TISSUE FLEXIBILITY, FASCIA THICKNESS, PAIN AND DISABILITY

POSITIVE EFFECTS OF KT ARE SEEN ON SOFT

of pain-free range of movement but the KT group achieved results after just three days compared to six days for the control group. There was no significant difference in pain or disability in either group by the end of the trial. Both papers demonstrate that although final outcomes in experimental and control groups are ultimately similar, the KT groups improved faster with less intervention. This suggests that KT could offer a low cost alternative to conventional treatment for shoulder impingement.

Chronic Low Back Pain Paolini et al. (14) addressed chronic lower back pain (CLBP) (Table 3), focusing on “flexion-relaxation” (FR) of the lumbar erector spinae. In healthy individuals, muscle activity is reduced

after forward flexion whereas in CLBP sufferers it is hypothesised that these same muscles are held in a state of contraction.

The effects were studied across

three treatment groups; KT only, KT plus home exercises and home exercises only. An immediate effect was seen on pain in all KT groups but it was the home exercise group that showed most improvement in disability at the end of the 4-week trial. Castro-Sanchez et al. (15) also

looked at CLBP (Table 3), comparing the effect of a ‘star’ application of KT against a single horizontal KT strip on pain, disability, kinesiophobia, trunk range of motion and muscle endurance when performing a side plank. No effect was seen on kinesiophobia although range of motion and disability slightly improved in the experimental group. This group demonstrated mild improvement in pain after one week, which was maintained four weeks later but the biggest improvement was seen in muscle endurance when performing the plank. However it is unclear as to whether the improvement was due to improvement

of pain or muscle strength. A study of healthy individuals (16)

found positive results in increased forward flexion immediately after using KT to facilitate lumbar erector spinae. Although no assessment was made of pain and a direct connection between increased range of movement and reduced pain is not possible from these results alone, when combined with the results in the two previous studies (14, 15) there is an indication of how KT could be used in CLBP.

Whiplash Associated Disorder (WAD) Gonzalez-Iglesias et al. (17) investigated the effect of KT on pain and cervical range of motion following WAD over a 24-hour period when compared to sham KT (applied with no tension). Although there were statistically significant improvements to both pain and range of motion in the KT group at the end of the trial, both were at levels deemed not clinically relevant (Table 3).

Plantar Fasciitis (PF) The last paper (18) focused on plantar

TABLE 3: SUMMARY OF RESULTS FROM SELECTED PAPERS INVESTIGATING CHRONIC LOW BACK PAIN (CLBP), WHIPLASH ASSOCIATED DISORDER (WAD) AND PLANTAR FASCIITIS (PF)

Study

Paoloni et al., 2011 (14) (CLBP)

Castro- Sanchez et al., 2012 (15) (CLBP)

Participants n=39

Outcomes measured

1. Pain 2. Disability

3. Muscle function (FR ability)

n=60

1. Pain 2. Disability 3. Kinesiophobia 4. Trunk ROM

5. Muscle endurance Experimental group

KT along lumber erector spinae and midline (3 strips total) (n=13)

Note: All participants taped initially for immediate results on pain and FR (n=39)

KT applied in a star pattern over area of greatest discomfort (n=30)

Control group

KT applied in same way + home exercises (n=13) Home exercises only (n=13)

KT applied in single horizontal strip over area of greatest

discomfort (n=30) Summary of results

n Immediate reduction in pain in all KT groups n Improved FR in 17/39 initially n Pain improved in all groups at end of trial n Disability improved most in non-KT group n FR most improved at end of trial in KT + Exercise group

n Marginally-relevant improvement in disability initially

n Mild pain improvement after 1 wk and maintained after 5 wks

n Kinesiophobia = no effect n Initial improvement on ROM n Significant improvement in muscle endurance

Gonzalez- Iglesias et al., 2009 (17) (WAD)

Tsai et al., 2010 (18) (PF)

n=41

1. Pain 2. Cervical spine ROM

n=52

1. Pain 2. Foot function 3. Thickness of plantar fascia in 2 positions

28

KT along posterior neck and across lower cervical spine (n=21)

KT over gastrocnemius and plantar fascia + daily physical therapy (ultrasound, TENS) (n=26)

KT applied with no tension in similar position (n=20)

Daily physical therapy only (n=26)

n Improvements to cervical ROM and pain in KT group were statistically but not clinically relevant

n Immediate improvement in pain and foot n Reduction in plantar fascia thickness in KT group in 1 of 2 designated sites only

sportEX dynamics 2012;34(October):24-30