Kinesio Taping looks so cool, but is it effective?

I imagine that you have seen regular people and athletes with colourful tape stuck to their skin. It is called Kinesio Tape. This therapeutic tape was developed by a Japanese chiropractor named Kenso Kaze. As I am a curious researcher and clinician, the colourful tape attracted my attention, and I found out that Kinesio Tape is supposed to achieve nearly anything, from treating haematomas to back pain, from enhancing performance in athletes to improving motor control in kids with Down Syndrome, and recently I found out that Kinesio taping can even improve performance in horses and flamingos! How cool is that? Obviously this seems too good to be true. How can a simple elastic tape improve different symptoms for a range of conditions?

grey Kinesio Taping looks so cool, but is it effective?

Mario Balotelli and kinesio tape

According to the creators of this technique, the Kinesio Tape should be applied in a way that lifts the skin. This would improve blood circulation, reduce pain and change activation of muscles (you can see this official kinesiotaping video for more details). To the best of my knowledge, none of these ideas has ever been tested and published in peer-reviewed journals. “But who cares? Patients love it, and at the end of the day, that is what matters, right?” (I heard this said by a famous American Kinesio Taping guru earlier this year).

Interestingly, I found many randomised controlled trials, and decided to do a systematic review on the effects of Kinesio Taping in patients with musculoskeletal conditions[1]. We identified twelve randomised controlled trials (pooled sample: 495 patients) with a range of conditions (shoulder pain, knee pain, back pain, neck pain, plantar fasciitis and mixed musculoskeletal conditions). These trials used different control groups, such as sham tape, manual therapy, electro-physical agents and exercise. All the eligible trials had small samples and the risk of bias of these trials was, on average, moderate. The results were very consistent: Kinesio Taping was no better than any control group for all conditions tested (we were unable to perform a meta-analysis due to the large clinical heterogeneity). There were very few comparisons that suggested that Kinesio Taping was better than the control groups, and their effect sizes did not reach clinical significance. One incidental finding from our review was that, although the results of these trials were not positive at all, many authors claimed that Kinesio Taping can be used in clinical practice – a claim which is very misleading for clinicians and patients. We concluded that the current evidence does not support the use of this intervention in clinical practice.

In order to be fair to this intervention we stated that larger trials are still needed. On the other hand, to be fair to patients and clinicians, we also think that this is a good time to stop selling this intervention as very effective and to invest time and resources in good studies. Our research team has already finished one large trial in patients with back pain (which has just been published and the results were consistent with the review – free text here)[2,3] and we have just finished recruitment for another trial[4], also in patients with back pain. (All texts are open access and free to read).

About Leo Costa

grey Kinesio Taping looks so cool, but is it effective? Leo Costa tried to be a professional tennis player unsuccessfully. He is a physiotherapist and Associate Professor at Universidade Cidade de São Paulo in Brazil. He did his PhD in Australia with Professor Chris Maher at the University of Sydney. His research interests are randomised controlled trials in patients with back pain, systematic reviews and research methodology in general. He also sees patients twice a week. Leo also is one of the bloggers of The ICECReam.

References

[1] Parreira, P., Costa, L., Hespanhol Junior, L., Lopes, A., & Costa, L. (2014). Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review Journal of Physiotherapy, 60 (1), 31-39 DOI: 10.1016/j.jphys.2013.12.00 Free text here

[2] Parreira, P., Costa, L., Takahashi, R., Junior, L., Junior, M., Silva, T., & Costa, L. (2014). Kinesio Taping to generate skin convolutions is not better than sham taping for people with chronic non-specific low back pain: a randomised trial Journal of Physiotherapy, 60 (2) DOI: 10.1016/j.jphys.2014.05.003 Free text here

