Kinesio Tape: A Literature Review

Kinesio tape is very popular today.  Kinesio Tape technique was first developed in the 1970’s by Dr. Kenzo Kase but never really brought to the publics’ attention.  In recent years the use of Kinesio Tape (KT) has been rampantly growing world-wide.  In the 2000’s the Kinesio taping companies started paying Olympians to wear their tape while they competed.  This situation has caused the everyday person in America to wear it around and try it out.  Today, Kase's product is marketed by various companies under brand names such as Spider Tech[TM], Kinesio[R] Tape, Kinesio[R] Tex Tape, Gold Tech[TM], KT Tape[R], PerformTex[TM] and RockTape[R] (Drouin , 2013).  KT is an elastic, latex-free tape which can be worn twenty-four hours a day for up to four days.  This type of tape is approximately the same thickness as the epidermis, consists of 100% cotton (allowing for faster evaporation of sweat and drying time) and has acrylic, heat-activated glue.  Another characteristic is the ability to stretch 130-140% of its original longitudinal static length (Mostert-Wentzel, 2012).  There is very little information out there about KT but people still wear it anyway.  Numerous studies have evaluated the effect of KT on sports injuries, pain reduction, range of motion (ROM) change, and muscle force.  However, the results were contradictory (Lumbroso, 2014).  This is important because athletes wear this stuff all the time and they do not know why.  It is also important because KT claims to help in some part of the healing process by reducing inflammation and pain management, so if this is true this may be a method of care that can be used with athletes.  The high percentage of research being done on KT is focused on the lower body.  We want to know how KT will affect the shoulder and surrounding muscles.  There needs to be more research done in this area because only a few articles were found on this same topic so many of the questions that are out there, have not yet been answered.  After looking at several articles on the lower body one can assume the shoulder and upper body will respond the same way as the lower body but this is not known for sure.  The purpose of this study is to find if KT on the shoulder has an effect on the peak power output of healthy college athletes.

        While trying to find research about the topic, it was found that most of the research being done is on the lower body.  There are many studies done on the ankle but the results have been very inconsistent.  Some research says it works and some say it does not. In (Fayson et al, 2103) the authors look at ankle stability before and after using KT. They took a sample of 30 women who were all 20 years old and no history of ankle injuries, fractures, or surgeries and had no lower extremity injuries in the last 6 months prior to testing.  They wanted to see if KT makes the ankle more stable, because the more stable the ankle the less chance there is of spraining the ankle.  All of the subjects underwent testing for static restraint and dynamic postural control under three conditions; baseline, immediately following tape application, and 24 hours after the tape application.  They tested their subjects by having an ankle arthrometer and measured the anterior translation of the ankle joint. This tested static restraint.  For the dynamic postural control they had their subjects hop forward, backward, laterally, and medially to the taped ankle.  When they hopped, they would land on a force plate.  They allowed 3 practice trials followed by 3 test hops.

        After performing their experiment the results stated that the tape had no significant effect on peak anterior displacement.  What they did find though is interesting.  The overall stiffness of the ankle was significantly higher after immediately applying the tape but stayed the same for 24 hours after the tape was applied.  For the dynamic postural control the results showed that KT application had no statistically significant effect on the ability to stabilize following a hop, however, the direction of the hop had a statistically significant effect on dynamic postural control (Fayson et al, 2013).  In conclusion of this article the authors state that KT for the ankle joint may be beneficial because it limits passive anterior stiffness, despite not altering peak laxity.  KT also increased the ankle stiffness following 24 hours of use suggesting that it may be used over a longer amount of time than traditional tape to aid in the prevention of ankle sprains.

        In her literature synthesis, The Effects of Kinesiotape on Athletic Performance Outcomes in Healthy, Active Individuals: A literature Synthesis, Jillian L. Drouin assesses the effects of KT on athletic-based performance outcomes in healthy, active individuals.  The athletic based performance test this study used was grip strength, vertical ground reaction force, gastrocnemius EMG activity, trunk flexion, single-leg hop test and peak torque within 0 to 45 minutes of application.  Ten articles met the inclusion criteria and were compared to athletic-based performance controls.  Seven of those articles had positive results in at least one athletic-based performance measure compared to controls.

