🧻 KINESIOTAPING in NECK PAIN 🤕

 



Neck pain is a major public health care problem, with the prevalence of neck pain in the general population ranging from 16.7% to 75.1% (mean 37.2%) and a lifetime prevalence of 48.5% (1,2). Mechanical neck pain (MNP) was defined as generalized neck pain and/or shoulder pain with mechanical features including symptoms aggravated by maintained neck posture, movement or palpation of cervical musculature (3). The etiology of MNP is not clear, however, it is thought to be multifactorial.
 
Various cervical structures, such as uncovertebral and intervertebral joints, neural tissues, discs, muscles or ligaments may be the source of neck pain. It is also claimed that myofascial trigger points localized in different head, neck, shoulder or upper back muscles, and paracervical muscle spasm may be responsible for MNP (2).
 
 

Kinesiotaping

 
A popular treatment technique used by physiotherapist in the management of musculoskeletal pathologies is kinesiotaping (KT).
 
We want to know the effects of KT in MNP, so we found a paper which study thirty-six patients (10 men, 26 women) with regards to pain intensity, range of motion (ROM), disability, quality of life, and depressive symptoms.
 
(Information extracted from: Onat SS, Polat CS, Bicer S, Sahin Z, Tasoglu O. Effect of Dry Needling Injection and Kinesiotaping on Pain and Quality of Life in Patients with Mechanical Neck Pain. Pain Physician. 2019 Nov;22(6):583-589. PMID: 31775405)
 


 

KT Application

 
KT application is shown in Fig. 1. The first layer of tape, a Y-strip, was placed over the posterior cervical extensor muscles, from the insertion to the origin, by stretching it 15% to 25% of its original length (4).
 
Each tail of the first strip was applied with the patient’s neck bending and rotating to the opposite site from the dorsal (T1-T2) to the upper cervical region (C1-C2). The overlying tape, spaced-strip with openings, was placed perpendicular to the Y-strip, over the midcervical region (C3-C6), with the patient’s cervical spine in flexion to apply tension to the posterior structures (5,6).
 
Patients wore the KT for a 4-week duration (renewed once a week periodically in this time).
 

Fig. 1: KT Application

 

Evaluations

 
- Numeric Rating Scale (NPS-11) was used to measure pain intensity. The NPS-11 ranges between 0 and 10 (0: minimum pain, 10: maximum pain). It has been shown to be a reliable and valid tool for the assessment of pain (7).
 
- The ROM was measured by using the universal goniometer (8). Neck Disability Index (NDI) was used to detect functional disability. The NDI consists of 10 questions, and total score is between 0 and 50 (9).
 
- For quality of life, the Short Form-36 Quality of Life Scale (SF-36 QOLS) was used. SF-36 QOLS consists of 8 subscores: physical function, physical role difficulties (PRD), body pain, general perception of health, vitality/energy, social function, mental status role, and mental health. The subscores were calculated separately between 0 and 100 (0: the worst, 100: the best health status). The scores of the 2 main components (physical score and mental score) were also evaluated. The Turkish validation was performed by Kocyiğit et al (10).
 
- Depressive symptoms were assessed by the Turkish version of the Beck Depression Inventory (BDI). The total score was between 0 and 63. Higher total scores indicate more severe depressive symptoms (11,12).
 



 

Discussion

 
This study revealed that KT is effective treatments for pain, quality of life, and depression in patients with MNP. We also found that KT may positively influence pain, disability, and ROM similar to the findings of others (5,6).
 
It may be possible that the application of KT provides a proper sensory feedback to the patients, decreasing fear of movement and thus improving ROM. Because the traction in KT lifts the epidermis relieving the pressure on the mechanoreceptors below the dermis, therefore decreasing nociceptive stimuli. Tension in the tape also provides afferent stimuli facilitating pain inhibition mechanisms, thereby contributing to reducing pain levels (5).
 
 

Conclusions

 
This study showed that both KT had a positive impact on pain, disability, quality of life, mood and ROM.
 
 
 

 
 
 

References

 
1. Fejer R, Ohm-Kyvik K, Hartvigsen J. The prevalence of neck pain in the world population: A systematic critical review of the literature. Eur Spine J 2006; 15:834-848.
 
2. Munoz-Munoz S, Munoz-Garcia MT, Alburquerque-Sendin F, Arroyo-Morales M, Fernandez-de-las-Penas CJ. Myofascial trigger points, pain, disability and sleep quality in individuals with mechanical neck pain. Manipulative Physiol Ther 2012; 35:608-613.
 
3. Castaldo M, Ge HY, Chiarotto A, Villafane JH, Arendt-Nielsen L. Myofascial trigger points in patients with whiplashassociated disorders and mechanical neck pain. Pain Med 2014; 15:842-849.
 