[3] Silva Parreira, P., Menezes Costa, L., Takahashi, R., Hespanhol Junior, L., Motta Silva, T., da Luz Junior, M., & Pena Costa, L. (2013). Do convolutions in Kinesio Taping matter? Comparison of two Kinesio Taping approaches in patients with chronic non-specific low back pain: protocol of a randomised trial Journal of Physiotherapy, 59 (1) DOI: 10.1016/S1836-9553(13)70147-4. Free text here

[4] Added, M., Costa, L., Fukuda, T., de Freitas, D., Salomão, E., Monteiro, R., & Costa, L. (2013). Efficacy of adding the kinesio taping method to guideline-endorsed conventional physiotherapy in patients with chronic nonspecific low back pain: a randomised controlled trial BMC Musculoskeletal Disorders, 14 (1) DOI: 10.1186/1471-2474-14-301 Free text here

Comments

  1. I’ve been using this tape for more than 10 years now and I find it effective if you combined it with other treatment approach. If you just use it solely to improve a dysfunction, I don’t think it will be that effective. To discredit it’s effectivity is not right. Just any other techniques if the Clinician knows how, where, when to apply it or utilize it , that’s when you will get the best result that you want. Kinesio Tape is proven to be effective even probably before you started your practice as a Physiotherapist.

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  2. Wow, that was a good Ad Hominem, Neitzy.

    On the other hand, I’ven using it for more than 10 years and done a review 2 years ago of all trials and, well, neither evidence or practice support this intervention (unless you make profit selling it to young students/practitioners).

    PS: I’m tired of listening to the same statements year after year. It was cool once, but that’s all.

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  3. Neitzy do you have references for your claim “it’s proven”?

    Thanks Leo for the clear message.

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  4. Awesome work, Leo. I wrote a similar article on KT last month, including an online interview with Professor John Brewer, Director of Sport at the University of Bedfordshire in the U.K. and a video about it from a recording at Texas Lutheran University. We draw pretty much similar conclusions. I am interested in larger studies, but based on past studies and systematic reviews, what are the chances that the results will yield similar answers?

    Thought you might be interested.

    Neitzy’s comment would be an example of an anecdotal fallacy and argument from authority.

    http://guardianlv.com/2014/05/kinesio-tape-fact-or-fad-video/

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  5. Hi Neitzy,

    Interesting thought. When you said “if you combined it with other treatment approach. If you just use it solely to improve a dysfunction, I don’t think it will be that effective. ” So how you know the treatment effectiveness comes from the tape or other intervention….?

    And certainly you need to provide any evidence for your claim.

    Regards,

    Hsieh-hsing

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  6. Ljiljana says:

    Awesome thinking and also very brave! In developing countries every kind of tapes are like magic stick and financial impact of that unproven fact is obvious.Good job colleague,good job!

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  7. Esther de Ru says:

    dear Leo and other colleagues,

    K. Kase’s original ideas as to how tape works were:
    * skin lifting effect and convolutions creating more ‘space’ and therefor lymph and bloodflow
    * and the most ‘researched’ the Origin-Insertion ‘rule’. Taping from either one to the other would either facilitate or inhibit muscles.
    His hypotheses that the tape worked because of the stimulation of proprioception is the only one that still holds today.

    You stated: “To the best of my knowledge, none of these ideas has ever been tested and published in peer-reviewed journals. “But who cares?”.

    I am happy to inform you that research into the above named effects have been carried out.
    Research: Direction tape (origin-insertion or visa versa):
    1. Yuan-Yuan Lee et al (2012) The effect of applied direction of kinesio taping in ankle muscle strength and flexibility. 30th Ann. Conf.Biom.I.Sports.Melbourne 2012 p.140-143
    2. Luque Saurez A et al (2013) Short term effects of kinesiotaping on acromio-humeral distance in asymptomatic subjects: a randomised controlled trail. http://dx.doi.org/10.10.16/j.math.2013.06.002
    In Both studies no significant differences were found relating direction of pull to effect. This ‘O-I rule’ is simply not true.

