Kinesio Taping in Treatment and Prevention of Sports Injuries. A Meta-Analysis of the Evidence for its Effectiveness
Williams S, Whatman C, Hume P, Sheerin K. Sports Med. 2011. Nov 29. [Epub ahead of print]
Since its international appearance at the 2008 Olympic Games, KinesioTape (KT) has become a popular intervention in clinical medicine. Because of its increasing popularity it has practitioners and researchers looking for the evidence to support its acclaimed therapeutic benefits. The purpose of this study was to determine the effectiveness of KT in the prevention and treatment of sports injuries based on the current published literature. Cochrane review methodology was used to complete an electronic data search of the literature. Of the 96 articles obtained, 10 were used for this meta-analysis. Papers were only included if they reported data on musculoskeletal outcomes (e.g., pain, range of motion [ROM], proprioception) and if there were at least 2 groups (KT group vs comparison group). It has been thought that some influence of the effects of KT is due to the placebo effect. The authors controlled for this by only evaluating studies that had more than 1 group. Seven of the studies involved healthy subjects while the remaining 3 had patients with shoulder impingement or whiplash disorders. For most studies, objective measures were evaluated within 24 hours of tape application. One study, Slupik et al evaluated the tape up to 72 hrs after application. This meta-analysis was grouped by outcome measure (pain, ROM, strength, proprioception and muscle activity). Gonzalez-Iglesias et al found a statistically significant improvement in pain rating after application of KT to the cervical spine in patients with whiplash. However the authors did not deem this to be clinically meaningful because the improvement was only 2 points on the Numerical Pain Rating scale (0 to 10 pain rating). Thelen et al evaluated pain free shoulder abduction ROM with glenohumeral KT taping compared to sham taping. They found a statistically significant result of an increase of 19.1° with the KT tape application. This was the only study evaluating ROM that the authors found to have a small clinical benefit despite other reports of statistical significance. The results for strength measures were more positive. Hsu et al found statistically and clinically significant improvements in lower trapezius strength with KT taping. Vithaoulka et al had significant findings when evaluating quadriceps eccentric strength with KT application. Proprioceptive changes were evaluated with force sense error during a grip strength test by Chang et al. They found that with the KT condition subjects were better able to sense the amount of force that they were generating and therefore had less error. Despite Hsu et al and Slupik et al having statistically significant results for an increase in muscle activity of the lower trapezius and vastus medialis, their measures were not clinically meaningful.
Eight of the 10 studies had at least one statistically significant measure. However, because of the author’s further analysis of the clinical meaning of these results only a small clinical benefit of strength improvements, force sense error and ROM was found. No clinical benefit was determined for pain, ankle proprioception or muscle activity. Despite the authors suggested small clinical benefit of the studies I think that the results are being softened. As clinicians we have a number of skills that we can use to help our patients, although not every modality is appropriate for every patient. KT is a modality that is a component of our treatment plan, not the only treatment. Gonzales-Iglesias et al found a 2 point decrease in pain within 24 hours of application of KT to whiplash patients. Initially when patients have increased pain we cannot complete therapeutic interventions. If we can use KT to further progress our patients I believe that this is clinically meaningful despite what the authors concluded. Despite the weak results would you still use KT for your patients? Or would you no longer use this intervention because it is not clinically meaningful? Do you think that authors of this review were too harsh on their analysis of the literature? Or were they appropriate to analyze the results to this degree?
Written By: Kathleen White
Reviewed By: Stephen Thomas
Articles used in Meta-Analysis:
Williams S, Whatman C, Hume PA, & Sheerin K (2011). Kinesio Taping in Treatment and Prevention of Sports Injuries: A Meta-Analysis of the Evidence for its Effectiveness. Sports Medicine (Auckland, N.Z.) PMID: 22124445
I use KT across the inferior angles of the scapulae as a feedback loop for retraction. Inexpensive alternative to the S3 or align med brace/shirt (which are good products in and among themselves).
Anecdotal I have seen great superficial ecchymosis drainage with KT tape also.
Thanks for your comments!
Im glad to hear that you have had such success with your use of KinesioTape.
I recently did a presentation on kinesiotape for a class I'm taking. I read a few articles and came up with similar results that there is very little evidence that it actually works. However there is a lot of anecdotal evidence that supports the use. I have used it on occasion for quad strains and in treating ecchymosis and have had good results with both. It is definitely less cumbersome than the more traditional method of wrapping a muscle for sport participation and it provides support for hard to treat areas. I think that more research needs to be conducted and that kinesiotape does work but perhaps not in the ways we think it should.
Thanks for your comment Kristen. Its great to hear that others are using kinesiotape with good results. Hopefully with time more evidence will be able to support the mechanism behind the benefits that we see.
Always important to remember that the pardigm of EBP involves research as well as pt preference and clinician experience so despite the research there is still value in anecdotal evidence