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

DO, Baltaci G, Toprak U, Atay AO. J
 Physiol Ther.
2014;37(6):422-432. DOI:

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.

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. 

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?

by: Lauren Hankle, Kayla Green
by: Kim Pritchard


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