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Prolonged use of Kinesiotaping does not enhance functional performance and joint proprioception in healthy young males: Randomized controlled trial

ABSTRACT

Objectives

The aim of this study was to investigate the effects of continuous (48-hour) use of Kinesiotaping (KT) on functional and proprioceptive performance in healthy, physically active men.

Method

Twenty-six healthy, physically active men (21.8±2.2 years old) were randomly allocated into two groups: 1) Kinesiotaping group (KG, tape applied with 40% tension for rectus femoris activation); 2) Control (CG, tape applied over rectus femoris without additional tension). Subjects attended the laboratory on five separate occasions: 1) familiarization; 2) baseline measurement without tape (BL); 3) immediately post-tape application (T0); 4) 24h (T24); and 5) 48h (T48) post-tape application. The outcomes were distance in the single (SHT) and triple hop tests (THT), vertical jump height (VJH), vertical jump power (VJP), and rate of force development (RFD). A mixed-model ANOVA was applied to verify differences between and within groups.

Results

No significant (p >0.05) differences were found in the SHT and THT between groups and moments. Likewise, the main effects for VJH, VJP, and RFD were not significant (p >0.05).

Conclusion

The present study demonstrated no significant immediate or prolonged (48h) effects of KT on functional and proprioceptive performance.

Keywords:
physical therapy; athletic performance; postural balance; kinesiotaping

Clinical Trial Registration number (Registro Brasileiro de Ensaios Clinicos):RBR-4t57rs

Bullet points

  • Previous studies assessed the immediate effects of KT on functional performance.

  • KT applied with tension has no differences compared to a non-tension condition.

  • The prolonged use of KT does not have a beneficial effect.

  • KT is not recommended for functional performance enhancement in healthy subjects.

Introduction

The Kinesiotaping (KT) method was created in the late 1970s and since then has been used widely in the sport and rehabilitation context11 Lim EC, Tay MG. Kinesio taping in musculoskeletal pain and disability that lasts for more than 4 weeks: is it time to peel off the tape and throw it out with the sweat? A systematic review with meta-analysis focused on pain and also methods of tape application. Br J Sports Med. 2015;49(24):1558-66. http://dx.doi.org/10.1136/bjsports-2014-094151.
http://dx.doi.org/10.1136/bjsports-2014-...
. The method is based on the application of an elastic adhesive tape that can be elongated up to 55-60% of its original resting length22 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.,33 Kase K, Wallis J, Kase T. Clinical therapeutic applications of the Kinesio Taping Method. Tokyo: Kinesio Taping Association; 2003. and can be used for several days. Recently, the KT method has been the focus of numerous studies on injury treatment44 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(2):105.

5 Thelen MD, Dauber JA, Stoneman PD. The clinical efficacy of kinesio tape for shoulder pain: a randomized, double-blinded, clinical trial. J Orthop Sports Phys Ther. 2008;38(7):389-95. http://dx.doi.org/10.2519/jospt.2008.2791.
http://dx.doi.org/10.2519/jospt.2008.279...

6 González-Iglesias J, Fernandez-De-Las-Penas C, Cleland J, Huijbregts P, Gutiérrez-Vega MDR. 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(7):515-21. http://dx.doi.org/10.2519/jospt.2009.3072.
http://dx.doi.org/10.2519/jospt.2009.307...
-77 Luz MA Jr, Sousa MV, Neves LA, Cezar AA, Costa LOP. Kinesio Taping® is not better than placebo in reducing pain and disability in patients with chronic non-specific low back pain: a randomized controlled trial. Braz J Phys Ther. 2015;19(6):482-90. http://dx.doi.org/10.1590/bjpt-rbf.2014.0128.
http://dx.doi.org/10.1590/bjpt-rbf.2014....
, proprioceptive support during joint movement88 Merino-Marban R, Mayorga-Vega D, Fernandez-Rodriguez E. Effect of Kinesio Tape Application on calf pain and ankle range of motion in duathletes. J Hum Kinet. 2013;37(1):129-35. http://dx.doi.org/10.2478/hukin-2013-0033.
http://dx.doi.org/10.2478/hukin-2013-003...
, and lymphatic circulation99 Tsai H-J, Hung H-C, Yang J-L, Huang C-S, Tsauo J-Y. Could Kinesio tape replace the bandage in decongestive lymphatic therapy for breast-cancer-related lymphedema? A pilot study. Support Care Cancer. 2009;17(11):1353-60. http://dx.doi.org/10.1007/s00520-009-0592-8.
http://dx.doi.org/10.1007/s00520-009-059...
.

This growing number of studies addressing KT is based on the proprioceptive and afferent stimuli of the elastic tape1010 Chang HY, Chou KY, Lin JJ, Lin CF, Wang CH. Immediate effect of forearm Kinesio taping on maximal grip strength and force sense in healthy collegiate athletes. Phys Ther Sport. 2010;11(4):122-7. http://dx.doi.org/10.1016/j.ptsp.2010.06.007.
http://dx.doi.org/10.1016/j.ptsp.2010.06...

11 Hoyo M, Álvarez-Mesa A, Sañudo B, Carrasco L, Domínguez S. Immediate effects of Kinesio Taping on muscle response in young elite soccer players. J Sport Rehabil. 2013;22(1):53-8.

12 Huang C-Y, Hsieh T-H, Lu S-C, Su F-C. Effect of the Kinesio tape to muscle activity and vertical jump performance in healthy inactive people. Biomed Eng Online. 2011;10(1):70-81. http://dx.doi.org/10.1186/1475-925X-10-70.
http://dx.doi.org/10.1186/1475-925X-10-7...

