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Original article

Kinesio Taping does not alter neuromuscular performance of femoral quadricepsor lower limb function in healthy subjects Randomized blind controlled clinicaltrial

Caio Alano de Almeida Lins ab Francisco Locks Neto ab Anita Barros Carlos de Amorim abLiane de Brito Macedo ab Jamilson Simotildees Brasileiro ab

a Department of Physiotherapy of the Federal University of Rio Grande do Norte (UFRN) Natal Brazilb Laboratoacuterio de Anaacutelise da Performance Neuromuscular (LAPERN) Departamento de Fisioterapia Universidade Federal do Rio Grande do Norte (UFRN) Av Senador Salgado Filho

3000 Campus Universitaacuterio Lagoa N ova CEP 59078-970 Natal e RN Brazil

a r t i c l e i n f o

Article history

Received 16 February 2012

Received in revised form

13 June 2012Accepted 18 June 2012

Keywords

Postural balanceElectromyography

Torque

a b s t r a c t

The aim of this study was to analyze the immediate effects of applying Kinesio Taping (KT) on the

neuromuscular performance of femoral quadriceps postural balance and lower limb function in healthysubjects This is a randomized blind controlled clinical trial where sixty female volunteers (age

233 25 years BMI 222 21 kgm2) were randomly assigned to three groups of 20 subjects eachcontrol (10 min at rest) nonelastic adhesive tape (application over the rectus femoris vastus lateralis andvastus medialis muscles) and KT (KT application over the same muscles) All individuals were assessed

for single and triple hops postural balance (by baropodometry) peak concentric and eccentric torque

and electromyographic activity of vastus lateralis before and after interventions No signi 1047297cant differ-ences in electromyographic activity of the VL or concentric and eccentric knee peak torque wererecorded between groups and initial and 1047297nal assessment in any of the three groups We also observed

no signi1047297cant alteration in single and triple-hop distance and one-footed static balance between the

three groups Application of KT to RF VL and VM muscles did not signi1047297cantly change lower limbfunction postural balance knee extensor peak torque or electromyographic activity of VL muscle inhealthy women

2012 Elsevier Ltd All rights reserved

1 Introduction

Physically active individuals who engage in recreationalamateur or professional level activities constantly seek recoursesto enhance their muscle performance

Within this context the Japanese chiropractor Kenso Kasedeveloped Kinesio Taping(KT) an elastic bandage with unique

characteristics applied over or around muscles to provide func-tional support (Kase et al 1996 2003) The technique consists of

a thin tape which is elastic and can be stretched up to 50 of itsoriginal length resulting in less restriction when compared toconventional tapes (Kase et al1996 2003) It is applied to decrease

pain and edema increase joint stability and improve muscle

performance (Kase et al 2003 Thelen et al 2008)The mechanisms by which KT application would achieve the

expected result have not been fully elucidated Some researchersstate that its direct application on the skin activates a number of

cutaneous mechanoceptors which would relieve pain directlythrough a gate-control theory Furthermore due to its adhesive and

elastic characteristics the KT bandage could increase interstitialspace favoring better blood and lymphatic 1047298ow (Kase et al 2003

Thelen et al 2008)Other researchers (Murray and Husk 2001 Cools et al 2002

Halseth et al 2004 Macgregor et al 2005) propose to explain thepossible mechanism that increases muscle activity during KT and

nonelastic tape application among which is neurofacilitationHowever these studies are still scarce and controversial

The effect of KT application has been the target of investigationsassessing its in1047298uence on balance and lower limb function as well

as muscle activation and force but with con1047298icting results (Murray2000 Murray and Husk 2001 Osterhues 2004 Fu et al 2008

Corresponding author Laboratoacuterio de Anaacutelise da Performance Neuromuscular

(LAPERN) Departamento de Fisioterapia Universidade Federal do Rio Grande do

Norte (UFRN) Av Senador Salgado Filho 3000 Campus Universitaacuterio Lagoa Nova

CEP 59078-970 Natal e RN Brazil Tel thorn55(0)8433422001

E-mail address brasileiroufrnetbr (JS Brasileiro)

Contents lists available at SciVerse ScienceDirect

Manual Therapy

j o u r n a l h o m e p a g e w w w e l s e v i e r c om m a t h

1356-689X$ e see front matter 2012 Elsevier Ltd All rights reserved

httpdxdoiorg101016jmath201206009

Manual Therapy 18 (2013) 41e45

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Firth et al 2010 Aytar et al 2011) For example Vithoulka et al(2010) demonstrated that KT applied to the femoral quadriceps

increased peak eccentric torque in healthy non-athlete womenHowever Fu et al (2008) showed that KT did not in1047298uence muscleforce when applied to the quadriceps of healthy athletes