    Research Trail into Convolutions has just been published in Journal of Physiotherapy Volume 60, Issue 1 , Pages 31-39, March 2014
    Carmo de Silva Parreira et al 14) Kinesio Taping to generate skin convolutions is not better than sham taping for people with chronic non-specific low back pain: a randomised trial. http://www.journalofphysiotherapy.com/article/S1836-9553(14)00036-8/abstract
    Results: placebo tape works just as well as tape with convolutions.

    I am hoping to have my letter to the editor regarding the Systematic Review by: Parreira, P., Costa, L., Hespanhol Junior, L., Lopes, A., & Costa, L. (2014). Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review Journal of Physiotherapy, 60 (1), 31-39 DOI: 10.1016/j.jphys.2013.12.00, will be published soon.
    I do not agree with the conclusions and outcome and react in detail. I have been informed that the authors have been asked for a reaction.

    This tape works but not because of the original ‘ideas’.
    It works alone, without any other modalities as I have been able to show in the case of the s-tape.
    It works in conjunction with other treatment options.

    Hope to liven this discussion in detail soon.

    Esther

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  8. Esther de Ru says:

    :) Just realized that Leo is actually one of the authors of the Systematic Review I am talking about. :)
    Looking forward to the responses. Esther

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  9. June Trenholm says:

    Thank you for doing this study. I have used taping for feedback and support of structures and considered the kinesiotaping to fall into the “for gentle feedback” category due to its stretchiness. To me there is a difference between the Kinsesiotaping not having an advantage over other taping or interventions and not recommending its use because it is ineffective. Can you clarify your thoughts for me? I’ll avoid the obvious comment on whether or not sham taping is really sham. I haven’t been on a K-tape course so I’m not coming from that angle.

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  10. Hey, if you reckon the kinesio tape is good, I’ve got a pile of special rubber bands you wear on your wrist…

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  11. If you need articles to support the effectivity of Kinesio taping, there are plenty out there and the above article is one of them. However, what’s your intention? If you want to disapprove it’s effectivity , you can read research/articles against it. However, if you’re pro-Kinesio taping, you can find articles as well. Simple, it’s a personal choice! I personally experienced the benefits and effectivity of it, so that’s the reason why I am standing for it. It’s a personal choice and preference! You don’t need a research all the time to prove something to be effective.

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  12. Leo Costa says:

    Hi Esther! Thank you for your comments! We indeed received your letter to the editor and we have already responded. For obvious copyright reasons, I cannot replicate the response here (as the both letter were not published yet). It will be published in the Journal of Physiotherapy in September. Just one point: you present the “evidence” of KT mechanisms by presenting congress presentations (that are not 100% peer reviewed like in peer reviewed journals) and presented a trial in normal subjects (which cannot be generalisable for patients with MSK conditions). Therefore, I can still support the argument that this intervention has never been properly investigated. It is great to discuss ideas with you! Leo

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  13. Esther de Ru says:

    Hi Leo,
    As far as I am concerned I would like research done into why the tape works, I am presuming it is the ‘touch aspect’, both sensory and mechanically. Even though it is not my area of expertise I would not be surprised if changes in body ‘energy’ (through meridians) are also in part responsible for the percieved results. Have just presented a poster at the SOSORT Meeting on elastic therapeutic tape use as a sensory stimulus, The ‘hands-on’ stimulus given in both Schroth and SEAS methods (for positioning and breathing) can be ‘taken home using a very small strips’ and this has been found to be very effective (patient experience). The poster can be downloaded on researchgate for those you have access.
    Hi June,
    I have been looking into the placebo tapes for a number of years. I find I can often reason as to why the placebo works just as well… interesting to have a deeper look into. Am currently using the placebo tape used in ‘The effects of kinesio Taping in musclar endurance of deep neck flexors for subjects with forward head posture: a pilot study’ by Chia-Ning Chuid and Lan-Yuen Guo from Taiwan. Was interested in this particular placebo tape as it was found to work better than the Kiniseo tape. Looks promising in the clinic but a little too early for conclusions yet.