13 Vithoulka I, Beneka A, Malliou P, Aggelousis N, Karatsolis K, Diamantopoulos K. The effects of Kinesio-Taping® on quadriceps strength during isokinetic exercise in healthy non athlete women. Isokinet Exerc Sci. 2010;18(1):1-6.

14 Kim H, Lee B. The effects of Kinesio Tape on isokinetic muscular function of horse racing jockeys. J Phys Ther Sci. 2013;25(10):1273-7. http://dx.doi.org/10.1589/jpts.25.1273.
http://dx.doi.org/10.1589/jpts.25.1273...
-1515 Serra MVGB, Vieira ER, Brunt D, Goethel MF, Gonçalves M, Quemelo PRV. Kinesio Taping effects on knee extension force among soccer players. Braz J Phys Ther. 2015;19(2):152-8. http://dx.doi.org/10.1590/bjpt-rbf.2014.0075.
http://dx.doi.org/10.1590/bjpt-rbf.2014....
. Recent findings demonstrated acute increases in eccentric muscle strength1313 Vithoulka I, Beneka A, Malliou P, Aggelousis N, Karatsolis K, Diamantopoulos K. The effects of Kinesio-Taping® on quadriceps strength during isokinetic exercise in healthy non athlete women. Isokinet Exerc Sci. 2010;18(1):1-6., force perception1010 Chang HY, Chou KY, Lin JJ, Lin CF, Wang CH. Immediate effect of forearm Kinesio taping on maximal grip strength and force sense in healthy collegiate athletes. Phys Ther Sport. 2010;11(4):122-7. http://dx.doi.org/10.1016/j.ptsp.2010.06.007.
http://dx.doi.org/10.1016/j.ptsp.2010.06...
, and concentric elbow peak torque1616 Fratocchi G, Di Mattia F, Rossi R, Mangone M, Santilli V, Paoloni M. Influence of Kinesio Taping applied over biceps brachii on isokinetic elbow peak torque. A placebo controlled study in a population of young healthy subjects. J Sci Med Sport. 2013;16(3):245-9. http://dx.doi.org/10.1016/j.jsams.2012.06.003.
http://dx.doi.org/10.1016/j.jsams.2012.0...
. However, evidence regarding the effectiveness of KT during musculoskeletal rehabilitation is still inconsistent11 Lim EC, Tay MG. Kinesio taping in musculoskeletal pain and disability that lasts for more than 4 weeks: is it time to peel off the tape and throw it out with the sweat? A systematic review with meta-analysis focused on pain and also methods of tape application. Br J Sports Med. 2015;49(24):1558-66. http://dx.doi.org/10.1136/bjsports-2014-094151.
http://dx.doi.org/10.1136/bjsports-2014-...
,22 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.,1717 Parreira PCS, Costa LCM, Hespanhol LC Jr, Lopes AD, Costa LOP. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. J Physiother. 2014;60(1):31-9. http://dx.doi.org/10.1016/j.jphys.2013.12.008.
http://dx.doi.org/10.1016/j.jphys.2013.1...
. Furthermore, according to Martínez-Gramage et al.1818 Martínez-Gramage J, Merino-Ramirez MA, Amer-Cuenca JJ, Lisón JF. Effect of Kinesio Taping on gastrocnemius activity and ankle range of movement during gait in healthy adults: a randomized controlled trial. Phys Ther Sport. 2016;18:56-61. http://dx.doi.org/10.1016/j.ptsp.2014.12.002
http://dx.doi.org/10.1016/j.ptsp.2014.12...
, the evidence of the possible effects of prolonged use of KT on functional activities or human performance is still questionable and needs further clarification.

In this context, a valuable way to assess functional performance and rehabilitation effectiveness is through the hop and vertical jump tests1919 Santos HH, Ávila MA, Hanashiro DH, Camargo PR, Salvini TF. The effects of knee extensor eccentric training on functional tests in healthy subjects. Rev Bras Fisioter. 2010;14(4):276-83. http://dx.doi.org/10.1590/S1413-35552010005000014.
http://dx.doi.org/10.1590/S1413-35552010...
. The hop tests were described by Noyes et al.2020 Noyes FR, Barber SD, Mangine RE. Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. Am J Sports Med. 1991;19(5):513-8. http://dx.doi.org/10.1177/036354659101900518.
http://dx.doi.org/10.1177/03635465910190...
and have been used as a low-cost screening assessment2121 Petschnig R, Baron R, Albrecht M. The relationship between isokinetic quadriceps strength test and hop tests for distance and one-legged vertical jump test following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 1998;28(1):23-31. http://dx.doi.org/10.2519/jospt.1998.28.1.23.
http://dx.doi.org/10.2519/jospt.1998.28....
of strength, power, proprioception, and neuromuscular performance. The vertical jump is a movement often used in sports and as a conditioning exercise to develop strength and power in the lower extremities2222 Lees A, Vanrenterghem J, De Clercq D. The maximal and submaximal vertical jump: implications for strength and conditioning. J Strength Cond Res. 2004;18(4):787-91.. Both movements consist of a multi-joint action involving the hip, knee, and ankle joints, with contraction of several muscles including the triceps surae, hamstrings, quadriceps, and lower back muscles.