In light of the scarcity of research on assessing the effect of KTonneuromuscular performance of the femoral quadriceps and lowerlimb function the present study aimed to analyze the immediateeffects of KT application clustering different variables individually

assessed in previously published articles electromyographicactivity of the VL knee concentric and eccentric extensor torquebalance and lower limb function in healthy women We hypothe-

sized that subjects submitted to KTapplication would exhibit betterneuromuscular and functional performance when compared tocontrol and non-elastic tape groups

2 Materials and methods

21 Subjects

Sixty healthy female volunteers mean age of 233 25 yearsand body mass index (BMI) of 222 21 kgm2 took part in the

study All subjects were between 18 and 28 years old recreationallyactive (Pincivero and Gandaio 2003) with no history of osteo-myoarticularlesion or surgery in the lower limbs in the previous six

months non-corrected neurological vestibular visual andorhearing impairments in addition to displaying no allergy toadhesive material Individuals experiencing pain during collectionprocedures or who did not perform exercises as instructed by the

researchers would be excluded However based on these criterianone of the subjects were excluded

Participants were recruited among students of a local universityby non-probabilistic convenience sampling and gave informed

consent according to Resolution 19696 of the National HealthCouncil after being informed of the study aims The study wasapproved by the local Research Ethics Committee under protocol

number 60411 and in accordancewith CONSORTrecommendations

22 Procedures

Initially all volunteers warmed up on a stationary bicycle (Ergo-

Fit Ergo Cycle 167 Pirmasens Germany) for 5 min with the seatadjusted to the height of the greater trochanter and a load of 20 WImmediately after we assessed lower limb function one-footedstatic balance concentric and eccentric peak knee extensor torque

and electromyographic activity of the VL Following this assessmentvolunteers were randomly distributed using the website wwwrandomizationcom into one of three groups of 20 individualseach Groups were color coded to allow blind analysis by a third

researcher The control group underwent initial assessment

remaining at rest for 10 min which was followed by1047297nal evaluationAfter initial assessment the kinesio taping (KT) group was

submitted to KT application (kinesio tex gold) to rectus femoris

(RF) VL and VM muscles in the dominant limb longitudinally fromthe proximal to the distal with 50 tension on the strip as sug-gested by Kase et al (2003) Kinesio taping was applied to the RF

from 10 cm below the anterior superior iliac spine to the upperedge of the patella The strip was 1047297xed on the VL muscle from thegreater trochanter to the lateral edge of the patella For the VMmuscle KT was applied to the middle third from the medial region

of the thigh to the medial edge of the patella This application wasperformed with subjects standing on one foot with the hip of thedominant limb at 0 and knee 1047298exed at 90 (Fig 1)

Nonelastic adhesive tape were applied to individuals from the

bandage group (Cremer

SA Brazil) also on RF VL and VM muscles

longitudinally from the proximal to the distal assuming the sameposition adopted in the KT group Following intervention subjectsunderwent a second evaluation identical to the 1047297rst

221 Assessment of lower limb functionWe conducted single and triple hop tests considered testing

measures of strength and functional stability (Keays et al 2000)

Initially subjects were familiarized with the tests which wererepeated once with the dominant limb They were instructed to hopwith no support from the contralateral limb as naturallyas possible

In the 1047297rst test (single hop) subjects were encouraged to hop asfar as possible on the dominant limb Halluxehallux distance was

the measure used In the second test (triple hop) they wereinstructed to perform three consecutive hops on the dominantlimb as far as possible concluding the hop on the same limb Thetotal distance of the three consecutive hops was recorded (Reid

et al 2007) Individuals wore no footwear and the distance wasmeasured with a metric tape Data were normalized as a function of the height of each subject (hop distanceheight 100) in order tocompare hop distances

Each hop was performed twice and the better result recorded

For the hop to be considered validsubjects had to remain in balancefor2 s aftercompleting it and the contralateral or upper limbs couldnot touch the ground If any of the above occurred the test was

repeated A 1-min rest period was allowed between each testThe use of two types of hops is justi1047297ed by the fact that they

incorporate a range of principles involved in controlling the

dynamic stability of the limb The single hop test differs from thetriple hop test in that it assesses different aspects related tosensory-motor control such as direction change speed accelera-tiondeceleration and rebound (Reid et al 2007)

