Can Kinesio Taping® influence the electromyographic signal intensity of trunk extensor muscles in patients with chronic low back pain? A randomized controlled trial

Personal belief on elastic tape and tape tension affect perceived performance, but not muscle activity and endurance

BACKGROUND

Previous studies reported inconsistent outcomes on elastic taping for three potential reasons: 1) poor control of placebo effect; 2) no consensus regarding the optimal tape tension; and 3) lack of investigation on muscle endurance, as the proposed tape recoiling force may not promote peak force generation but exert a consistently low force and improve submaximal contraction.

PURPOSE

This study compared the effects of elastic tape and its tension on muscle activity and endurance in people with extremely positive and negative personal belief on elastic tape.

METHODS

Using a validated instrument, we identified 20 participants with extremely positive personal belief on elastic tape (+ belief), and 20 with extremely negative personal belief (- belief). They performed wrist isometric endurance tests under three taping conditions (i.e. no tape, 50%, and 100% tension). We measured isometric wrist extensor muscle endurance, electromyography muscle activity, and self-perceived performance for each condition.

RESULTS

The differences between the two groups in isometric muscle endurance (p = .85) and muscle activity (p = .53) were not statistically significant, regardless of tape conditions. However, participants with + belief reported better perceived performance than those with - belief (p < .001, partial eta squared = 0.70). Specifically, 100% tape tension yielded stronger self-perceived performance than 50% tension (Cohen's d = 0.91) and no tape (Cohen's d = 1.86). On the other hand, participants with - belief perceived similar performance across tape tensions (p = .55).

CONCLUSION

Elastic tape does not modulate muscle activity and enhance muscle endurance. People with a strong positive personal belief on elastic tape may perceive a better performance with a greater tape tension.

The importance of context (placebo effects) in conservative interventions for musculoskeletal pain: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND OBJECTIVE

Contextual effects (e.g. patient expectations) may play a role in treatment effectiveness. This study aimed to estimate the magnitude of contextual effects for conservative, non-pharmacological interventions for musculoskeletal pain conditions. A systematic review and meta-analysis of randomized controlled trials (RCTs) that compared placebo conservative non-pharmacological interventions to no treatment for musculoskeletal pain. The outcomes assessed included pain intensity, physical functioning, health-related quality of life, global rating of change, depression, anxiety and sleep at immediate, short-, medium- and/or long-term follow-up.

DATABASES AND DATA TREATMENT

MEDLINE, EMBASE, CINAHL, Web of Science Core Collection, CENTRAL and SPORTDiscus were searched from inception to September 2021. Trial registry searches, backward and forward citation tracking and searches for prior systematic reviews were completed. The Cochrane risk of bias 2 tool was implemented.

RESULTS

The study included 64 RCTs (N = 4314) out of 8898 records. For pain intensity, a mean difference of (MD: -5.32, 95% confidence interval (CI): -7.20, -3.44, N = 57 studies with 74 outcomes, GRADE: very low) was estimated for placebo interventions. A small effect in favour of the placebo interventions for physical function was estimated (SMD: -0.22, 95% CI: -0.35, -0.09; N = 37 with 48 outcomes, GRADE: very low). Similar results were found for a broad range of patient-reported outcomes. Meta-regression analyses did not explain heterogeneity among analyses.

CONCLUSION

The study found that the contextual effect of non-pharmacological conservative interventions for musculoskeletal conditions is likely to be small. However, given the known effect sizes of recommended evidence-based treatments for musculoskeletal conditions, it may still contribute an important component.

SIGNIFICANCE

Contextual effects of non-pharmacological conservative interventions for musculoskeletal conditions are likely to be small for a broad range of patient-reported outcomes (pain intensity, physical function, quality of life, global rating of change and depression). Contextual effects are unlikely, in isolation, to offer much clinical care. But these factors do have relevance in an overall treatment context as they provide almost 30% of the minimally clinically important difference.

The Effects of Kinesio Taping® on Muscle Interplay within the Lumbo–Pelvic–Hip Complex: A Randomized Placebo-Controlled Trial

Coordination of muscle activity is determined by the recruitment order of agonists and synergists that results from their onset times. Motor recruitment deficits are possible. This study examined the acute and prolonged effects of three different techniques of the kinesio taping method in optimizing the intermuscular coordination within the lumbo–pelvic–hip complex. The sample consisted of 56 healthy participants of both genders, randomly divided into equal groups by kinesio taping muscle facilitation, muscle inhibition and functional correction technique, and placebo kinesio taping condition. The onsets of the ipsilateral and contralateral erector spinae muscles, in relation to the semitendinosus muscle of the tested leg, were measured using the surface electromyography, during the active performance of the prone hip extension test. Time span was also determined. Measurements were performed at baseline, 60 min, and 48 h post-intervention. For the control group, we did not find statistically significant differences in the onset between the measurement points (p > 0.05), while in the experimental groups, there was a significant delay in the onset of the contralateral erector spinae (p < 0.001) in the second and third measurement points. These results indicate that the kinesio taping method can optimize the intermuscular coordination, with the potential for primary injury prevention.

