Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome
Kaya E, Zinnuroglu M, Tugcu I. Clin Rheumatol. (2011) 30;201-207.
Kinesio taping (KT) has been around since 1973, but only recently become more popular since its appearance at the 2008 summer Olympic Games in China. Despite its recent popularity, there is limited evidence regarding its effectiveness. The purpose of this study was to explore the short-term effects of KT applications on shoulder pain and compare them to commonly used therapeutic modalities, such as transcutaneous electrical nerve stimulation (TENS) and ultrasound (1 MHz, 1 Watt/cm2 for 5 minutes). 60 consecutive patients, demonstrating symptoms of subacromial impingement as seen with clinical examination (e.g., positive empty can test, positive Hawkins-Kennedy tests), were enrolled in this study and assigned to a modality or KT group. The KT group received 3 separate tapings, described as space and lymphatic correction techniques (15 to 25% tension on the tape). It was applied to the supraspinatus, deltoid, and teres minor muscles. The modality group received daily modalities including TENS, moist heat, and ultrasound. Both groups were given the same HEP including rotator cuff and periscapular strengthening exercises, posterior shoulder stretching, and range of motion exercises. Both groups completed this protocol for two weeks. Outcome measures were self-reported upper limb physical function and symptom score (DASH) as well as pain at night, rest, and with active shoulder movements (visual analog scale; VAS). Both groups had significantly lower DASH and VAS scores after 2 weeks of treatment compared to baseline. The KT group had significantly lower DASH scores at two weeks compared to the modality group. Furthermore, the KT group had significantly lower VAS pain scores at week one but not at week two compared to the modality group. While no adverse outcomes were reported the modality group lost 5 patients to follow-up (3 had persistent pain requiring myofascial trigger point injections, 1 stopped attending, and 1 was found to have concomitant labral tear).
These findings are interesting because they suggest that KT is a beneficial modality acutely for this patient population. Clinically, a rapid reduction in pain symptoms will allow for therapeutic interventions to be implemented sooner. Ultimately, allowing for a faster recovery. As a Certified Kinesio Taping Practitioner, I was surprised with the authors’ description of their taping technique as lymphatic and space corrections. I was instructed that 15 to 25% tension on the tape is used for muscle inhibition, 10 to 15% tension for lymphatic correction, and 25 to 50% for space correction. Despite this discrepancy, I agree with their ultimate results of decreased patient symptoms. Theoretically, muscle inhibition leads to decreased muscle spasm and/or inhibition of over-activated muscles, ultimately allowing for restoration of proper posturing of the glenohumeral joint. Unfortunately, theory is the best evidence currently available for many KT techniques. More research is needed to determine how KT techniques influence clinical outcomes and how to optimize the techniques. More clinical trials will also help establish the clinical utility of KT. As a practicing clinician who uses KT, I have seen similar results of decreased patient symptoms. However, Kinesio tape is not a treatment to be used on its own. It is a secondary modality that is used to assist with other therapeutic interventions. More information regarding KT can be found at https://www.kinesiotaping.com/.
Written by: Kathleen White
Reviewed by: Jeffrey Driban