The results of this literature synthesis showed that there is scant evidence to support KT techniques as a successful means of affecting athletic-based performance outcomes such as improved strength, proprioception and range of motion, in healthy persons (Drouin, 2013).  This is not to say that no evidence was found to support KT improving athletic based performances.  There is some evidence showing KT can improve certain athletic-based performance outcomes.  Five studies found immediate statistically significant increases in grip strength, vertical ground reaction force, electromyographic (EMG) activity, range of motion, and peak torque with KT over no tape when measurements were taken within forty-five minutes of tape application (Drouin, 2013).  Results from this literature review give pause to healthcare practitioners looking to justify using KT for improving athletic performance in healthy athletes.  Although it does not seem to further hinder athletic performance, additional research is needed before any conclusive statements can be made with regard to the recommended use of KT and its effects on athletic-based performance outcomes for healthy athletes (Drouin, 2013).

        In (Huang et al, 2011) article The Effect of the Kinesio Tape to Muscle Activity and Vertical Jump Performance in Healthy Inactive People, the authors are trying to figure out if KT will increase the overall jump performance of the subject’s vertical jump.  In this study, it was hypothesized that elastic taping to the triceps surae would increase muscle activity and cause positive effect to jump height.  We think the reason they used this joint is because there are a limited number of muscles involved with the movement of the joint so their variables will be more consistent and they can determine what is going on where as in the shoulder there are so many different muscles that act on it.  Huang and his co-authors took 31 healthy adults that had an age range from 21 to 31 years old.  They were completely inactive without habit of regular exercise before the study.  The subjects executed the vertical jump before the tape was applied and after.  They used a Placebo tape and KT to see if they could get a response with either.  They all went through a very short dynamic workout so they would be loose and warm before they jumped. They were all instructed on how to properly jump and were given time to practice.  They stood on a force plate that measured their force when they pushed off to jump and measured their force when they landed on the ground.  The subjects jumped 5 times with no tape to get a baseline test.  After this they put on one of the elastic tapes and waited 30 minutes and did another trial of 5 jumps.  When this was completed they removed the tape and waited for 3 days to make sure the effects of the tape would not be an issue. They jumped 5 more times with no tape and got baseline scores again.  After this the subjects got taped with the other tape that was not used in the previous trial. After waiting for 30 minutes they jumped 5 more times with the tape on their foot and each jump was measured and then the tape was removed.

        The vertical ground reaction force or the force that was produced when they pushed off of the ground to jump greatly increased when KT was applied but only to the medial gastrocnemius.  Although the EMG activity of medial gastrocnemius tended to increase in the KT group, there were no differences in EMG activity for the lateral gastrocnemius, tibialis anterior and soleus muscles in either group (Hsieh, 2011). The overall jump height did not increase though. The Placebo taping actually caused a significant decrease in jump height and did not affect the VGRF in any way.  This lead to the conclusion that various types of elastic taping have different effects on exercise activity (Huang et al, 2011).  This also shows that KT may help with the firing of some muscles but not enough to actually increase overall performance.

        In (Kaya et al, 2011) the authors did a study on KT and shoulder impingement.  They wanted to see if KT could be used instead of modalities to increase range of motion and be effective with pain management.  They used 55 patients with shoulder impingement syndrome.  30 of the subjects used KT while 25 did the regular treatments with modalities every day for 2 weeks.  The subjects using KT got new tape every 3 days for 2 weeks.  Kaya and her researchers used a questionnaire to help them in this study.  They asked them pain scale questions that had to do with night pain, daily pain, and pain with motion.  This study was very simple and could be easily recreated.

        The results showed that KT group had lower pain scale ratings after the first week than the group who just used modalities.  After the second week there was no significant difference between the two groups.  This leads us to believe that KT may be better used if a patient needs immediate pain relief (Kaya et al, 2011).  After reading this though it made me wonder how effective rehab would be if we used KT and modalities.  The patients would experience pain relief much faster and be better in a shorter amount of time.

