|ORIGINAL RESEARCH REPORT
|Year : 2018 | Volume
| Issue : 2 | Page : 102-106
Kinesio taping is an effective stop-gap measure in alleviating the symptoms of osteoarthritis of the knee
Ayoola Ibifubara Aiyegbusi, Olufemi Mohammed Ogunfowodu, Sunday Rufus Akinbo
Department of Physiotherapy, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
|Date of Web Publication||21-May-2018|
Ayoola Ibifubara Aiyegbusi
Department of Physiotherapy, College of Medicine, University of Lagos, PMB 12003, Idi-Araba, Lagos
Source of Support: None, Conflict of Interest: None
Background: Osteoarthritis comes with periods of exacerbation of symptoms and therefore necessitates an effective stop-gap measure that will alleviate symptoms. Aims: The aim of the study was to determine the comparative effects of sham taping and Kinesio Taping (KT) on pain and functional parameters in participants with knee osteoarthritis (KOA). Setting and Design: This study design was a clinical control study. Materials and Methods: Thirty participants with KOA were assigned into two groups (Sham taping and KT) using consecutive sampling technique. Sham and KT were applied on the participants in the appropriate groups following baseline evaluation. Numerical Pain Intensity Scale, Western Ontario and McMaster Universities Osteoarthritis Index, Berg Balance Scale, and wet footprint were used to evaluate the pain, disability, balance, and gait parameters, respectively, both at baseline and immediately posttaping. Data were analyzed using descriptive statistics of mean and standard deviation whereas posttaping differences between the groups were compared using Mann–Whitney U- and independent t-test. The level of significance was set at P ≤ 0.05. Results: Both the Sham and KT groups had significant (P < 0.05) improvements in the outcome parameters, but analysis of the mean differences pre- and post-taping in the outcome variables showed KT as having better significant (P <.005) clinical effects in all the outcome parameters. Conclusion: KT alleviates pain, disability, and improves balance on immediate application to the knee of participants with osteoarthritis (OA). It is, therefore, recommended that physiotherapists prescribe KT to patients with knee OA as an immediate therapeutic modality to alleviate the symptoms.
Keywords: Disability, gait parameters, Kinesio Taping, osteoarthritis, pain, sham taping
|How to cite this article:|
Aiyegbusi AI, Ogunfowodu OM, Akinbo SR. Kinesio taping is an effective stop-gap measure in alleviating the symptoms of osteoarthritis of the knee. J Clin Sci 2018;15:102-6
|How to cite this URL:|
Aiyegbusi AI, Ogunfowodu OM, Akinbo SR. Kinesio taping is an effective stop-gap measure in alleviating the symptoms of osteoarthritis of the knee. J Clin Sci [serial online] 2018 [cited 2018 Jun 20];15:102-6. Available from: http://www.jcsjournal.org/text.asp?2018/15/2/102/232816
| Introduction|| |
Knee osteoarthritis (KOA) as a prevalent musculoskeletal condition causes pain, physical disability, and reduced the quality of life (QoL) with considerable economic burden on the health-care system. Pain, swelling around the joint, stiffness, crepitus, abnormal gait pattern, deformities, and spur formation are classical symptoms. The repetitive joint loading associated with walking affects the gait parameters in patients with osteoarthritis (OA) as they tend to walk with an antalgic gait. According to Basedow et al., management of knee OA presents a challenge for the scientific community and several modalities have been used to alleviate symptoms in patients with mild-moderate KOA.
Kinesio Taping (KT) which is an elastic adhesive material that has a high stretching capacity to ensure the free mobility of the applied area has emerged as a method that can be applied virtually in any musculoskeletal injury. A recent study investigated the immediate effects of KT in KOA and pain was found to decrease significantly immediately after taping with KT compared with sham taping. However, this study only compared pain, active range of motion, and proprioception. Effects of KT on isokinetic quadriceps torque in KOA was investigated in another study and therapeutic KT was found to be effective in improving isokinetic quadriceps torque and reducing pain  whereas Kocyigit et al. found inconclusive evidence of the beneficial effects of KT on functional parameters and QoL over sham taping in patients with KOA.