222 Determination of one-footed static balanceA 40 cm 40 cm computerized baropodometer (Eclipse 3000

Guy-Capron SA Franccedila) was used to collect one-footed static

balance data Subjects were standing on the platform of the

Fig 1 Kinesio taping applied on quadriacuteceps muscle

CAA Lins et al Manual Therapy 18 (2013) 41e4542

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baropodometer with support on the dominant leg and knee 1047298exedat 20 as measured by a universal goniometer Individuals were

instructed to keep their head in the neutral position staring ata 1047297xed point spine erect with upper limbs supported on the hipThe non-dominant lower limb remained with the hip at 0 andknee 1047298exed at 90 Data acquisitiontime was 10 s using 200 frames

per second Subjects were assessed twice with the best resultconsidered for analysis (Ageberg et al 2005) A 1-min rest periodwas allowed between each test and the variables analyzed weredisplacement amplitude and displacement velocity of the pressure

center in the antero-posterior and latero-lateral directions

223 Assessment knee extensor torque

An isokinetic dynamometer (Biodex Multi-Joint System 3

Biodex Biomedical System Inc New York USA) calibrated weeklyaccording to manufacturerrsquos recommendations was used for thisassessment

Subjects were seated in the dynamometer chair with the thigh

of the non-dominant leg as well as the pelvic and thorax regionssecured by a belt The rotation axis of the dynamometer wasaligned with the lateral epicondyle of the femur The lever arm was

then adjusted in the distal region of the leg and 1047297xed 5 cm above

the medial malleolus of the dominant limb The gravity correctionfactor was applied by the dynamometer itself which is correctedfor the weight of the dominant leg relaxed at 30 of knee1047298exion All

adjustments were in accordance with Dvir recommendations(2004)

Dynamometric assessment was carried out using 1047297ve maximumconcentric and eccentric knee extensor contractions at 60s

Concentric assessment started with the knee 1047298exed at 90concluding with complete extension while eccentric evaluationconsidered knee 1047298exion between 30 and 90 Peak torquenormalized for body weight was recorded for both assessments and

expressed in percentage (PTBW 100)Verbal encouragement was given during the entire dynamo-

metric test as well as visual feedback on the computer monitor

Subjects were familiarized with the equipment through submax-imal contractions before each assessment

224 Electromyographic activity of the VLThe electromyographic signal was captured by a four-channel

signal conditioner module (EMG System do Brasil) with a 12-bits analogical-digital (AD) converter (CAD1236-60K) The devicehas a common-mode rejection ratio (CMRR) gt 80 Db withsampling frequency con1047297gured at 2000 Hz and the signal was

1047297ltered between 20 and 500 Hz Signalswere ampli1047297ed 1000 times20 times in the electrodes and 50 times in the converter The devicewas linked by a battery and connected to a laptop which receivedthe signal and stored it in a 1047297le EMGLab software (EMG System do

Brasil Brasil) was used for digital analysis of the signals

To capture electromyographic activity of the VL muscle the skinof subjects was shaved and cleaned with 70 alcohol We useda self-adhesive surface electrode (AgAgCl Noraxon USA) with

single differentials and inter-electrode distance of 2 cm positioned

on the VL muscle following SENIAM recommendations (Hermenset al 2000) The reference electrode (monopolar self-adhesive -Noraxon USA) in turn was placed on the tibial tubercle of thesame limb

Electromyographic activity of the VL muscle was recorded

simultaneously to knee extensor torque assessment Thus toanalyze root mean square (RMS) during concentric and eccentricevaluation we considered the mean electromyographic signal

recorded over 2 s of the highest torque of 1047297ve recorded on theisokinetic dynamometer with RMS normalized by maximumvoluntary isometric contraction (MVIC) according to DeLucarecommendations (1997)

225 Statistical analysisThe Statistical package SPSS 170 was utilized for all statistical

analyses Study power was calculated prospectively obtaininga type 1 error of 005 and type 2 error of 020 It was estimated that18 subjects would be needed in each group to detect a differencearound 10 with a power of 80 Values for knee extensor torque

before and immediately after intervention was utilized in order thiscalculus

The Kolmogorove

Smirnov (Ke

S) test was applied to check fornormality of data All variables exhibited normal distribution

Descriptive statistics were used to derive mean SD for all vari-ables Repeated measures one-way analysis of variance (ANOVA)was used to determine intergroup and intragroup differences

before and after interventions A 5 signi1047297cance level was used instatistical analysis

3 Results

31 Electromyographic activity of the VL and knee extensor torque

Electromyographic activity showed no signi1047297cant alteration

between initial and 1047297

nal assessments for concentric and eccentricRMS of the VL in any of the study groups Similarly no differenceswere recorded between initial and 1047297nal evaluations in the three

groups for the variable concentric and eccentric PTBW Moreoverwe observed no signi1047297cant difference between the three groups(Table 1)

32 Lower limb function and one-footed static balance

In relation to lower limb function Table 2 shows no signi1047297cantalterationin the singleand triple hop for the three groups In regardto one-footed static balance no signi1047297cant differences were foundbetween initial and 1047297nal assessments for the variables antero-

posterior amplitude latero-lateral amplitude antero-posterior

velocity and latero-lateral velocity in the three groups Nor wasany signi1047297cant difference detected between the three groups