There are contradicting results regarding the effectiveness of KT in hop tests and vertical jump performance, as previous studies found no acute significant effects2323 Lins CA, Locks F No, Amorim AB, Macedo LB, Brasileiro JS. Kinesio Taping® does not alter neuromuscular performance of femoral quadriceps or lower limb function in healthy subjects: randomized, blind, controlled, clinical trial. Man Ther. 2013;18(1):41-5. http://dx.doi.org/10.1016/j.math.2012.06.009.
http://dx.doi.org/10.1016/j.math.2012.06...
,2424 Bicici S, Karatas N, Baltaci G. Effect of athletic taping and kinesiotaping® on measurements of functional performance in basketball players with chronic inversion ankle sprains. Int J Sports Phys Ther. 2012;7(2):154., while others confirmed some acute benefits of the KT1212 Huang C-Y, Hsieh T-H, Lu S-C, Su F-C. Effect of the Kinesio tape to muscle activity and vertical jump performance in healthy inactive people. Biomed Eng Online. 2011;10(1):70-81. http://dx.doi.org/10.1186/1475-925X-10-70.
http://dx.doi.org/10.1186/1475-925X-10-7...
,2525 Aktas G, Baltaci G. Does kinesiotaping increase knee muscles strength and functional performance? Isokinet Exerc Sci. 2011;19(3):149-55.. In addition, there is a lack of studies on the prolonged effects of KT, as most studies focused on the acute responses1010 Chang HY, Chou KY, Lin JJ, Lin CF, Wang CH. Immediate effect of forearm Kinesio taping on maximal grip strength and force sense in healthy collegiate athletes. Phys Ther Sport. 2010;11(4):122-7. http://dx.doi.org/10.1016/j.ptsp.2010.06.007.
http://dx.doi.org/10.1016/j.ptsp.2010.06...
,1414 Kim H, Lee B. The effects of Kinesio Tape on isokinetic muscular function of horse racing jockeys. J Phys Ther Sci. 2013;25(10):1273-7. http://dx.doi.org/10.1589/jpts.25.1273.
http://dx.doi.org/10.1589/jpts.25.1273...
,2323 Lins CA, Locks F No, Amorim AB, Macedo LB, Brasileiro JS. Kinesio Taping® does not alter neuromuscular performance of femoral quadriceps or lower limb function in healthy subjects: randomized, blind, controlled, clinical trial. Man Ther. 2013;18(1):41-5. http://dx.doi.org/10.1016/j.math.2012.06.009.
http://dx.doi.org/10.1016/j.math.2012.06...
,2626 Vercelli S, Sartorio F, Foti C, Colletto L, Virton D, Ronconi G, et al. Immediate effects of kinesiotaping on quadriceps muscle strength: a single-blind, placebo-controlled crossover trial. Clin J Sport Med. 2012;22(4):319-26. http://dx.doi.org/10.1097/JSM.0b013e31824c835d.
http://dx.doi.org/10.1097/JSM.0b013e3182...
,2727 Wong OM, Cheung RT, Li RC. Isokinetic knee function in healthy subjects with and without Kinesio taping. Phys Ther Sport. 2012;13(4):255-8. http://dx.doi.org/10.1016/j.ptsp.2012.01.004.
http://dx.doi.org/10.1016/j.ptsp.2012.01...
. This is noteworthy and conflicting, considering that the recommendation for the KT method is to use the tape for more than 24 hours in order to obtain the claimed effects. In fact, few studies compared the effects of KT on electromyography activity after 48h2828 Slupik A, Dwornik M, Białoszewski D, Zych E. Effect of Kinesio Taping on bioelectrical activity of vastus medialis muscle. Preliminary report. Ortop Traumatol Rehabil. 2007;9(6):644-51. and 72h1818 Martínez-Gramage J, Merino-Ramirez MA, Amer-Cuenca JJ, Lisón JF. Effect of Kinesio Taping on gastrocnemius activity and ankle range of movement during gait in healthy adults: a randomized controlled trial. Phys Ther Sport. 2016;18:56-61. http://dx.doi.org/10.1016/j.ptsp.2014.12.002
http://dx.doi.org/10.1016/j.ptsp.2014.12...
, pain and disability within 48h of KT application for chronic low back pain2929 Parreira PC, Costa LC, Takahashi R, Hespanhol LC Jr, Luz MA Jr, Silva TM, et al. Kinesio taping to generate skin convolutions is not better than sham taping for people with chronic non-specific low back pain: a randomised trial. J Physiother. 2014;60(2):90-6. http://dx.doi.org/10.1016/j.jphys.2014.05.003.
http://dx.doi.org/10.1016/j.jphys.2014.0...
, and pain-free active range of motion scores within 1 day of KT use55 Thelen MD, Dauber JA, Stoneman PD. The clinical efficacy of kinesio tape for shoulder pain: a randomized, double-blinded, clinical trial. J Orthop Sports Phys Ther. 2008;38(7):389-95. http://dx.doi.org/10.2519/jospt.2008.2791.
http://dx.doi.org/10.2519/jospt.2008.279...
. Thus, it is possible to assume that the increased peripheral nerve stimulation and recruitment of motor units attributed to the KT method may reach its maximal efficacy after 24h, and this could influence the performance of clinical assessments such as hop and vertical jump tests. This is in line with Vercelli et al.2626 Vercelli S, Sartorio F, Foti C, Colletto L, Virton D, Ronconi G, et al. Immediate effects of kinesiotaping on quadriceps muscle strength: a single-blind, placebo-controlled crossover trial. Clin J Sport Med. 2012;22(4):319-26. http://dx.doi.org/10.1097/JSM.0b013e31824c835d.
http://dx.doi.org/10.1097/JSM.0b013e3182...
, who recognized the need to investigate the effects on a prolonged application of KT. Therefore, it is hypothesized that the effects on a prolonged application of KT could increase muscle efficiency and, consequently, improve the performance of the hop and vertical jump tests. The aim of the present study was to investigate the effects of prolonged and continuous (48h) use of KT on functional and proprioceptive performance in healthy, physically active men.