Sham taping designs of previous studies have been inconsistent, with different taping techniques used when comparing KT with sham taping., There is still a dearth of study on the immediate effects of KT on KOA, and there is inconclusive evidence that KT has a beneficial advantage over sham taping in patients with KOA. This study is needful because the increased incidence and prevalence of KOA have necessitated a need for a stop-gap relief measure which participants with KOA can perform by themselves to improve their functional abilities before they can gain access to a physiotherapist.
The aim of this study was, therefore, to determine and compare the immediate effects of KT with sham taping on pain, balance, disability, and gait parameters in participants with KOA.
| Materials and Methods|| |
Thirty participants with KOA between the ages of 40–65 years who have already been diagnosed with KOA by their orthopedic doctors were recruited from a specialist orthopedic hospital. Participants with a history of tape allergy, recent knee injections (prior 3 months), history of knee or hip surgery, and sensory and motor deficits were excluded from the study. Participants with inflammatory condition of other joints or any other concurrent pain were also excluded from the study. The minimum sample size was calculated to be 15 participants per group based on a study by Faqih et al.
This is a thin, stretchy, elastic cotton strip with an acrylic adhesive. Therapeutic kinesiology tape has been reported to be beneficial in a wide variety of musculoskeletal and sports injuries in addition to inflammatory conditions.
Western Ontario and McMaster Universities Osteoarthritis Index
This is a disease-specific, self-administered questionnaire used for participants who have hip or KOA. It contains a multidimensional scale made up of 24 items grouped into three dimensions: Pain (5-items), stiffness (2-items), and physical function (17-items). Each item has five response levels representing different degrees of intensity (none, mild, moderate, severe, or extreme) that are scored from 0 to 4. The final score for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is determined by adding the aggregate scores for pain, stiffness, and physical function and it has a test–retest reliability of 86, 0.68, and 0.89, respectively. The data are standardized to a range of values from 0 to 100, where 0 represents the best health status and 100 the worst possible status. An improvement is achieved by reducing the overall score.
Numeric Pain Intensity Scale
The Numeric Pain Intensity Scale uses a 10-point numerical rating scale for determining pain intensity, ranging from 0 (no pain) to 10 (very severe pain). Numerical Pain Intensity Scale (NPIS) has a high test–retest reliability of 0.96 and 0.95. When used as a graphic rating scale, a 10 cm baseline is used with a reliability of 0.99.,
Berg Balance Scale
The Berg Balance Scale (BBS) measures both static and dynamic aspects of balance using a 14-item scale that quantitatively assesses balance and risk for falls in older community-dwelling adults through direct observation of their performance. The scale typically requires 10–20 min to complete and measures the patient's ability to maintain balance statically or during the performance of various functional movements, for a specified duration of time. Each item is scored from 0 to 4, with a score of 0 representing inability to complete the task and a score of 4 representing independence with task. A total score is calculated out of 56 possible points.
BBS Scoring (points):
- 0–14 - severe balance impairment
- 15–32 - moderate balance impairment
- 33–49 - mild balance impairment
- 50–56 - normal balance.
Before the commencement of this study, ethical approval was sought and obtained from the Health Research and Ethics Committee of the Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria (ADM/DCST/HREC/APP/842). All procedures were explained to the participants verbally and an information sheet which contains detailed information of what the study was all about was given to the participants. Informed consent was also sought from the participants before the commencement of the study.
Consenting participants who met the inclusion criteria were assigned into two treatment groups using consecutive sampling technique.
- Group 1: KT group who had kinesiology tape applied to their affected knee
- Group 2: Sham tape group who had a nonelastic, nontherapeutic tape applied to their affected knee.
Participants were assessed using the NPIS to evaluate the pain level, WOMAC for evaluation of disability, BBT for assessment of balance, and the gait parameters evaluated using the footprint method.
After the initial assessment, participants were administered the appropriate tape to the knee according to their groups. The same taping technique was used for both the sham taping and the KT taping, so the result gotten will be more attributable to the therapeutic effect of the material used instead of the taping technique.