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  14. Luke Parkitny says:

    Just a small observation, but could it be the “other treatment approach” that is the active therapy?

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  15. Luke Parkitny says:

    Esther

    When you use “body energy” do you mean metabolism? The capacity for physical activity? Unfortunately this word has become a catch all in many non specific ideas – the words “quantum physics” are a bigger culprit. However, each has a very clear definition.
    As for a very funny example of why we don’t purely rely on people’s experience to an uncontrolled experiment, there is a fantastic episode of penn and teller’s bull**** on “bottled water” that’s well-worth checking out.

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  16. Esther de Ru says:

    Hi Luke,
    I mean the energy as spoken of by acupuncturists and others that use the principles of ‘Eastern’ Medicine. This energy is called ‘Prana’, ‘Chetana’ or ‘Qi’ (Chi). Qi is composed of two kinds of forces: ‘Yin’ and ‘Yang’.
    There is a whole group of health professionals taping on meridians and acupuncture points in Germany and other European countries. http://www.acuprime.com/en/products/acutape/acu-tape. On acu-taping, no research found, only one book:
    Acupressure Taping: The Practice of Acutaping for Chronic Pain and Injuries by Hans-Ulrich Hecker M.D. (Amazon)

    I have read about Spiral taping used in Brasil. In this method the direction of the tape is of importance (direction Chi). It would be great if Leo could tell us more about this manner of taping. http://www.grupooriental.com.br/spiral/spiral.php
    I have only been able to find one case study on spiral taping so far.
    Chaegil L et al (2013) The effect of kinesio taping and spiral taping on menstrual pain and premenstrual syndrome. J.Physc.Ther.Sc.25:761-764,2013

    I have seen some really good results come of using tape on meridians especially with scar treatment, AND I have seen the different effects of taping in one diagonal or the other… really interesting…

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  17. Wow. The big barrel of medicalised BS just never empties. I kept objective until we hit meridians! The ‘Bumunculus’ proved that for me – no matter how implausible – folks will believe just about anything.
    http://www.bmj.com/content/341/bmj.c6979.full?sid=399ff70a-c25d-45f9-a875-67d8f83b4ddf
    Kind thoughts,
    Steve

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  18. Esther de Ru says:

    Hi Steve, I try to stay objective and open-minded for all possibilities there are to treat my patients.
    Who are we to judge and call what others do ‘cows manure’? Who says we, Western Medicine trained folks are right all the time?
    I have been around long enough to be impressed by what can be done in this area. I have seen reactions in patients that cannot be ‘explained’ and am forever open to new ideas. I sincerely hope we remain respectful of others and are willing to lend an ear to those who think differently. I am sure it will be to our benefit.

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  19. John Ware, PT says:

    I don’t see the article by Thedon et al (2011) often cited when taping is discussed. The findings are very interesting:
    “Abstract
    It has been shown that the ability of humans to maintain a quiet standing posture is degraded after fatigue of the muscles at the ankle. Yet, it has also been shown that skin stimulation at the ankle could improve postural performance. In the present study, we addressed the issue of the interaction of these two effects. Subjects were tested with the eyes closed in four conditions of quiet stance: with or without skin stimulation and before and after a fatigue protocol. The skin was stimulated with a piece of medical adhesive tape on the Achilles’ tendon. The fatigue protocol consisted of multiple sets of ankle plantar flexion of both legs on stool. Without fatigue, we did not observe a significant effect of the tape. With fatigue, subjects decreased their postural performance significantly, but this effect was cancelled out when a piece of tape was glued on the Achilles’ tendon. This indicated that the beneficial effect of the tape was unveiled by the degraded postural performance after fatigue. We conclude that, when the muscular sensory input flow normally relevant for the postural system is impaired due to fatigue, the weight of cutaneous information increases for the successful representation of movements in space to adjust postural control.”