Method

Study design

This is a randomized controlled trial (RCT) in which healthy, physically active men were randomly assigned to one of two intervention groups (Figure 1). This RCT was reported following the recommendations of the CONSORT Statement3030 Schulz KF, Altman DG, Moher D, Group C, CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;8(1):18. http://dx.doi.org/10.1186/1741-7015-8-18.
http://dx.doi.org/10.1186/1741-7015-8-18...
. In addition, according to Miller et al.3131 Miller FG, Wendler D, Swartzman LC. Deception in research on the placebo effect. PLoS Med. 2005;2(9):853-9. http://dx.doi.org/10.1371/journal.pmed.0020262.
http://dx.doi.org/10.1371/journal.pmed.0...
, a deceptive design was adopted.

Figure 1
Study flowchart.

Participants

Thirty healthy male subjects were selected at random from the respondents to fliers distributed to health sports clubs, posters placed in strategic points on the university campus, and by word-of-mouth. Sample size was calculated a priori using GPower software, version 3.1.9. Considering a statistical power of 80%, α-value of 5%, and a moderate effect size (d =0.5) between KT and control groups, a minimum of 22 subjects should be included in the study design.

Anthropometric data and physical evaluations were taken prior to the randomization procedure. The International Physical Activity Questionnaire (IPAQ)3232 Matsudo S, Araújo T, Marsudo V, Andrade D, Andrade E, Oliveria LC, et al. Questinário internacional de atividade física (IPAQ): estudo de validade e reprodutibilidade no Brasil. Rev Bras Ativ Fis Saúde. 2001;6(2):5-18. was applied in order to evaluate the physical activity level of the participants. Inclusion criteria were: a) males; b) aged between 18 and 30 years; c) physically active (classified as moderate or higher, according to the IPAQ questionnaire); d) height between 1.65 m and 1.85 m (in order to prevent anthropometric variability between subjects); and e) absence of pain and musculoskeletal symptoms. Exclusion criteria included open wounds or scars in the region of tape application, hypersensitivity, and erythema or lower limb injury in the past 6 months prior to the study. Participants who met the inclusion criteria were invited to read and sign an informed consent. The study was approved by the Institutional Research Ethics Committee of Faculdade de Saúde, Universidade de Brasília (UnB), Brasília, DF, Brazil (protocol n. 11350813.2.0000.0030).

Subjects who were selected to participate were admitted sequentially and randomly allocated to one of two groups: 1) Kinesiotaping group (KG, tape applied with 40% tension for rectus femoris muscle activation), and 2) Control Group (CG, tape applied without tension on the rectus femoris). For the randomization process, sequentially numbered sealed opaque envelopes containing the name of the intervention groups were used. Randomization was based on a table of random numbers generated by the website Random.Org3333 Random.Org [Internet]. 2015 [cited 2014 Aug 15]. Available from: www.random.org
http://www.random.org...
. This procedure was performed by an investigator who was blinded to the objectives and purposes of the study.

Kinesiotaping application

For the present study, the Kinesio Tex Gold® tape (Albuquerque, NM, USA) was used and applied on clean and dry skin. For the KG, a tension of 40% was applied on the dominant limb (leg used to kick a ball), from origin to insertion (proximal to distal) according to the technique proposed by Kase et al.33 Kase K, Wallis J, Kase T. Clinical therapeutic applications of the Kinesio Taping Method. Tokyo: Kinesio Taping Association; 2003. to facilitate the rectus femoris muscle activation.

Before the tape application, the subject lied in a supine position on a bench. Subsequently, the distance (DIS) between 10 cm below the anterior superior iliac spine (ASIS) and the tibial tuberosity was measured. In order to standardize and control the tape tension, after measurement, the strip was cut based on the Equation 1:

S B = ( D I S F P ) 1.4 + 10 c m (1)

where:

SB: the size of the tape to be cut (cm);

DIS: distance between the point 10 cm below the ASIS and the tuberosity of the tibia;

FP: 10 cm of the anchors (5 cm each).

After the calculation of the SB value and removal of the paper backing from the tape, the strip was applied with the subject lying on a bench with the leg positioned off, and the knee from the dominant limb flexed at 90º (Figure 2). The strip was stretched until it reached the DIS value, which according to the equation would produce a tension of approximately 40%. Tape was always administered by the same certified physical therapist (certified KT1/KT2). The CG used the same application and technique, however, no tension was added to the tape along the longitudinal line on the anterior thigh until reaching the tibial tuberosity. For the CG group, the equation was not applied. All participants received verbal and written guidance regarding tape care, diet, and exercise procedures during the study period. The subjects were also instructed to keep the tape on for 48h after the application.

Figure 2
Illustration of the tape, after application.

Testing procedures

After the process of randomization and allocation to the respective groups (KG or CG), the subjects attended the laboratory on five different occasions at 24h intervals: 1) familiarization; 2) baseline measurement (BL); 3) immediate post-application (T0); 4) 24h post-application (T24); and 5) 48h post-application (T48). The BL measurements were applied without tape, for both groups. After the tape was applied, subjects were instructed not to remove it. The testing procedures were applied and controlled by the same investigator, who was not blinded to the treatment allocation.

Hop Tests

Two types of hop tests were used in order to assess the functional and proprioceptive performance2121 Petschnig R, Baron R, Albrecht M. The relationship between isokinetic quadriceps strength test and hop tests for distance and one-legged vertical jump test following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 1998;28(1):23-31. http://dx.doi.org/10.2519/jospt.1998.28.1.23.
http://dx.doi.org/10.2519/jospt.1998.28....
: 1) the single hop test (SHT) and 2) the triple hop test (THT). According to Ross et al.3434 Ross MD, Langford B, Whelan PJ. Test-retest reliability of 4 single-leg horizontal hop tests. J Strength Cond Res. 2002;16(4):617-22., both tests present a high level of reliability (Intraclass Correlation Coefficient - ICC of 0.92 and 0.97, respectively).