(Table 2)

Table 1

Means and standarddeviations of the variables normalized RMS of theVL during concentric (RMSconc) and eccentric contraction (RMSexc)peak torque normalized for body

weight of concentric (PTBW conc) and eccentric assessment (PTBW exc) pre and post protocol application in the three groups (control nonelastic adhesive tape and KT)

Variables (n frac14 20) Control Nonelastic TAPE KT p

Mean SD Mean SD Mean SD

Pre Post Pre Post Pre Post

RMS conc () 1122 215 1108 257 104 171 1092 18 1013 218 1055 224 054

RMS ecc () 95 144 892 226 93 263 962 29 84 211 893 20 046

PTBW conc () 2182 575 2213 468 2206 505 2184 49 228 47 2334 452 086PTBW ecc () 3073 612 2863 494 310 452 298 48 3122 584 2977 616 061

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4 Discussion

In the present study no signi1047297cant differences in electromyo-graphic activity of the VL or peak concentric and eccentric knee

torque at 60s were recorded between groups and initial and 1047297nalassessment in any of the three groups

Briem et al (2011) assessed the effect of KT on the level of activation of the 1047297bularis longus muscle during a ldquosudden distur-

bancerdquo of the ankle in 51 healthy athletes 1047297nding no signi1047297cantalterations in this variable On the other hand Hsu et al (2009)reported that KT application provoked a signi1047297cant increase in

the electromyographic activity of the lower trapezius muscleduring shoulder abduction in 17 athletes underscoring that theyexhibited shoulder impingement syndrome

A number of theories attempt to explain how KT increases

neuromuscular recruitment including 1) the tactile stimulusprovided by KT activates cutaneous receptors facilitating motorunit activation 2) KT applied directly to the skin increases inter-stitial space enhancing blood 1047298ow and possibly favoring a rise in

muscle activation (Kase et al 2003)However in the present study no signi1047297cant alterations were

detected in the electromyographic activity of the VL muscle indi-

cating that tactile stimulation promoted by KT was not suf 1047297cient tochange recruitment of this muscle Corroborating the results of thepresent research experimental studies (Fu et al 2008 Vithoulkaet al 2010) have indicated that KT applied directly to the femoral

quadriceps has no immediate effect on peak torque in healthysubjects

We also observed no signi1047297cant alteration in single-hop andtriple-hop distance between the three groups Likewise the vari-

ables displacement amplitude and displacement velocity of theantero-posterior and latero-lateral pressure center showed nosigni1047297cant difference between groups and initial and 1047297nal values in

the three study groupsSimilar 1047297ndings were reported by Firth et al (2010) who found

no alteration in single-hop distance in either healthy subjects or

those with Achilles tendinopathy after KT application to the ankleHuang et al (2011) analyzed vertical hop height 30 min after KTapplication to the ankle in healthy subjects also 1047297nding nosigni1047297cant alteration With respect to static balance Aytar et al(2011) detected an improvement during KT application to the

femoral quadriceps in women with patellofemoral pain syndromeFew studies have assessed lower limb function and one-footedstatic balance after KT application hindering analysis of the real

effects of this technique on these variablesThe present study showed no signi1047297cant alteration in the single

and triple hop and one-footed static balance for the three groupsKT application only to femoral quadriceps muscles may not have

been responsible for altering these variables given that othermuscles and joints such as the hip and ankle are also involved in

these activities

Our 1047297ndings indicate that applying KT to femoral quadricepsdoes not alter neuromuscular performance or lower limb function

These 1047297ndings can be explained by a number of hypotheses Firstour sample was composed of healthy subjects which leads us tobelieve that KT applied to this population had no effect whatsoeversince they exhibited no neuromuscular dysfunctions that could beminimized by applying this technique

Second it is questionable whether applying a bandage to the

skin surface can alter the population of recruited motor unitsthereby enhancing neuromuscular performance Moreover thisstudy suggested that whether through nonelastic tape or KT

applied over the same area of skin did nothing to change thevariables explored

Finally the hypothesis that KT would produce an increaseinterstitial space enhancing blood 1047298ow and possibly favoring a rise

in muscle activation was not proven suggesting that the tensionproduced from the bandage is not suf 1047297cient to promote thesealterations

5 Conclusion

The results of the present study suggest that KT application to

RF VL and VM muscles is not capable of altering lower limb func-tion one-footed static balance peak knee extensor torque or acti-vation amplitude of the VL muscle in healthy women Moreoverthe application of nonelastic adhesive tape over the same area of

skin did not signi1047297cantly change these variables Finally it isimportant to remind that the1047297ndings presented here are limited toactive healthy women engaging in recreational physical activity Itis therefore suggested that further studies be conducted to assess

the acute and chronic effects of KT on the function balance andneuromuscular performance of patients under a rehabilitationprogram