    To the extent that a persistent pain problem might impair the patient’s position sense and that tape might help to improve kinesthesia via skin mechanoreceptors, I think it could be helpful in disrupting the pain neurotag. There’s little doubt in my mind that the effect is at the level of the skin.

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  20. Esther de Ru says:

    Hi John,
    I cite this article along with the following articles and presentations:
    *Mori A & Takasaki M (2005) Activation of cerebral cortex in various regions after using kinesio tape. Kinesio Symposium 20,2005 pp141-144
    * Yuh-Hwan Liu et al (2007) Motion tracking on elbow tissue from ultrasonic image sequence for patients with lateral epicondylitis. Conf.IEEE EMBS THB 04.06 95-98
    *Callaghan M J & Selfe J (2011) Patellar taping for patellofemoral pain syndrome in adults Cochrane Intervention Review 1-11
    *Callaghan M J et al (2002) The effects of patellar taping on joint proprioception. J.of.athletic training 2002;37(1)19-24
    * Callaghan (2011) What does proprioception testing tell us about patellofemoral pain? Man Ther. 2011 Feb;16(1):46-7
    *Konishi Y (2012) Tactile stimulation with Kinesiology tape alleviates muscle weakness attributable to attenuation of I1 afferents. JSciMedSport 2012 juni 6 PMID:22682093
    *Sea-Hyun Bae et al (2013) The effect of kInesio taping on potential in chronic low back pain patients anticipatory postural control and cerebral cortex J.Phy.Ther.Sci25:1367-1371,2013
    *Presentation at WCPT Congres Amsterdam on skin movement of Fukui T. (2011) Physiological skin movement using Vicon Motion Systems 64 markers trunk (books: Skin Physiology 2011 and on Skin Taping 2014).

    Am very interested to hear if you know of any others that might fit in this list.

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  21. So taping helps heighten awareness of skin sensation by various mechanisms of re-assurance and distraction; increased bandwith taken by proprioception – less for pain awareness, not to mention all the wonders of therapist interaction maximising down regulation; belief, hope and trust. All very good for the present moment but debateable about the medium to long term effectiveness of those strategies unless the down regulation gets embedded in the neurology by plasticity we just have a new and different safety seeking behaviour. I note a hell of a lot of confounding variables for researchers to wheedle out too. Maybe Menke can turn his statistical approaches to this work in time.
    But sticking the stuff to ‘meridians’ – is that really necessary? Is that not gilding the lily, telling the emporer that his suit is made from the very finest cloth of gold?
    It also undermines a good argument for the effects of heightened sensory awareness and the interactions of that with a belief structure and the alteration of interoception and the changes of behaviour that ensue by associating it with such non-science. Put it on their lay lines too while you are at it. And their chakras. Hey why not tape their astral energy field with astral tape. When we descend into the barrel who knows when to stop.
    Sorry to go off on one but I really like coming to this site to read neuroscientifically aware discussion of what has until recently been ‘manual therapy’ but is now stepping out of its chrysalis and becoming something new and hopefully scientifically reasonable and rigorous.
    Kind thoughts,
    Steve

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  22. Esther de Ru says:

    dear Steve,

    When speaking of taping meridians, I merely said that there are many people doing so. There are people taping MELS (mayor elasticity lines of skin) and Chachras as well :). I find that fascinating even though I do not understand it all.
    Like you I am also here to discuss with colleagues in my ‘quest’ to find out why this tape works. I have mentioned the s-tape earlier. This little tape, applied under the chin can influence swallow frequency (in normals and patients) and motor performance thereby decreasing drooling in nearly 25% of the cases I have tried it on. No other therapy is given. The tape was developed with clinical reasoning and I have written about the long-term effects (6 months) in my book. I am trying to collect data on the longer-term effects and now have 6 people using it successfully for more than a year. As part of my patient population has serious cognitive and developmental delays my rol as a therapist is not of importance, and any placebo effect can be ruled out. As you can imagine, skin care and contact allergy prevention is my main concern now.

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  23. Esther,

    I have a few points and a question about your comments.