All measurements were taken from the dominant limb. The SHT started with the participants in single-leg standing behind a line marked on the floor with a knee slightly flexed for 10 seconds, until a verbal command was given (Figure 3). Immediately after the verbal command, they were asked to jump forward as quickly and as long as possible and to land with the same limb. In order to prevent influences of the upper limbs during the propulsion phase, subjects were instructed to maintain their hands on the waist. The jump was considered valid if the participants could maintain their balance for at least 5 seconds after landing. Subjects performed three SHTs with a 1-minute interval between tests, and the best attempt was used for analysis purposes.

Figure 3
Illustration of the initial position of the hop test (A) and vertical jump test (B).

The THT was performed with the same initial position. After the verbal command, subjects had to perform three consecutive and uninterrupted jumps as long as possible with the same limb on a straight line. As for the SHT, the attempt was considered valid if the participants could maintain the balance for at least 5 seconds after the third landing. Subjects performed three THTs with a 1-minute interval between jumps, and the best attempt was used for analysis. All subjects performed a 5-min warm-up walk before the tests. Subjects had a three-minute rest interval between the SHT and THT. Jump distance was marked on a measuring tape positioned on the ground for both tests.

One-legged vertical jump

A force plate (AMTI, model BP400600-HF-2000; Advanced Mechanical Technology, Inc., Watertown, MA, USA) fixed at ground level was used to evaluate the jump height, jump power, and the rate of force development (RFD) during a one-legged vertical jump. The sampling rate was 1000 Hz. This test presents high levels of reliability for functional and strength performance (ICC: 0.94)3535 Cordova ML, Armstrong CW. Reliability of ground reaction forces during a vertical jump: implications for functional strength assessment. J Athl Train. 1996;31(4):342-5..

Following a 10-min interval after the hop tests, subjects were placed in front of the force plate. Initially, subjects had to step up on the platform and maintain a static one-legged upright position with their hands on the waist for 5 seconds, until a verbal command was given (Figure 3). After the verbal command, subjects were instructed to jump vertically as high as possible and land on the same limb. A 1-min rest interval was used between trials. Three trials were performed, and the best jump was used for analysis.

Data from the force plate software were exported to a text file (.txt) and analyzed in a Matlab subroutine (version 7.13 release 2011b, MathWorks Inc., Natick, MA, USA). The velocity curve was obtained by dividing the resultant ground reaction force by the subjects’ body mass, and the displacement curve was obtained by integrating the velocity signal. Finally, the displacement curve was integrated, in order to obtain the center of mass displacement at each instant. Thus, the greatest vertical displacement was considered as jump height (measured in cm)3636 Ugrinowitsch C, Tricoli V, Rodacki AL, Batista M, Ricard MD. Influence of training background on jumping height. J Strength Cond Res. 2007;21(3):848-52.,3737 Dal Pupo J, Detanico D, Santos SG. Kinetic parameters as determinants of vertical jump performance. Rev Bras Cineantropom Desempenho Hum. 2012;14(1):41-51.. The RFD was calculated using the moment-time curve (0-30 ms interval) from the beginning of the acceleration phase of the jump3737 Dal Pupo J, Detanico D, Santos SG. Kinetic parameters as determinants of vertical jump performance. Rev Bras Cineantropom Desempenho Hum. 2012;14(1):41-51.. Jump Power was obtained by multiplying the ground reaction force by velocity at the beginning of the jump3737 Dal Pupo J, Detanico D, Santos SG. Kinetic parameters as determinants of vertical jump performance. Rev Bras Cineantropom Desempenho Hum. 2012;14(1):41-51.. Data were low-pass filtered (Butterworth 4th order) with a cutoff frequency of 200 Hz.

Statistical analysis

The Statistical Package for the Social Sciences (SPSS version 22.0) was used. Normality assumptions were confirmed by the Kolmogorov-Smirnov test, and data are presented as mean and standard deviation. The independent variable was tape condition (KG or CG). Dependent variables were SHT and THT distance (in cm), jump height (in cm), power (W/kg), and RFD (in N/s). The Box’s M test was used to verify the equality of covariance matrices. A mixed-model 2 X 4 ANOVA was used to verify differences between groups (KG and CG) and within moments (BL, T0, T24, and T48), with syntax according to the multivariate model. The effect size (ES) was calculated using the Cohen's d3838 Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Erlbaum Associates; 1988.. The magnitude of the effect size was classified as small (d<0.50), moderate (d≥0.50) or large (d>0.8). Significance was set at 5% (p <0.05).

Results

Thirty individuals were assessed for eligibility and included for enrollment in this study. Four participants were excluded for not meeting the inclusion criteria (2) and declined to participate (2) – Figure 1. During the intervention, four participants from the CG group and one from the KG were excluded due to withdrawal from the study or removal of the tape (Figure 1). The remaining 21 participants received the original assigned interventions and were included in the subsequent analyses. Demographic characteristics of the participants are presented in Table 1.

Table 1
Participants’ physical characteristics. Data are presented as mean (standard deviation).

Data regarding the distance of the SHT and THT are presented in Table 2. For the SHT, no significance differences or interactions were found between groups (F =0.10; p =0.75) and moments (F =0.23; p =0.87). The THT presented neither significant differences between groups (F =0.97; p =0.33) nor moments (F =0.38; p =0.76). Small effect sizes were found for all comparisons.

Table 2
Values of the single hop test (SHT), triple hop test (THT), vertical jump height, power, and rate of force development (RFD) for the Kinesiotaping group (KG) and control group (CG). Data are presented as mean (standard deviation).