4. Saavedra-Hernández M, Castro-Sánchez AM, Cuesta-Vargas AI, Cleland JA, Fernández-de-las-Peñas C, Arroyo-Morales M. The contribution of previous episodes of pain, pain intensity, physical impairment, and pain-related fear to disability in patients with chronic mechanicalneck pain. Am J Phys Med Rehabil 2012; 91:1070-1076.
 
5. González-Iglesias J, Fernández-de-Las- Peñas C, Cleland JA, Huijbregts P, Del Rosario Gutiérrez-Vega M. Short-term effects of cervical kinesio taping on pain and cervical range of motion in patients with acute whiplash injury: A randomized clinical trial. J Orthop Sports Phys Ther 2009; 39:515-521.
 
6. Saavedra-Hernández M, Castro-Sánchez AM, Arroyo-Morales M, Cleland JA, Lara- Palomo IC, Fernández-de-Las-Peñas C. Short term effects of kinesio taping versus cervical thrust manipulation in patients with mechanical neck pain: A randomized clinical trial. J Orthop Sports Phys Ther 2012; 42:724-730.
 
7. Jensen MP, Turner JA, Romano JM, Fisher LD. Comparative reliability and validity of chronic pain intensity measures. Pain 1999; 83:157-162.
 
8. Fletcher JP, Bandy WD. Intrarater reliability of CROM measurement of cervical spine ac tive range of motion in persons with and without neck pain. J Orthop Sports Phys Ther 2008; 38:640-645.
 
9. Macdemid JC, Walton DM, Avery S, et al. Measurement properties of the neck disability index: A systematic review. J Orthop Sports Phys Ther 2009; 39:400-417.
 
10. Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. The reliability and validity of Turkish version of Short form 36 (SF 36). J Drug Treat 1995; 12:102-106.
 
11. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4:561-571.
 
12. Hisli N. Beck Depresyon Envanterinin geçerliği üzerine bir çalışma. Psikoloji Dergisi 1988; 6:118-122.

KINESIOTAPING and KNEE OSTEOARTHRITIS

 

Knee osteoarthritis (OA) is the most prevalent chronic joint disease. Cartilage is the central tissue affected by OA and causes subsequent symptoms, including joint pain, stiffness and joint swelling, which diminishes the range of motion (1,2).

Currently, no reliable treatment has been confirmed to prevent progression of knee OA. The aim this review was to evaluate the efficacy of Kinesio Taping (KT) in reducing pain and increasing knee function in patients with OA.
 

Knee osteoarthritis

(Information extracted from: Lu, Zhijun, et al. "Kinesio taping improves pain and function in patients with knee osteoarthritis: A meta-analysis of randomized controlled trials." International Journal of Surgery (2018))

 

Kinesio Taping Application

Five studies were included in this review. They compared an intervention group who received KT to a placebo group received sham Taping.

1. Cho et al. (3) an I-shaped KT starting at the origin of the rectus femoris and a Y-shaped KT proximal to the superior patellar boarder. While KT was applied, the quadriceps muscle was being stretched.
 

Cho et al.

 2. Wageck et al. (4) three KT elements applied simultaneously. 

A) Drainage element of the experimental application. B) Muscle strength element of the experimental application. C) Pain-relief element of the experimental application. D) Combined experimental application.
 

Wageck et al.

 3. Mutlu et al. (5) KT on their quadriceps femoris and hamstring muscle. First, patients were taped with a Y-shaped Kinesio type at the quadriceps femoris. The tape was applied a point 5 cm inferior to the anterior superior iliac spine to the knee cap (origin to insertion), with the patient in a supine position with 25% tension. Then, each patient flexed his or her knee, and the Y-shaped tape (the tails of the tape) was circled around the patella, ending at its inferior side with no tension.
 

Next, patients were taped with a Y-shaped Kinesio type at the hamstring muscle. The tape was applied from ischial tuberosity to the back of the knee, with the patients in a standing position with their trunk bent. Then, the Y-shaped tape (the tails of the tape) was applied around the lateral side of the knee and medial side of the knee.
 

Mutlu et al.

 4. Aydogdu et al. (6) KT on quadriceps and hamstring muscles was performed with Y-shaped technique. The subjects lay in the supine position with the hip flexed at 30◦ and the knee flexed at 60◦. In the supine position, taping was first applied to the quadriceps femoris. The tape was applied from a point 10 cm inferior to the anterior superior iliac spine, bisected at the junction between quadriceps femoris tendon and the patella, and circled around the patella, ending at its inferior side. The first 5 cm of the tape were not stretched. The portion between the first part of tape and superior patella was stretched to 50–70%. The remaining tape around the patella remained un-stretched. After that, in the prone position, hamstring was taped secondly with the same method.
  