    1) If we are to accept the theory of “energy”/”meridians” we need to essentially abandon our current scientific knowledge and accept a very implausible hypothesis. There is no credible evidence that meridians or energy fields (which make no sense, http://skeptoid.com/episodes/4411) are real and there is no logical argument that they are likely to exists. There are several much more likely explanations for the observed response to tape. To even bring up energy/meridians makes me question your understanding of the human body, science and critical thinking. Keeping an open mind does not mean we believe or give equal weight to everything we hear. It means we are willing to examine the evidence and come to the most logical conclusion. When new evidence is available an open minded person is willing reassess their previous conclusion. Coming to the conclusion that energy fields and meridians are not real, is a logical position based on the evidence and is not closed minded.

    2) “Like you I am also here to discuss with colleagues in my ‘quest’ to find out why this tape works.” Shouldn’t we also (or maybe even first) be trying to find out if the tape works.

    3) “As part of my patient population has serious cognitive and developmental delays my rol as a therapist is not of importance, and any placebo effect can be ruled out.”
    I don’t get this. So you are claiming that your role as a therapist (not sure what you mean by “your role”) has no impact on patients with serious cognitive delays and that placebo effects don’t happen in patients with cognitive delays? I don’t know the data on this but would be interested in what it says. Also, what about your impact on family members and other caregivers? Couldn’t that have an effect on the perceived effectiveness of an intervention?

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  24. Esther de Ru says:

    Hello Adam,

    I have stirred things up I see :)

    First: evidence based medicine is under severe scrutiny and has been for a while:
    * Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ 2003;327:1459 Gordon C S Smith, & Jill P Pell, consultant Cambridge University, Glasgow. I am presuming you know this one.
    *Tonelli Mark. R. (2006) Integrating evidence into clinical practice: an alternative to evidence based approaches. Journal of Evaluation in Clinical Practice 12:3;248-256 Clinical research is only 1 of the 5 main topics and according to Tonelli “No single topic has a general priority over any other and the relative importance of a topic will depend upon the circumstances of the particular case”.
    * An now we have the essay on BMJ : Evidence based medicine: a movement in crisis? by Trisha Greenhalgh, Dean for research impact, Jeremy Howick, senior research fellow, Neal Maskrey, professor of evidence informed decision making for the Evidence Based Medicine Renaissance Group. http://www.bmj.com/content/348/bmj.g3725 This group has some welfounded criticisms and recommendations.
    According to the authors:
    I. Crisis in evidence based medicine?
    The evidence based “quality mark” has been misappropriated by vested interests
    The volume of evidence, especially clinical guidelines, has become unmanageable
    Statistically significant benefits may be marginal in clinical practice
    Inflexible rules and technology driven prompts may produce care that is management driven rather than patient centred
    Evidence based guidelines often map poorly to complex multimorbidity
    II. What is Real evidence based medicine?:
    Makes the ethical care of the patient its top priority
    Demands individualised evidence in a format that clinicians and patients can understand
    Is characterised by expert judgment rather than mechanical rule following
    Shares decisions with patients through meaningful conversations
    Builds on a strong clinician-patient relationship and the human aspects of care
    Applies these principles at community level for evidence based public health
    III. Campaigns aligned with real evidence based medicine that the group recommends are:
    1. Too much medicine: A rapidly growing movement, led jointly by clinicians, academics and patients, aims to reduce harm from overdiagnosis, overscreening, and too much medication. http://www.preventingoverdiagnosis.net
    2. All trials : an international initiative to ensure that all clinical trials are registered at inception and no findings are withheld from publication http://www.alltrials.net
    3. Improving publishing standards. A campaign by the International Committee of Medical Journal Editors to improve the quality and transparency of medical publishing www.icmje.org/urm_main.html
    In the Lancet: Reducing waste and increasing value in medical research (www.thelancet.com/series/research) highlighting research that:
    addresses the wrong questions
    uses inappropriate study designs
    is weighed down by bureaucracy,
    or is so badly or inaccessibly reported that practitioners and policymakers simply cannot apply it.