References

Ageberg E Roberts D Holmstroumlm E Frideacuten T Balance in single-limb stance inpatients with anterior cruciate ligament injury relation to knee laxityproprioception muscle strength and subjective function The American Journalof Sports Medicine 2005331528e35

Aytar A Ozunlu N Surenkok O Baltaci G Oztop P Karatas M Initial effects of kinesio taping in patients with patellofemoral pain syndrome a random-ized double-blind study Isokinetics and Exercise Science 201119(2)135e42

Briem K Eythoumlrsdoumlttir H Magnuacutesdoacutettir RG Paacutelmarsson R Ruacutenarsdoumlttir TSveinsson H Effects of kinesio tape compared with nonelastic sports tape andthe untaped ankle during a sudden inversion perturbation in male athletes Journal Orthopaedic and Sports Physical Therapy 201141(5)328e35

Cools AM Witvrouw EE Danneels LA Cambier DC Does taping in1047298uence electro-myographic Muscle activity in the scapular rotators in healthy shouldersManual Therapy 20027(3)154e62

DeLuca CJ The use of surface electromyography in biomechanics Journal of AppliedBiomechanics 199713135e63

Dvir Z Isokinetics e muscle testing interpretation and clinical applications 2nd ed

UK Churchill Livingstone 2004

Table 2

Means and standard deviations of the variables single-hop and triple-hop distance (normalized for height) displacement amplitude and displacement velocity antero-

posterior (AP) and latero-lateral (LL) of the center of pressure before and after applying the protocol in the three groups (control nonelastic adhesive tape and KT)

Variables (n frac14 20) Control Nonelastic tape KT p

Mean SD Mean SD Mean SD

Pre Post Pre Post Pre Post

Single hop () 761 153 80 142 76 92 794 92 757 121 802 04 051

Triple hop () 2276 389 230 474 223 28 2287 312 2238 343 231 38 095Amplitude AP (mm) 156 61 153 51 166 76 198 82 183 81 20 62 011

Amplitude LL (mm) 121 47 134 57 107 55 127 63 134 44 117 47 056

Velocity AP (mms) 109 44 95 27 97 30 96 28 106 40 94 29 061

Velocity LL (mms) 58 27 53 22 55 34 56 35 61 23 51 21 089

CAA Lins et al Manual Therapy 18 (2013) 41e4544

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Firth BL Dingley P Davies ER Lewis JS Alexander CM The effect of kinesiotapeon function pain and motoneuronal excitability in healthy people andpeople with achilles tendinopathy Clinical Journal of Sport Medicine 201020416e21

Fu TC Wong A Pei YC Wu K Chou SW Lin YC Effect of kinesio taping on musclestrength in athletes -a pilot study Journal of Science and Medicine in Sport200811(2)198e201

Halseth T McChesney JW DeBeliso M Vaughn R Lien J The effects of kinesio tapingon proprioception at the ankle Journal of Sports Science and Medicine 200431e7

Hermens HJ Freriks B Disselhorst-Klug C Rau G Development of recommenda-tions for SEMG sensors and sensor placement procedures Journal of Electro-myography and Kinesiology 200010(5)361e74

Hsu YH Chen WY Lin HC Wang WTJ Shih YF The effects of taping on scapularkinematics and muscle performance in baseball players with shoulderimpingement syndrome Journal of Electromyography and Kinesiology 200919(6)1092e9

Huang CY Hsieh TH Lu SC Su FC Effect of the kinesio tape to muscle activity andvertical jump performance in healthy inactive people Biomedical EngineeringOnLine 20111070

Kase K Tatsuyuki H Tomoko O Development of kinesio tape Kinesio taping perfectmanual Kinesio Taping Association 1996

Kase k Wallis J Kase T Clinical therapeutic applications of the kinesio tapingmethod 2nd ed Kinesio Taping Association 2003

Keays SL Bullock-Saxon J Keays AC Strength and function before and after anteriorCruciate Ligament Reconstruction Clinical Orthopaedics and Related Research2000373174e83

Macgregor K Gerlach S Mellor R Hodges PW Cutaneous stimulation from patellatape causes a differential increase in vasti muscle activity in people withpatellofemoral pain Journal of Orthopaedic Research 200523351e8

Murray H Kinesio taping muscle strength and ROM after ACL repair JournalOrthopaedic and Sports Physical Therapy 2000301

Murray H Husk L Effects of kinesio taping on proprioception in the ankle JournalOrthopaedic and Sports Physical Therapy 200131A-37

Osterhues D The use of Kinesio Taping in the management of traumatic patelladislocation A case study Physiotherapy Theory and Practice 200420267e70

