) history of cervical surgery, d) diagnosis of
cervical radiculopathy or myelopathy, e) diagnosis of fibromyalgia
syndrome, f) previous spinal manipulation therapy or Kinesio Tape therapy, h)
tape allergies, and i) younger than 18 or older than 55 years old. Thirteen participants
were excluded from the study leaving 80 to undergo baseline testing. Baseline
testing was comprised of completing demographic and clinical information,
numeric pain rating scale, the Neck Disability Index, and a body diagram to assess the
location and distribution of pain. Participants were then randomly allocated to
a “tape group” or “manipulation group”. The person performing the assessments
was blinded to what group participants were assigned to and the participants
were not told what their treatment was being compared to. Participants in the tape group received a “Y” strip placed over the
posterior cervical extensor muscles with an overlying strip placed
perpendicular to the “Y” strip over the midcervical region. Participants wore
the tape for the duration of the study (7 days). Participants in the
manipulation group received 2 separate cervical thrust manipulations. One
directed at the midcervical spine (C3) and the other at the cervicothoracic junction (C7-T1). Participants (n = 76) returned for
follow-up 7 days post-intervention where all tests from baseline were repeated.
Overall, both Kinesio Tape and cervical thrust manipulation resulted in similar
reduction in neck pain, which was considered clinically meaningful. Both
therapies also increased cervical range of motion although the changes were
small and not clinically relevant.
neck pain is a common ailment which can affect as much as 33% of the
population. While manual therapy is often performed, a gold standard for
managing mechanical neck pain has yet to be determined. Also supported for
managing mechanical neck pain is the use of Kinesio Tape, although there is
limited evidence to support this. Therefore, Saavedra-Hernández and colleagues completed a randomized
clinical trial comparing manual therapy to Kinesio Taping. The primary outcomes
measured were neck pain intensity, disability, and cervical range of motion. A
total of 93 patients were screened for eligibility. Participants were excluded
if the following criteria were met: a) contraindication to neck manipulation,
b) history of whiplash, c) history of cervical surgery, d) diagnosis of
cervical radiculopathy or myelopathy, e) diagnosis of fibromyalgia
syndrome, f) previous spinal manipulation therapy or Kinesio Tape therapy, h)
tape allergies, and i) younger than 18 or older than 55 years old. Thirteen participants
were excluded from the study leaving 80 to undergo baseline testing. Baseline
testing was comprised of completing demographic and clinical information,
numeric pain rating scale, the Neck Disability Index, and a body diagram to assess the
location and distribution of pain. Participants were then randomly allocated to
a “tape group” or “manipulation group”. The person performing the assessments
was blinded to what group participants were assigned to and the participants
were not told what their treatment was being compared to. Participants in the tape group received a “Y” strip placed over the
posterior cervical extensor muscles with an overlying strip placed
perpendicular to the “Y” strip over the midcervical region. Participants wore
the tape for the duration of the study (7 days). Participants in the
manipulation group received 2 separate cervical thrust manipulations. One
directed at the midcervical spine (C3) and the other at the cervicothoracic junction (C7-T1). Participants (n = 76) returned for
follow-up 7 days post-intervention where all tests from baseline were repeated.
Overall, both Kinesio Tape and cervical thrust manipulation resulted in similar
reduction in neck pain, which was considered clinically meaningful. Both
therapies also increased cervical range of motion although the changes were
small and not clinically relevant.
This study
presents an interesting look at reducing pain in patients with mechanical neck
pain. While cervical thrust manipulations may be the more common treatment,
Kinesio Tape may also be considered as a comparable treatment option. While both
methods appeared to show similar analgesic abilities, one should approach this
with caution. During follow-up, 5 participants reported adverse reactions to
their treatment. Three of these participants were in the manipulation group and
reported increase in neck pain or fatigue after manipulation. The 2 participants
in the tape group that reported adverse reactions described cutaneous
irritation. Perhaps if both treatments elicit similar analgesic abilities
Kinesio Tape could be the more beneficial treatment because it does not cause
as many, or as severe, adverse reactions as cervical spine manipulation. Tell
us what you think. Have you used either of these treatments to treat mechanical
neck pain? If so, have your patients expressed any preferences or adverse
reactions to the treatment?