Vertical jump data are presented in Table 2. Jump height presented no significant differences between groups (F =0.60; p =0.44) and moments (F =0.75; p =0.46). Small effect sizes were found for all comparisons. Likewise, no significant differences were found on RFD between groups (F =0.04; p =0.83) and moments (F =0.48; p =0.69). Similarly, regarding the jump power no interactions were found between groups (F =0.34; p =0.56) and moments (F =0.57; p =0.63). Higher jump power values with moderate effect size were found for the CG group at T0xBL. However, for T48xBL a decrease on power performance and a medium effect size was also found (Table 2). For the KG, small effect sizes were found for all comparisons.

Concerning within-group differences, we observed that both the KG and CG group presented an increase in RFD with moderate effect size at T0 and the CG a large effect size at 48 h.

Discussion

The present study evaluated the influence of Kinesiotaping applied to the rectus femoris muscle on lower-body functional and proprioceptive performance. The general findings demonstrated that the use of KT does not have a beneficial effect on functional performance of healthy, physically active individuals immediately after and up to 48h after post-tape application.

Regarding single and triple hop tests, the present study demonstrated no significant KT effects between groups or within moments. Recent studies found similar results on hop tests performance2323 Lins CA, Locks F No, Amorim AB, Macedo LB, Brasileiro JS. Kinesio Taping® does not alter neuromuscular performance of femoral quadriceps or lower limb function in healthy subjects: randomized, blind, controlled, clinical trial. Man Ther. 2013;18(1):41-5. http://dx.doi.org/10.1016/j.math.2012.06.009.
http://dx.doi.org/10.1016/j.math.2012.06...
,2626 Vercelli S, Sartorio F, Foti C, Colletto L, Virton D, Ronconi G, et al. Immediate effects of kinesiotaping on quadriceps muscle strength: a single-blind, placebo-controlled crossover trial. Clin J Sport Med. 2012;22(4):319-26. http://dx.doi.org/10.1097/JSM.0b013e31824c835d.
http://dx.doi.org/10.1097/JSM.0b013e3182...
. Lins et al.2323 Lins CA, Locks F No, Amorim AB, Macedo LB, Brasileiro JS. Kinesio Taping® does not alter neuromuscular performance of femoral quadriceps or lower limb function in healthy subjects: randomized, blind, controlled, clinical trial. Man Ther. 2013;18(1):41-5. http://dx.doi.org/10.1016/j.math.2012.06.009.
http://dx.doi.org/10.1016/j.math.2012.06...
performed a randomized trial in which they compared the acute (immediate) application of three taping conditions. The KT applied over the vastus medialis and rectus femoris for quadriceps activation was compared with a group using tape without elastic properties, and a group without taping. The results demonstrated no effects from the KT and no significant differences between groups. The study of Vercelli et al.2626 Vercelli S, Sartorio F, Foti C, Colletto L, Virton D, Ronconi G, et al. Immediate effects of kinesiotaping on quadriceps muscle strength: a single-blind, placebo-controlled crossover trial. Clin J Sport Med. 2012;22(4):319-26. http://dx.doi.org/10.1097/JSM.0b013e31824c835d.
http://dx.doi.org/10.1097/JSM.0b013e3182...
evaluated the acute application of KT on subjects of both sexes, and also found no significant KT influences on hop tests performance, corroborating our immediate post-tape application (T0) results. However, Aktas and Baltaci2525 Aktas G, Baltaci G. Does kinesiotaping increase knee muscles strength and functional performance? Isokinet Exerc Sci. 2011;19(3):149-55. found significant acute effects of the KT on hop test performance. They evaluated healthy individuals of both sexes comparing four conditions: 1) control (no tape), 2) knee brace, 3) KT, and 4) KT plus knee brace. Similar to the present study, all subjects performed the single hop test and a vertical jump. The authors found a significant difference between control and KT application for male subjects, meaning that KT improved the jump distance during the single hop test. Regarding the vertical jump performance, the authors did not find any significant effects for all groups.

The improvement on hop test performance found in the study of Aktas and Baltaci2525 Aktas G, Baltaci G. Does kinesiotaping increase knee muscles strength and functional performance? Isokinet Exerc Sci. 2011;19(3):149-55. was explained by underlying mechanisms claimed by the KT method and commonly described in the literature involving the method3939 Nakajima MA, Baldridge C. The effect of kinesio® tape on vertical jump and dynamic postural control. Int J Sports Phys Ther. 2013;8(4):393.. It was hypothesized by Aktas and Baltaci2525 Aktas G, Baltaci G. Does kinesiotaping increase knee muscles strength and functional performance? Isokinet Exerc Sci. 2011;19(3):149-55. that the stimuli provided by the KT enhanced the proprioception by mechanical stimuli on muscular and joint peripheral receptors transmitted along afferent pathways of the sensorimotor system. According to Mandelbaum et al.4040 Mandelbaum BR, Silvers HJ, Watanabe DS, Knarr JF, Thomas SD, Griffin LY, et al. Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. Am J Sports Med. 2005;33(7):1003-10. http://dx.doi.org/10.1177/0363546504272261.
http://dx.doi.org/10.1177/03635465042722...
, these stimuli are crucial to neuromuscular control and motor performance. In addition, the KT method is purported to facilitate the effect of cutaneous mechanoreceptors, which would improve neuronal excitability and, consequently, muscle function1414 Kim H, Lee B. The effects of Kinesio Tape on isokinetic muscular function of horse racing jockeys. J Phys Ther Sci. 2013;25(10):1273-7. http://dx.doi.org/10.1589/jpts.25.1273.
http://dx.doi.org/10.1589/jpts.25.1273...
. Another mechanism claimed by the KT is a facilitatory effect of cutaneous mechanoreceptors that improves neuronal excitability and, consequently, muscle function1414 Kim H, Lee B. The effects of Kinesio Tape on isokinetic muscular function of horse racing jockeys. J Phys Ther Sci. 2013;25(10):1273-7. http://dx.doi.org/10.1589/jpts.25.1273.
http://dx.doi.org/10.1589/jpts.25.1273...
. However, Halseth et al.4141 Halseth T, McChesney JW, DeBeliso M, Vaughn R, Lien J. The effect of Kinesio taping on proprioception at the ankle. J Sports Sci Med. 2004;3:1-7. evaluated the effects of taping the anterior and lateral portion of the ankle as a strategy to enhance ankle proprioception compared to a condition without taping. Their findings demonstrated no proprioceptive enhancement of KT during a joint position sense task. Similarly, our study provides evidence that KT has no proprioceptive and performance enhancement from acute or prolonged application, contradicting the influences of the aforementioned KT mechanisms. It seems that for optimal improvement in sprint, jumping, and strength performance, resistance or plyometric training appears to be more effective4242 Zech A, Hübscher M, Vogt L, Banzer W, Hänsel F, Pfeifer K. Balance training for neuromuscular control and performance enhancement: a systematic review. J Athl Train. 2010;45(4):392-403. http://dx.doi.org/10.4085/1062-6050-45.4.392.
http://dx.doi.org/10.4085/1062-6050-45.4...
. For example, a previous study demonstrated significant effects of plyometric training on shoulder position sense, which was explained by peripheral adaptations resulting from repetitive stimulation of the articular mechanoreceptors near the end range of motion of the shoulder during the exercises4343 Swanik KA, Lephart SM, Swanik CB, Lephart SP, Stone DA, Fu FH. The effects of shoulder plyometric training on proprioception and selected muscle performance characteristics. J Shoulder Elbow Surg. 2002;11(6):579-86. http://dx.doi.org/10.1067/mse.2002.127303.
http://dx.doi.org/10.1067/mse.2002.12730...
.