Pincivero DM Gandaio GB Ito Y Gender-speci1047297c knee extensor torque 1047298exor tor-que and muscle fatigue responses during maximal effort contractions Euro-pean Journal of Applied Physiology 200389134e41

Reid A Birmingham TB Stratford PW Alcock GK Gif 1047297n JR Hop testing providesa reliable and valid outcome measure during rehabilitation after anteriorcruciate ligament reconstruction Physical Therapy 200787337e49

Thelen MD Dauber JA Stoneman PD The clinical ef 1047297cacy of kinesio tape forshoulder pain a randomized double-Blinded clinical trial Journal Orthopaedicand Sports Physical Therapy 200838(7)389e95

Vithoulka I Beneka A Malliou P Aggelousis N Karatsolis K Diamantopoulos K Theeffects of kinesio-taping on quadriceps strength during isokinetic exercise inhealthy non athlete women Isokinetics and Exercise Science 2010181e6

CAA Lins et al Manual Therapy 18 (2013) 41e45 45

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4 Discussion

In the present study no signi1047297cant differences in electromyo-graphic activity of the VL or peak concentric and eccentric knee

torque at 60s were recorded between groups and initial and 1047297nalassessment in any of the three groups

Briem et al (2011) assessed the effect of KT on the level of activation of the 1047297bularis longus muscle during a ldquosudden distur-

bancerdquo of the ankle in 51 healthy athletes 1047297nding no signi1047297cantalterations in this variable On the other hand Hsu et al (2009)reported that KT application provoked a signi1047297cant increase in

the electromyographic activity of the lower trapezius muscleduring shoulder abduction in 17 athletes underscoring that theyexhibited shoulder impingement syndrome

A number of theories attempt to explain how KT increases

neuromuscular recruitment including 1) the tactile stimulusprovided by KT activates cutaneous receptors facilitating motorunit activation 2) KT applied directly to the skin increases inter-stitial space enhancing blood 1047298ow and possibly favoring a rise in

muscle activation (Kase et al 2003)However in the present study no signi1047297cant alterations were

detected in the electromyographic activity of the VL muscle indi-

cating that tactile stimulation promoted by KT was not suf 1047297cient tochange recruitment of this muscle Corroborating the results of thepresent research experimental studies (Fu et al 2008 Vithoulkaet al 2010) have indicated that KT applied directly to the femoral

quadriceps has no immediate effect on peak torque in healthysubjects

We also observed no signi1047297cant alteration in single-hop andtriple-hop distance between the three groups Likewise the vari-

ables displacement amplitude and displacement velocity of theantero-posterior and latero-lateral pressure center showed nosigni1047297cant difference between groups and initial and 1047297nal values in

the three study groupsSimilar 1047297ndings were reported by Firth et al (2010) who found

no alteration in single-hop distance in either healthy subjects or

those with Achilles tendinopathy after KT application to the ankleHuang et al (2011) analyzed vertical hop height 30 min after KTapplication to the ankle in healthy subjects also 1047297nding nosigni1047297cant alteration With respect to static balance Aytar et al(2011) detected an improvement during KT application to the

femoral quadriceps in women with patellofemoral pain syndromeFew studies have assessed lower limb function and one-footedstatic balance after KT application hindering analysis of the real

effects of this technique on these variablesThe present study showed no signi1047297cant alteration in the single

and triple hop and one-footed static balance for the three groupsKT application only to femoral quadriceps muscles may not have

been responsible for altering these variables given that othermuscles and joints such as the hip and ankle are also involved in

these activities

Our 1047297ndings indicate that applying KT to femoral quadricepsdoes not alter neuromuscular performance or lower limb function

These 1047297ndings can be explained by a number of hypotheses Firstour sample was composed of healthy subjects which leads us tobelieve that KT applied to this population had no effect whatsoeversince they exhibited no neuromuscular dysfunctions that could beminimized by applying this technique

Second it is questionable whether applying a bandage to the

skin surface can alter the population of recruited motor unitsthereby enhancing neuromuscular performance Moreover thisstudy suggested that whether through nonelastic tape or KT

applied over the same area of skin did nothing to change thevariables explored

Finally the hypothesis that KT would produce an increaseinterstitial space enhancing blood 1047298ow and possibly favoring a rise

in muscle activation was not proven suggesting that the tensionproduced from the bandage is not suf 1047297cient to promote thesealterations

5 Conclusion

The results of the present study suggest that KT application to

RF VL and VM muscles is not capable of altering lower limb func-tion one-footed static balance peak knee extensor torque or acti-vation amplitude of the VL muscle in healthy women Moreoverthe application of nonelastic adhesive tape over the same area of

skin did not signi1047297cantly change these variables Finally it isimportant to remind that the1047297ndings presented here are limited toactive healthy women engaging in recreational physical activity Itis therefore suggested that further studies be conducted to assess

the acute and chronic effects of KT on the function balance andneuromuscular performance of patients under a rehabilitationprogram