The participant was in a sitting position with knee in full extension. One strip of tape was attached to the anchor on the medial side of the knee and was pulled obliquely downward to the lateral side with the top edge of the tape passing just under the inferior pole of the patella. The same action was repeated lateral to medial to make a cross-over effect. One anchor strap was placed over the inferior pole of patella [Figure 1].
|Figure 1: Similar taping technique used for both the kinesiotape and the sham tape group|
Click here to view
Re-evaluation for pain, balance, and gait parameters was done immediately after the application of taping with the participants bearing weight on the affected knees.
The data collected were analyzed using Statistical Package for the Social Sciences, version 20 (IBM SPSS Statistics for Windows). Descriptive statistics of mean and standard deviation were used to summarize the variables. To measure the changes that occurred in pain intensity, disability, balance, and gait parameters such as step length and stride length between the pre- and post-taping, paired t-test and Wilcoxon signed-rank test was used for both groups. Posttaping differences between the groups were compared using Mann–Whitney U- and independent t-test. The level of significance was set at P ≤ 0.05
| Results|| |
The results of the pre- and post-taping outcome parameters in the two groups show significant (P< 0.05) differences as shown in [Table 1]. There were also significant (P< 0.05) differences in the mean changes in all the outcome variables between the two groups except for the gait parameters (P > 0.05) as seen in [Table 2].
|Table 1: Pre- and post-taping evaluation of the outcome parameters in the sham group and kinesiotaping group|
Click here to view
| Discussion|| |
While knee taping is recommended for some patients with OA, there is conflicting scientific evidence that supports this recommendation. A recent study by Kwansub et al. had reported significant improvements in pain relief, daily living activities, and range of motion in patients with KOA who had KT when compared with conservative physiotherapy management after 12 treatment sessions given over 4 weeks. The findings from our study, however, showed that the application of KT and sham tape on participants with KOA had immediate significant (P< 0.05) improvement in their pain level and functional parameters of disability, balance, and on the stride length. This study documented a significant improvement in the outcome parameters for the participants in both groups; with KT having a better improvement in all of the outcome parameters except the step length when compared with the sham tape. This is contrary to the findings of some previous studies , that found no significant differences while comparing pain control between KT and other forms of taping but consistent with the results of some other studies which reported significant differences between Kinesio Tape and sham tape in pain reduction., These conflicting findings could be due to the fact that sham taping designs of previous studies have been inconsistent, with different taping techniques used when comparing it with KT., To eliminate this, the same taping design and technique were used for both groups in this study.
When compared with the sham taping, the immediate effects of KT on the outcome parameters were quite significant. Cho et al. also investigated the immediate effects of KT on active range of motion and proprioception in participants with KOA, and Anandkumar et al. reported that the application of KT was also effective in improving isokinetic quadriceps torque, reducing pain during stair climbing. These studies further support the findings made in this study on the significant immediate effects of KT on pain, disability, and balance in KOA participants.
There were no significant differences in the improvement of the gait parameters in the KT group though the application of KT demonstrated better clinical outcomes in gait parameters over sham taping. The improvements in the outcome parameters as seen in both groups can be explained by the mechanical support provided by both tapes. It is believed that knee taping causes subtle changes to joint pressure that may also help reduce strain on inflamed soft tissue around the knee, improve the patient's awareness of body position, and improve quadriceps muscle strength. However, since the same taping technique was used, the better outcome seen in the KT group can be explained by the nature of the material it is made from.
Although a prior study had reported that KT was effective in alleviating pain and improving the ROM in both degenerative and traumatic injuries, the immediate beneficial effect of KT reported in this study is very pertinent because OA is a degenerative condition with symptoms that get exacerbated periodically. These patients can thus employ KT as a stop-gap measure to improve pain, disability, balance, and gait parameters before visiting the physiotherapy clinic. Although outside the scope of this study, the improvement in these symptoms is expected to result in better QoL for these patients.
Most of the participants had only mild balance impairments; it was, therefore, difficult to determine if taping would have had a significant effect on severe balance impairments.
| Conclusion|| |
This study showed that KT can help alleviate pain, disability, and improve balance on immediate application to the knee of patients with KOA. It is, therefore, recommended that physiotherapists prescribe KT to patients with KOA as an immediate therapeutic modality to alleviate the symptoms. Further studies are needed on the evaluation of the effect of KT on severe balance impairments and the QoL of the patients.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Briggs AM, Cross MJ, Hoy DG, Sànchez-Riera L, Blyth FM, Woolf AD, et al.