[Problems and prospects of kinesiotaping use in clinical practice]

Currently the concept of kinesiotaping has become widespread. Kinesiotaping, which was originally implemented in sports medicine, is increasingly used in rehabilitation and various spheres of medicine, such as orthopedics, traumatology, pediatrics, etc. In recent years, the new publications about the kinesiotaping use in neurology and rheumatology have been released, where previously unknown effects, such as improved sensory feedback, have been demonstrated. Great attention is paid to comparative studies of the effects of kinesiotaping and other methods of taping, which have been used for many years. Nevertheless, despite the popularity of this physical therapy and rehabilitation method, the number of scientific studies supporting its use remains insufficient. The effects originally attributed to kinesiotaping are still controversial, and there is insufficient scientific evidence supporting them. It is not reliably determined whether the tape has a tonic or relaxing effect due to the stimulation of the mechanoreceptors and how the taping affects fascial tissue. Its effect on the reduction of pressure in subcutaneous structures, its mechanisms of action on the microcirculatory bloodstream by stimulating exteroceptors and proprioceptors is unclear. The difficulty of kinesiotaping efficacy evaluation consists in the variety of techniques and the necessity to choose the location of the tape applying, its shape, the suitable tension and adhesion time. The article represents the results of the latest scientific researches on the pathogenetic mechanisms of kinesiotaping and efficacy of this technique in various nosologies.

Placebo effects in low back pain: A systematic review and meta-analysis of the literature

BACKGROUND AND OBJECTIVE

The current treatments of primary musculoskeletal low back pain (LBP) have a low to moderate efficacy, which might be improved by looking at the contribution of placebo effects. However, the size of true placebo effects in LBP is unknown. Therefore, a systematic review and meta-analysis were executed of randomized controlled trials investigating placebo effects in LBP.

DATABASES AND DATA TREATMENT

The study protocol was registered in the international prospective register of systematic reviews Prospero (CRD42019148745). A literature search (in PubMed, Embase, The Cochrane Library, CINAHL and PsycINFO) up to 2021 February 16th yielded 2,423 studies. Two independent reviewers assessed eligibility and risk of bias.

RESULTS

Eighteen studies were eligible for the systematic review and 5 for the meta-analysis. Fourteen of the 18 studies were clinical treatment studies, and 4 were experimental studies specifically assessing placebo effects. The clinical treatment studies provided varying evidence for placebo effects in chronic LBP but insufficient evidence for acute and subacute LBP. Most experimental studies investigating chronic LBP revealed significant placebo effects. The meta-analysis of 5 treatment studies investigating chronic LBP depicted a significant moderate effect size of placebo for pain intensity (SMD = 0.57) and disability (SMD = 0.52).

CONCLUSIONS

This review shows a significant contribution of placebo effects to chronic LBP symptom relief in clinical and experimental conditions. The meta-analysis revealed that placebo effects can influence chronic LBP intensity and disability. However, additional studies are required for more supporting evidence and evidence for placebo effects in acute or subacute LBP.

SIGNIFICANCE

This systematic review and meta-analysis provides evidence of true placebo effects in low back pain (LBP). It shows a significant contribution of placebo effects to chronic LBP symptom relief. The results highlight the importance of patient- and context-related factors in fostering treatment effects in this patient group. New studies could provide insight into the potential value of actively making use of placebo effects in clinical practice.

Kinesiology Tape: A Descriptive Survey of Healthcare Professionals in the United States

BACKGROUND

The existing body of kinesiology tape (KT) research reveals inconsistent results which challenges the efficacy of the intervention. Understanding professional beliefs and KT clinical application might provide insight for future research and development of evidence-based guidelines.

PURPOSE

The purpose of this study was to survey and document the beliefs and clinical application methods of KT among healthcare professionals in the United States.

DESIGN

Cross-sectional survey study.

METHODS

A 30-question online survey was emailed to members of the National Athletic Trainers Association, Academy of Orthopedic Physical Therapy, and American Academy of Sports Physical Therapy. Professionals were also informed through a recruitment post in different private healthcare Facebook groups.

RESULTS

One thousand and eighty-three respondents completed the survey. Most respondents used KT for post-injury treatment (74%), pain modulation (67%), and neuro-sensory feedback (60%). Most believed that KT stimulates skin mechanoreceptors (77%), improve local circulation (69%), and modulates pain (60%). Some respondents believed KT only created a placebo effect (40%) and use it for such therapeutic purposes (58%). Most used a standard uncut roll (67%) in black (71%) or beige (66%). Most respondents did not use any specialty pre-cut tape (83%), infused tape (99.54%), or a topical analgesic with tape (65%). The most common tape tension lengths used by respondents were 50% tension (47%) and 25% (25%) tension. Patient reported outcomes (80%) were the most common clinical measures. Most respondents provided skin prep (64%) and tape removal (77%) instructions. Some did not provide any skin prep (36%) or tape removal (23%) instruction. The average recommended times to wear KT were two to three days (60%). The maximum times ranged from two to five days (81%).

CONCLUSION

This survey provides insight into how professionals use KT and highlights the gap between research and practice. Future research should address these gaps to better determine evidence-based guidelines.

LEVEL OF EVIDENCE

3.