References

Ageberg E Roberts D Holmstroumlm E Frideacuten T Balance in single-limb stance inpatients with anterior cruciate ligament injury relation to knee laxityproprioception muscle strength and subjective function The American Journalof Sports Medicine 2005331528e35

Aytar A Ozunlu N Surenkok O Baltaci G Oztop P Karatas M Initial effects of kinesio taping in patients with patellofemoral pain syndrome a random-ized double-blind study Isokinetics and Exercise Science 201119(2)135e42

Briem K Eythoumlrsdoumlttir H Magnuacutesdoacutettir RG Paacutelmarsson R Ruacutenarsdoumlttir TSveinsson H Effects of kinesio tape compared with nonelastic sports tape andthe untaped ankle during a sudden inversion perturbation in male athletes Journal Orthopaedic and Sports Physical Therapy 201141(5)328e35

Cools AM Witvrouw EE Danneels LA Cambier DC Does taping in1047298uence electro-myographic Muscle activity in the scapular rotators in healthy shouldersManual Therapy 20027(3)154e62

DeLuca CJ The use of surface electromyography in biomechanics Journal of AppliedBiomechanics 199713135e63

Dvir Z Isokinetics e muscle testing interpretation and clinical applications 2nd ed

UK Churchill Livingstone 2004

Table 2

Means and standard deviations of the variables single-hop and triple-hop distance (normalized for height) displacement amplitude and displacement velocity antero-

posterior (AP) and latero-lateral (LL) of the center of pressure before and after applying the protocol in the three groups (control nonelastic adhesive tape and KT)

Variables (n frac14 20) Control Nonelastic tape KT p

Mean SD Mean SD Mean SD

Pre Post Pre Post Pre Post

Single hop () 761 153 80 142 76 92 794 92 757 121 802 04 051

Triple hop () 2276 389 230 474 223 28 2287 312 2238 343 231 38 095Amplitude AP (mm) 156 61 153 51 166 76 198 82 183 81 20 62 011

Amplitude LL (mm) 121 47 134 57 107 55 127 63 134 44 117 47 056

Velocity AP (mms) 109 44 95 27 97 30 96 28 106 40 94 29 061

Velocity LL (mms) 58 27 53 22 55 34 56 35 61 23 51 21 089

CAA Lins et al Manual Therapy 18 (2013) 41e4544

8122019 1-s20-S1356689X12001506-main

httpslidepdfcomreaderfull1-s20-s1356689x12001506-main 55

Firth BL Dingley P Davies ER Lewis JS Alexander CM The effect of kinesiotapeon function pain and motoneuronal excitability in healthy people andpeople with achilles tendinopathy Clinical Journal of Sport Medicine 201020416e21

Fu TC Wong A Pei YC Wu K Chou SW Lin YC Effect of kinesio taping on musclestrength in athletes -a pilot study Journal of Science and Medicine in Sport200811(2)198e201

Halseth T McChesney JW DeBeliso M Vaughn R Lien J The effects of kinesio tapingon proprioception at the ankle Journal of Sports Science and Medicine 200431e7

Hermens HJ Freriks B Disselhorst-Klug C Rau G Development of recommenda-tions for SEMG sensors and sensor placement procedures Journal of Electro-myography and Kinesiology 200010(5)361e74

Hsu YH Chen WY Lin HC Wang WTJ Shih YF The effects of taping on scapularkinematics and muscle performance in baseball players with shoulderimpingement syndrome Journal of Electromyography and Kinesiology 200919(6)1092e9

Huang CY Hsieh TH Lu SC Su FC Effect of the kinesio tape to muscle activity andvertical jump performance in healthy inactive people Biomedical EngineeringOnLine 20111070

Kase K Tatsuyuki H Tomoko O Development of kinesio tape Kinesio taping perfectmanual Kinesio Taping Association 1996

Kase k Wallis J Kase T Clinical therapeutic applications of the kinesio tapingmethod 2nd ed Kinesio Taping Association 2003

Keays SL Bullock-Saxon J Keays AC Strength and function before and after anteriorCruciate Ligament Reconstruction Clinical Orthopaedics and Related Research2000373174e83

Macgregor K Gerlach S Mellor R Hodges PW Cutaneous stimulation from patellatape causes a differential increase in vasti muscle activity in people withpatellofemoral pain Journal of Orthopaedic Research 200523351e8

Murray H Kinesio taping muscle strength and ROM after ACL repair JournalOrthopaedic and Sports Physical Therapy 2000301