Musculoskeletal health conditions represent a global threat to healthy aging: A report for the 2015 World Health Organization World report on ageing and health. Gerontologist 2016;56 Suppl 2:S243-55.
Henriksen M, Graven-Nielsen T, Aaboe J, Andriacchi TP, Bliddal H. Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain. Arthritis Care Res (Hoboken) 2010;62:501-9.
Basedow M, Runciman WB, March L, Esterman A. Australians with osteoarthritis; the use of and beliefs about complementary and alternative medicines. Complement Ther Clin Pract 2014;20:237-42.
Kalron A, Bar-Sela S. A systematic review of the effectiveness of Kinesio Taping – Fact or fashion? Eur J Phys Rehabil Med 2013;49:699-709.
Cho HY, Kim EH, Kim J, Yoon YW. Kinesio taping improves pain, range of motion, and proprioception in older patients with knee osteoarthritis: A randomized controlled trial. Am J Phys Med Rehabil 2015;94:192-200.
Anandkumar S, Sudarshan S, Nagpal P. Efficacy of kinesio taping on isokinetic quadriceps torque in knee osteoarthritis: A double blinded randomized controlled study. Physiother Theory Pract 2014;30:375-83.
Kocyigit F, Turkmen MB, Acar M, Guldane N, Kose T, Kuyucu E, et al.
Kinesio taping or sham taping in knee osteoarthritis? A randomized, double-blind, sham-controlled trial. Complement Ther Clin Pract 2015;21:262-7.
Choi YK, Nam CW, Lee JH, Park YH. The effects of taping prior to PNF treatment on lower extremity proprioception of hemiplegic patients. J Phys Ther Sci 2013;25:1119-22.
Faqih A, Gavankar U, Tambekar N, Rairikar S, Shyam A, Sancheti P. Effect of rigid taping on pain and gait parameters in knee osteoarthritis. Int J Curr Res Rev. 2015;7:24-27.
Salaffi F, Leardini G, Canesi B, Mannoni A, Fioravanti A, Caporali R, et al.
Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee. Osteoarthritis Cartilage 2003;11:551-60.
Escobar A, Quintana JM, Bilbao A, Aróstegui I, Lafuente I, Vidaurreta I. Responsiveness and clinically important differences for the WOMAC and SF-36 after total knee replacement. Osteoarthritis Cartilage 2007;15:273-80.
van der Roer N, Ostelo RW, Bekkering GE, van Tulder MW, de Vet HC. Minimal clinically important change for pain intensity, functional status, and general health status in patients with nonspecific low back pain. Spine (Phila Pa 1976) 2006;31:578-82.
Blum L, Korner-Bitensky N. Usefulness of the Berg Balance Scale in stroke rehabilitation: A systematic review. Phys Ther 2008;88:559-66.
Lee K, Yi CW, Lee S. The effects of kinesiology taping therapy on degenerative knee arthritis patients' pain, function, and joint range of motion. J Phys Ther Sci 2016;28:63-6.
Kwansub Lee, Chae-Woo Yi, Sangyong Lee. The effects of kinesiology taping therapy on degenerative knee arthritis patients' pain, function, and joint range of motion. J Phys Ther Sci. 2016; 28: 63–66.
Campolo M, Babu J, Dmochowska K, Scariah S, Varughese J. A comparison of two taping techniques (kinesio and mcconnell) and their effect on anterior knee pain during functional activities. Int J Sports Phys Ther 2013;8:105-10.
David Perrin. Athletic Taping and Bracing. Human Kinetic Publishers. 3rd Ed. IL USA. 2012.
Akinbo SR, Ojetunde AM. Comparison of the effect of kinesiotape on pain and joint range of motion in patients with knee joint osteoarthritis and knee sport injury. Nigerian Medical Practitioner.2007; 52:65-69. [DOI: 10.4314/nmp.v52i3.28895].
[Table 1], [Table 2]