presents an interesting look at reducing pain in patients with mechanical neck
pain. While cervical thrust manipulations may be the more common treatment,
Kinesio Tape may also be considered as a comparable treatment option. While both
methods appeared to show similar analgesic abilities, one should approach this
with caution. During follow-up, 5 participants reported adverse reactions to
their treatment. Three of these participants were in the manipulation group and
reported increase in neck pain or fatigue after manipulation. The 2 participants
in the tape group that reported adverse reactions described cutaneous
irritation. Perhaps if both treatments elicit similar analgesic abilities
Kinesio Tape could be the more beneficial treatment because it does not cause
as many, or as severe, adverse reactions as cervical spine manipulation. Tell
us what you think. Have you used either of these treatments to treat mechanical
neck pain? If so, have your patients expressed any preferences or adverse
reactions to the treatment?
Written by: Kyle
Harris
Harris
Reviewed by: Jeffrey
Driban
Driban
Related Posts:
Saavedra-Hernández M, Castro-Sánchez AM, Arroyo-Morales M, Cleland JA, Lara-Palomo IC, & Fernández-de-Las-Peñas C (2012). Short-Term Effects of Kinesiotaping Versus Cervical Thrust Manipulation in Patients With Mechanical Neck Pain: A Randomized Clinical Trial. The Journal of Orthopaedic and Sports Physical Therapy PMID: 22523090
Is it not a glaring error that there was no control group? Both interventions may work equally as well, but they both may have done nothing and the pain got better on its own.
Hi Michael: Thanks for the comment. There is actually a growing trend to comparative effectiveness trials. Rather than compare a novel treatment to placebo this asks if the novel treatment is better than the standard/common treatment. It's true that this ignores whether both interventions are mostly placebo but it puts the focus on is the new idea better than the old. Plus, we've gotten into the bad habit of thinking that the placebo effect is not important in our treatments. In fact, placebo is a common part of most of our treatments. In some cases, placebos perform as well if not better than the standard medications often applied. That's not to knock those medications but highlight how beneficial the placebo effect can be. Another advantage of the comparative effectiveness trial is that it is easier to blind the study participant b/c they don't know which intervention is the experimental intervention. In the coming years we'll be seeing more and more comparative effectiveness trials. Any thoughts?
Jeff, couldn't have said it better myself. Introducing a placebo/control is pretty easy when you're looking at something like a new drug. However, the issue is a little more complicated with manual therapy is involved (how convincing is fake manipulation?).
Anyway nice to see some studies coming out looking at Kinesio tape!
Jeff, I feel the shift towards comparative effectiveness trials is welcoming. As a clinician I find this kind of research more relevant because it compares different treatment methods. I think in this particular study it could have benefited from adding a third group consisting of participants who received both treatments. Also, I agree with Dr. Delanghe that it is good to see some studies on k-tape.
One concern that I have with this study that was not touched on for a limitation was the length of time the K-tape was left on. While I have never taken a course on K-tape, from what I've seen clinically the maximum amount of time the tape stays on the body and is effective is only around 3-5 days. I'd be curious to see if repeating the tape intervention has any effect on results. I know this borders repeated interventions which could be an entirely different study. Thoughts?
Aaron,
Thanks for the comment. Firstly, I too agree with you and Dr. Delanghe that its good to see a study on Kinesio tape as many athletes I encounter have questions about it. I enjoyed your idea that this study could have benefited from a third group which received both treatments. I think this would indeed add another dimension to this study. Perhaps the effects seen by the manipulation would be further extrapolated by the addition of the Kinesio tape. As reported, some patients also felt a slight increase in neck pain after recieving the manipulation. I would also wonder if the application of the Kinesio tape would mitigate this. Great thought!
On your point regarding the length of time the Kinesio tape was left of the study subject. I too have never taken a Kinesio tape course but I like the idea of repeating the tape intervention. I would also be interested in seeing a study which used a single Kinesio tape application at 5 days follow up (to see how this would differ from this study using 7 days). In the end, I think looking at how long to leave the Kinesio tape on a patient will be an important part of future research.
These are all great comments for the use of Kinesiotape.
I agree with Aaron, the effectiveness of the tape lessens after 5 days. It is possible that the 2 cases that had reports of irritation were due to extended use of the tape. This is also a simple fix. Most individuals do not react adversely to the tape since it is latex free. However, by treating the skin before applying the tape with a liquid malox solution often decreases the irritation to the skin.
I think this is a great paper in support for kinesiotape as an effective treatment modality.