        Soriano is the author of The effects of Kinesio Taping on Muscle Tone in Healthy Subjects: A Double-Blind, Placebo-Controlled Crossover Trial. In Gomez-Soriano’s study, the main goal was to assess whether KT would modulate muscle tone or other associated measures such as muscle extensibility, strength and evoked EMG activity (Gomez-Soriano, 2014).  To achieve this goal a double-blind, crossover trial was designed including a masking technique so that subject and evaluator were blinded to the application of either sham or active KT.  The subjects of this study were considered healthy.  The exclusion criteria included any history of lower limb severe injury, pain which would have affected muscle tone during the study.  A series of quantitative measures were used to demonstrate the potential effect of KT treatment on gastrocnemius muscle function.  These results demonstrated that the application of KT in the gastrocnemius muscles had no effect on healthy muscle tone, extensibility or strength (Gomez-Soriano, 2014).  The study found that there was no significant connection between KT and strength.

Lumbroso and a team of professionals in the field of physiotherapy also conducted a study involving the gastrocnemius and KT.  The study they conducted was called The Effects of Kinesio Tape Application on the Hamstring and Gastrocnemius Muscles in Healthy Young Adults.  The purpose of the study was to evaluate the effect of KT application over the gastrocnemius and hamstring on range of motion and peak force (Lumbroso, 2014).  The participants were composed of thirty-six physical therapy students, eighteen per group.  KT was applied with 30% tension for forty-eight hours to: Group One- the gastrocnemius; Group Two - the hamstrings.  The quadriceps and hamstrings peak forces were evaluated prior to the application KT, fifteen minutes and forty-eight hours after application of KT.  A significant increase of peak force in the gastrocnemius group appeared immediately and forty-eight hours later (Lumbroso, 2014).  No immediate change of peak force in the hamstrings group occurred, however, after the forty-eight hours the peak force significantly increased (Lumbroso, 2014).  This study showed that it is possible that certain muscles react differently when KT is applied, and the effect may be subsequently detected.  The results of this study are in direct contrast to Julio Gomez-Soriano’s study where they found no connection between muscle strength and the application of KT.  The results of these two studies are a prime example of contradictory data surrounding the effects that KT may or may not have on athletic performance.

Mostert-Wentzel and a team of professionals in the field of physiotherapy conducted a study, Effect of Kinesio Taping on Explosive Muscle Power of Gluteus Maximus of Male Athletes, to determine the short-term effect of KT application on the explosive gluteus maximus power of male athletes.  They did this by comparing a recommended application pattern with a placebo.  Sixty healthy university male athletes participated in this double-blinded randomized controlled study.  Those athletes with any musculoskeletal injury six weeks prior to screening, serious medical conditions in the previous six months or metabolic conditions affecting joint integrity were not selected.  A different investigator from the one who administered the application randomly assigned participants to groups.  Group A received a recommended Y-strip KT application and group received a neutral placebo application.  Height displacement during a counter-movement jump was measured with a reliable Vertec apparatus.  Measurements were recorded at baseline, immediately after application and thirty minutes later.  Participants and raters were blinded to group assignments.  The results of this study showed that the measurements after application had significant differences compared with the baseline measurements (Mostert-Wentzel, 2012).  The recommended application type of taping with KT was equally effective in significantly improving the explosive power of the gluteus maximus in male athletes immediately after and thirty minutes after taping in both groups (Mostert-Wentzel, 2012).  This study differs from the other studies because there was a common and significant increase in improvement of the explosive power in the muscle where the KT was applied.  This supports the suggestion of the possibility that certain muscles react differently when KT is applied, and the effect may be subsequently detected (Lumbroso, 2014).

The last study we read was a systematic review of KT (Morris et al, 2013).  They looked at 14 different articles that were done on KT.  They found many problems with KT as well as many things that were useful.  One of the reasons we wanted to save this study until the end was because of what these authors determined after this study.  They state that “there currently exists insufficient evidence to support the use of KT over other modalities in clinical practice” (Morris et al, 2013).  Every study that we looked at and talked about has proven this point.  KT has helped small details of things but has not increased the overall performance of whatever was being tested.  KT has shown to help with pain management in some studies but has no effect on the overall outcome of the study being done.  We have seen this pattern throughout this study.