To the best of our knowledge, this is one of the few randomized trials that investigated the prolonged (48 h) effects of KT on functional performance, and the results did not support the hypotheses that the prolonged use of KT would be beneficial. In addition, the small effect sizes found for the SHT and THT reinforce the interpretation that prolonged use of KT is not effective. It was expected that the continued use of the KT could increase the afferent stimuli of the mechanoreceptors claimed by previous studies and, consequently, improve the proprioceptive responses and functional performance. However, as the functional performance is related to muscle strength2121 Petschnig R, Baron R, Albrecht M. The relationship between isokinetic quadriceps strength test and hop tests for distance and one-legged vertical jump test following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 1998;28(1):23-31. http://dx.doi.org/10.2519/jospt.1998.28.1.23.
http://dx.doi.org/10.2519/jospt.1998.28....
, our findings may be explained by the fact that KT has no effects on muscle strength2626 Vercelli S, Sartorio F, Foti C, Colletto L, Virton D, Ronconi G, et al. Immediate effects of kinesiotaping on quadriceps muscle strength: a single-blind, placebo-controlled crossover trial. Clin J Sport Med. 2012;22(4):319-26. http://dx.doi.org/10.1097/JSM.0b013e31824c835d.
http://dx.doi.org/10.1097/JSM.0b013e3182...
,4444 Fu TC, Wong AM, Pei YC, Wu KP, Chou SW, Lin YC. Effect of Kinesio taping on muscle strength in athletes-a pilot study. J Sci Med Sport. 2008;11(2):198-201. http://dx.doi.org/10.1016/j.jsams.2007.02.011.
http://dx.doi.org/10.1016/j.jsams.2007.0...
. It is possible that the effects of the KT application are more evident in different muscle groups and in subjects with musculoskeletal dysfunction. Previous studies55 Thelen MD, Dauber JA, Stoneman PD. The clinical efficacy of kinesio tape for shoulder pain: a randomized, double-blinded, clinical trial. J Orthop Sports Phys Ther. 2008;38(7):389-95. http://dx.doi.org/10.2519/jospt.2008.2791.
http://dx.doi.org/10.2519/jospt.2008.279...
,66 González-Iglesias J, Fernandez-De-Las-Penas C, Cleland J, Huijbregts P, Gutiérrez-Vega MDR. 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(7):515-21. http://dx.doi.org/10.2519/jospt.2009.3072.
http://dx.doi.org/10.2519/jospt.2009.307...
demonstrated pain reduction in patients with neck dysfunction immediately and 24h post-tape application and an improvement on shoulder range of motion immediately post-application. In addition, Hsu et al.4545 Hsu YH, Chen WY, Lin HC, Wang WT, Shih YF. The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome. J Electromyogr Kinesiol. 2009;19(6):1092-9. http://dx.doi.org/10.1016/j.jelekin.2008.11.003.
http://dx.doi.org/10.1016/j.jelekin.2008...
observed a significant improvement of the ascendant trapezius strength, when the KT was compared to a placebo condition in baseball players with shoulder impingement syndrome. Thus, further high quality randomized trials focusing on musculoskeletal dysfunctions and functional performance are recommended.