Aydogdu et al.

5. Rahlf et al. (7) KT on their quadriceps femoris and hamstring muscle. A medial and a lateral “I” strap as well as 1 “I” strap over the patella were applied. “I” strap means the tape is not cut into different parts; The strap across the patella was applied in individual maximum knee flexion. The base of the tape was applied at the tibial tuberosity and pulled in maximum tension over the patella, ending at the lower third of the quadriceps femoris muscle. The medial and lateral straps were applied in 45° knee flexion along the collateral medial and lateral ligaments.
  

Rahlf et al.

Outcomes after place KT

Visual analog scale (VAS)

VAS scale was adopted to measure pain and it was considered a subjective method.

Taping was associated with a significantly reduction in VAS scale at rest, as well as at movement in patients with knee OA. This pain reduction can be attributed to neurological suppression, due to stimulation of cutaneous mechanoreceptors.

Anandkumar et al. (8) showed that there was a decreased pain in Kinesio Taping groups while climbing stairs. The present meta-analysis indicated that Kinesio Taping was associated with a significantly reduction in VAS scale at rest.

Range of motion and McMaster Universities Arthritis Index (WOMAC) scale
Articular cartilage can be damaged by normal wear and abnormal mechanical loading which may cause abnormal cellular activities in cartilage and synovium, resulting in stiffness, loss of range of motion (9).

Our review demonstrated that Kinesio Taping was associated with an improved WOMAC compared with sham Taping. So Kinesio Taping could significantly improve knee flexion range of motion.
 

Muscle strength

Quadriceps femoris muscle weakness is a common symptom in knee OA and this may affect joint function and accelerate progress of degeneration (10,11). There was no significant difference in quadriceps femoris muscle in patients with knee OA.
 

Conclusions

Kinesio Taping is effective in improving for pain and joint function in patients with knee OA.
 

Bibliography

 1. M. Hurley, K. Dickson, R. Hallett, R. Grant, H. Hauari, N. Walsh, C. Stansfield, S. Oliver, Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review, Cochrane Database Syst. Rev. 4 (2018) CD010842. 

2. S. Demehri, D. Shakoor, Structural Changes in Aging-knee versus Early-knee Osteoarthritis: Review of Current Evidence and Future Challenges, Osteoarthritis and cartilage, 2018. 

3. H.Y. Cho, E.H. Kim, J. Kim, Y.W. Yoon, Kinesio taping improves pain, range of motion, and proprioception in older patients with knee osteoarthritis: a randomized controlled trial, Am. J. Phys. Med. Rehabil. 94 (3) (2015) 192–200. 

4. B. Wageck, G.S. Nunes, N.B. Bohlen, G.M. Santos, M. de Noronha, Kinesio Taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial, J. Physiother. 62 (3) (2016) 153–158. 

5. E. Kaya Mutlu, R. Mustafaoglu, T. Birinci, A. Razak Ozdincler, Does kinesio taping of the knee improve pain and functionality in patients with knee osteoarthritis?: a randomized controlled clinical trial, Am. J. Phys. Med. Rehabil. 96 (1) (2017) 25–33. 

6. O. Aydogdu, Z. Sari, S.U. Yurdalan, M.G. Polat, Clinical outcomes of kinesio taping applied in patients with knee osteoarthritis: a randomized controlled trial, J. Back Musculoskelet. Rehabil. 30 (5) (2017) 1045–1051. 

7. A.L. Rahlf, K.M. Braumann, A. Zech, Kinesio taping improves perceptions of pain and function of patients with knee osteoarthritis. A randomized, controlled trial, J. Sport Rehabil. (2018) 1–21. 

8. S. Anandkumar, S. Sudarshan, P. Nagpal, Efficacy of kinesio taping on isokinetic quadriceps torque in knee osteoarthritis: a double blinded randomized controlled study, Physiother. Pract. 30 (6) (2014) 375–383. 

9. D. Chen, J. Shen, W. Zhao, T. Wang, L. Han, J.L. Hamilton, H.J. Im, Osteoarthritis: toward a comprehensive understanding of pathological mechanism, Bone Res. 5 (1) (2017) 1–13. 

10. C. Slemenda, D.K. Heilman, K.D. Brandt, B.P. Katz, S.A. Mazzuca, E.M. Braunstein, D. Byrd, Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women? Arthritis Rheum. 41 (11) (1998) 1951–1959. 

11. M.B. Conroy, C.K. Kwoh, E. Krishnan, M.C. Nevitt, R. Boudreau, L.D. Carbone, H. Chen, T.B. Harris, A.B. Newman, B.H. Goodpaster, Muscle strength, mass, and quality in older men and women with knee osteoarthritis, Arthritis Care Res. 64 (1) (2012) 15–21.