        The purpose of this study was to find if KT on the shoulder has an effect on the peak power output of healthy college athletes.  The information that was read about the hamstrings, gastrocnemius, ankle joint and other areas of the lower body can be applied to the shoulder.  The evidence that was found is not supportive of using KT over other various methods to increase peak force production. The articles that were reviewed in this paper reflected the current information known about the effects of KT on athletic performance based activities. There were some contradictions in the results of several of the studies. The results of the majority of the studies suggested the possibility that certain muscles react differently when KT is applied, and the effect may be subsequently detected.  There is a huge need for research in this area.  What little research there is in the area of KT is not aimed at the shoulder or upper body.  Most of the research done is geared more towards the lower body with the ankle in particular. Further research should be done in this area because this could help with daily living.  Some people cannot get themselves around because of a number of different issues and KT could be used to help aid them.  KT is a very interesting tool and hopefully someday we will figure out the proper way to use it to help daily living routines.

References

Drouin, J. L., McAlpine, C. T., Primak, K. A., & Kissel, J. (2013). The effects of kinesiotape on athletic-based performance outcomes in healthy, active individuals: a literature synthesis. Journal of the Canadian Chiropractic Association, 57(4), 356+. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE%7CA356039634&v=2.1&u=txshracd2559&it=r&p=HRCA&sw=w&asid=dada683d890ff4fc1d8ae93e240661e4

Fayson, S., Needle, A., & Kaminski, T. (2013). The Effects of Ankle Kinesio Taping on Ankle Stiffness and Dynamic Balance. Research in Sports Medicine, 21(3), 204-216. Retrieved September 23, 2014, from EBSCO.

Gomez-Soriano, J., Abian-Vicen, J., Aparicio-Garcia, C., Ruiz-Lazaro, P., Simon-Martinez, C., Bravo-Estaban, E., Fernandez- Rodroguez, J. M. (2014).The effects of Kinesio taping on muscle tone in healthy subjects: A double-blind, placebo-controlled crossover trial. Manual Therapy, 19(2), 131+. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE%7CA364122902&v=2.1&u=txshracd2559&it=r&p=HRCA&sw=w&asid=ee97a98bc1d3d0d5e48af372a782a90a

Huang, C., Hsieh, T., Lu, S., & Su, F. (2011). Effect of the Kinesio Tape to Muscle Activity and Vertical Jump Performance in Healthy Inactive People. BioMedical Engineering OnLine, 10(70), 1-11. Retrieved January 1, 2014, from EBSCO.

Kaya, E., Tugcu, I., & Zinnuroglu, M. (2011). Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome. Clinical Rheumatology, 30(2), 201-201. Retrieved October 23, 2014, from Health Reference Center.

Lumbroso, D., Ziv, E., Vered, E., & Kalichman, L. (2014, January). The effect of kinesio tape application on hamstring and gastrocnemius muscles in healthy young adults. Journal of Bodywork & Movement Therapies, 18(1), 130+. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE%7CA356088076&v=2.1&u=txshracd2559&it=r&p=HRCA&sw=w&asid=fac33094582cf9a0aa8aebca80880b67

Morris, D., Jones, D., Ryan, H., & Ryan, C. (2013). The clinical effects of Kinesio® Tex taping: A. Physiotherapy Theory and Practice, 259-270. Retrieved October 28, 2014, from EBSCO.

Mostert-Wentzel, K., Swart, J. J., Masenyetse, L. J., Sihlali, B. H., Cilliers, R., Clarke, L., ...Steenkamp, L. (2012). Effect of kinesio taping on explosive muscle power of gluteus maximus of male athletes. South African Journal of Sports Medicine, 24(3), 75+. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE%7CA304725267&v=2.1&u=txshracd2559&it=r&p=HRCA&sw=w&asid=4c89ffe96ff0bb77bbd6e173a4d25cfd