The present study found no significant influences of KT on vertical jump height, RFD, and power, corroborating Nakajima and Baldridge3939 Nakajima MA, Baldridge C. The effect of kinesio® tape on vertical jump and dynamic postural control. Int J Sports Phys Ther. 2013;8(4):393.. They evaluated the effects of KT with tension and without tension on vertical jump height on fifty-two subjects (28 men and 24 women) randomized into 2 groups: 1) KT with tension, and 2) KT without tension. The tape was applied at the gastrocnemius and soleus, for muscle activation. No significant differences were found in the measurements of vertical jump height. According to Nakajima and Baldridge3939 Nakajima MA, Baldridge C. The effect of kinesio® tape on vertical jump and dynamic postural control. Int J Sports Phys Ther. 2013;8(4):393., one possible explanation for the present findings is that the tactile input from the KT is not strong enough to increase muscle power to influence vertical jump height. This is in line with Petschnig et al.2121 Petschnig R, Baron R, Albrecht M. The relationship between isokinetic quadriceps strength test and hop tests for distance and one-legged vertical jump test following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 1998;28(1):23-31. http://dx.doi.org/10.2519/jospt.1998.28.1.23.
http://dx.doi.org/10.2519/jospt.1998.28....
, which found that the height of the vertical jump was attributed to the strength of the knee extensor muscles. Thus, it is possible to assume that KT did not produced increases in knee extensors muscle strength and, consequently, did not influence the jump height. Similarly, Huang et al.1212 Huang C-Y, Hsieh T-H, Lu S-C, Su F-C. Effect of the Kinesio tape to muscle activity and vertical jump performance in healthy inactive people. Biomed Eng Online. 2011;10(1):70-81. http://dx.doi.org/10.1186/1475-925X-10-70.
http://dx.doi.org/10.1186/1475-925X-10-7...
evaluated the performance of vertical jump in thirty-one healthy individuals (19 men and 12 women). They used an application similar to the Nakajima’ study, in which the tape was applied for the activation of the triceps surae, however, the vertical jump was performed with both limbs. They found a significant increase in vertical ground reaction force and EMG activity of the medial gastrocnemius during the jumping task with the KT. For jump height, no significant effects were found. The comparisons of our study with Huang and colleagues1212 Huang C-Y, Hsieh T-H, Lu S-C, Su F-C. Effect of the Kinesio tape to muscle activity and vertical jump performance in healthy inactive people. Biomed Eng Online. 2011;10(1):70-81. http://dx.doi.org/10.1186/1475-925X-10-70.
http://dx.doi.org/10.1186/1475-925X-10-7...
must be carefully done, considering that in the present study the tape was applied on the rectus femoris while Huang et al.1212 Huang C-Y, Hsieh T-H, Lu S-C, Su F-C. Effect of the Kinesio tape to muscle activity and vertical jump performance in healthy inactive people. Biomed Eng Online. 2011;10(1):70-81. http://dx.doi.org/10.1186/1475-925X-10-70.
http://dx.doi.org/10.1186/1475-925X-10-7...
applied it on the triceps surae. In addition, a squat jump may have influenced the difference between studies. Probably, the neuronal input of KT is not sufficient to increase hop test performance2323 Lins CA, Locks F No, Amorim AB, Macedo LB, Brasileiro JS. Kinesio Taping® does not alter neuromuscular performance of femoral quadriceps or lower limb function in healthy subjects: randomized, blind, controlled, clinical trial. Man Ther. 2013;18(1):41-5. http://dx.doi.org/10.1016/j.math.2012.06.009.
http://dx.doi.org/10.1016/j.math.2012.06...
and muscle strength4444 Fu TC, Wong AM, Pei YC, Wu KP, Chou SW, Lin YC. Effect of Kinesio taping on muscle strength in athletes-a pilot study. J Sci Med Sport. 2008;11(2):198-201. http://dx.doi.org/10.1016/j.jsams.2007.02.011.
http://dx.doi.org/10.1016/j.jsams.2007.0...
.

Nevertheless, it is possible to assume that the elastic property of the tape allows free joint motion and could offer a mechanism to increase joint loading and muscle activity1212 Huang C-Y, Hsieh T-H, Lu S-C, Su F-C. Effect of the Kinesio tape to muscle activity and vertical jump performance in healthy inactive people. Biomed Eng Online. 2011;10(1):70-81. http://dx.doi.org/10.1186/1475-925X-10-70.
http://dx.doi.org/10.1186/1475-925X-10-7...
and may explain the moderate effect size found for the KG`s rate of force development at T0 and T24. However, an interesting finding was that the CG also presented an increase of RFD with moderate effect size at T0 and large effect size at T48. This is an unexpected finding that raises an important question regarding the different applications of KT and tape tension. The absence of performance increments of hop tests and vertical jump in the present study may be explained by the tension applied to the tape (40% of the rest length). This is an important feature of clinical practice, considering that tape tension is a key element of the KT method. The guidelines of the method claim that a tension of approximately 25-35% must be applied when the aim is to stimulate a muscle. However, the literature reported a broad range of tension and no standardized application procedures have been used. Unlike previous studies, the present study adopted an equation in order to minimize the subjectivity around tape tension; however, this issue is warranted in future studies.

One limitation of the present study was the use of KT in one muscle group only, during a multi-joint task. Thus, future studies should consider the use of KT with multiple applications (e.g. quadriceps femoris and triceps surae). Another limitation was the lack of assessor’s blinding, which should be observed in clinical trials with the KT.

Conclusion

The present study demonstrated no immediate or prolonged effects of KT during the performance of the hop and vertical jump tests. Likewise, there were no significant differences between KT application with tension when compared to a condition without tension. Therefore, the KT method is not recommended when the objective is to improve the functional or proprioceptive performance of healthy, physically active individuals.

Acknowledgements

This work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil under Grant no. 473590/2013-1.

  • HOW TO CITE THIS ARTICLE Magalhães I, Bottaro M, Freitas JR, Carmo J, Matheus JPC, Carregaro RL. Prolonged use of Kinesiotaping does not enhance functional performance and joint proprioception in healthy young males: Randomized controlled trial. Braz J Phys Ther. ano 2016 Mês-Mês; xx(x):xx-xx. http://dx.doi.org/10.1590/bjpt-rbf.2014.0151

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Publication Dates

  • Publication in this collection
    18 Mar 2016
  • Date of issue
    May-Jun 2016

History

  • Received
    11 May 2015
  • Reviewed
    17 June 2015
  • Accepted
    10 Nov 2015
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