Murray H Husk L Effects of kinesio taping on proprioception in the ankle JournalOrthopaedic and Sports Physical Therapy 200131A-37

Osterhues D The use of Kinesio Taping in the management of traumatic patelladislocation A case study Physiotherapy Theory and Practice 200420267e70

Pincivero DM Gandaio GB Ito Y Gender-speci1047297c knee extensor torque 1047298exor tor-que and muscle fatigue responses during maximal effort contractions Euro-pean Journal of Applied Physiology 200389134e41

Reid A Birmingham TB Stratford PW Alcock GK Gif 1047297n JR Hop testing providesa reliable and valid outcome measure during rehabilitation after anteriorcruciate ligament reconstruction Physical Therapy 200787337e49

Thelen MD Dauber JA Stoneman PD The clinical ef 1047297cacy of kinesio tape forshoulder pain a randomized double-Blinded clinical trial Journal Orthopaedicand Sports Physical Therapy 200838(7)389e95

Vithoulka I Beneka A Malliou P Aggelousis N Karatsolis K Diamantopoulos K Theeffects of kinesio-taping on quadriceps strength during isokinetic exercise inhealthy non athlete women Isokinetics and Exercise Science 2010181e6

CAA Lins et al Manual Therapy 18 (2013) 41e45 45

8122019 1-s20-S1356689X12001506-main

httpslidepdfcomreaderfull1-s20-s1356689x12001506-main 55

Firth BL Dingley P Davies ER Lewis JS Alexander CM The effect of kinesiotapeon function pain and motoneuronal excitability in healthy people andpeople with achilles tendinopathy Clinical Journal of Sport Medicine 201020416e21

Fu TC Wong A Pei YC Wu K Chou SW Lin YC Effect of kinesio taping on musclestrength in athletes -a pilot study Journal of Science and Medicine in Sport200811(2)198e201

Halseth T McChesney JW DeBeliso M Vaughn R Lien J The effects of kinesio tapingon proprioception at the ankle Journal of Sports Science and Medicine 200431e7

Hermens HJ Freriks B Disselhorst-Klug C Rau G Development of recommenda-tions for SEMG sensors and sensor placement procedures Journal of Electro-myography and Kinesiology 200010(5)361e74

Hsu YH Chen WY Lin HC Wang WTJ Shih YF The effects of taping on scapularkinematics and muscle performance in baseball players with shoulderimpingement syndrome Journal of Electromyography and Kinesiology 200919(6)1092e9

Huang CY Hsieh TH Lu SC Su FC Effect of the kinesio tape to muscle activity andvertical jump performance in healthy inactive people Biomedical EngineeringOnLine 20111070

Kase K Tatsuyuki H Tomoko O Development of kinesio tape Kinesio taping perfectmanual Kinesio Taping Association 1996

Kase k Wallis J Kase T Clinical therapeutic applications of the kinesio tapingmethod 2nd ed Kinesio Taping Association 2003

Keays SL Bullock-Saxon J Keays AC Strength and function before and after anteriorCruciate Ligament Reconstruction Clinical Orthopaedics and Related Research2000373174e83

Macgregor K Gerlach S Mellor R Hodges PW Cutaneous stimulation from patellatape causes a differential increase in vasti muscle activity in people withpatellofemoral pain Journal of Orthopaedic Research 200523351e8

Murray H Kinesio taping muscle strength and ROM after ACL repair JournalOrthopaedic and Sports Physical Therapy 2000301

Murray H Husk L Effects of kinesio taping on proprioception in the ankle JournalOrthopaedic and Sports Physical Therapy 200131A-37

Osterhues D The use of Kinesio Taping in the management of traumatic patelladislocation A case study Physiotherapy Theory and Practice 200420267e70

Pincivero DM Gandaio GB Ito Y Gender-speci1047297c knee extensor torque 1047298exor tor-que and muscle fatigue responses during maximal effort contractions Euro-pean Journal of Applied Physiology 200389134e41

Reid A Birmingham TB Stratford PW Alcock GK Gif 1047297n JR Hop testing providesa reliable and valid outcome measure during rehabilitation after anteriorcruciate ligament reconstruction Physical Therapy 200787337e49

Thelen MD Dauber JA Stoneman PD The clinical ef 1047297cacy of kinesio tape forshoulder pain a randomized double-Blinded clinical trial Journal Orthopaedicand Sports Physical Therapy 200838(7)389e95

Vithoulka I Beneka A Malliou P Aggelousis N Karatsolis K Diamantopoulos K Theeffects of kinesio-taping on quadriceps strength during isokinetic exercise inhealthy non athlete women Isokinetics and Exercise Science 2010181e6

CAA Lins et al Manual Therapy 18 (2013) 41e45 45