    Second:
    - Most research is still only performed in the English language only… The Systematic review of Parreira, P., Costa, L., Hespanhol Junior, L., Lopes, A., & Costa, L. (2014). Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review Journal of Physiotherapy, 60 (1), 31-39 mentioned by Leo here above is one of the only exceptions.
    - I know of a number of Student supervisors that have little knowledge of subject (taping in this case) and ‘supervise’ students (Thesis) nevertheless
    - clinicians are not communicating their results
    - clinicians and researchers are not communicating sufficiently and/or speak in different tongues :)

    So you see, I am a little critical of what people mean by evidence :)

    Back to you question: regarding my rol as a therapist…”I don’t get this. So you are claiming that your role as a therapist (not sure what you mean by “your role”) has no impact on patients with serious cognitive delays and that placebo effects don’t happen in patients with cognitive delays?”

    Have you worked with this patient group? I ask because of course we have impact, as soon as we touch.
    I am a paediatric physiotherapist and have applied tape to children and adults of various ages. When applying I have not ‘promoted’ the tape, I am not telling the patient what my goal is. I am observing (assessing in some way) and in many cases, when applying tape to any of these patients I do only that, no more. If after applying the tape, my patients motor behaviour changes and he/she can do something, they couldn’t do before, then my ‘tape goal’ has been achieved.

    In a number of these cases I am quite sure there will be no placebo effect whatsoever.
    When we look at the definition of placebo effect online there are various descriptions: what they have in commen is:
    - a fake treatment
    - expectation plays a potent role in the placebo effect.
    - a positive therapeutic effect claimed by a patient after receiving a placebo believed by him to be an active drug/placebo effect
    the change is usually beneficial and is assumed result from the person’s faith in the treatment or preconceptions about what the experimental drug was supposed to do.

    In babies and toddlers and in the patient group spoken of earlier, there cannot really be a placebo effect.
    I am sorry I cannot give you any data on this as I have no idea if there is but ask anyone working with these patient groups and I think you will get a similar answer. Let call this the expert opinion :)

    Your question regarding does it work? ‘Shouldn’t we also (or maybe even first) be trying to find out if the tape works’.
    As said above, I have seen it work so many times i do not need to find that out any more. It works, not always but it works. I have seen this too many a time and am this enthusiastic about the tape that I am going to the trouble of trying to find out more.
    As far as I am concerned it is one of the best ‘new’ little tools that I now have to my disposal… and believe me, I have a large toolbox :)

    Hoping others can help me with more research and literature into why we think the tape works.

    [Reply]

  25. Adam Rufa says:

    Thanks for the response Esther. EBP should be under severe scrutiny as should every model we use. Without scrutiny there is no growth. However, to return to a time where we make judgments about cause an effect based on experience is a move in the wrong direction. Despite all attempts to institute controls and safe guards science is messy however clinical experience has none of the controls science has, making it even messier.

    The BMJ parachute commentary you cited is a great example of why we need to consider prior plausibility (a limitation of EBP). There is good basic science evidence which justifies the use of parachutes and provides a science based explanation for the observed effects. If someone were to claim that invisible flying turtles where the cause of the reduced velocity we would rightfully be skeptical. The use of energy fields and meridians as an explanation for anything in the medical world is annalogos to the invisible flying turtle explanation.

    I do not treat young or older patients with cognitive difficulties and have not thought much about the potential for placebo in that group. However, if the measures you are using are fairly subjective don ‘t think your expectations and the expectation of caregivers may be affected the results?

    [Reply]

  26. Esther de Ru says:

    Adam,
    We are not going back to a period based on experience, I think you need to read the papers (Tonellie and BMJ paper) first.
    We are in a period of growth and I do not believe that turtles can fly.

    It is a pity that you chose to dig into one (well 2) subject only.
    - I suggest on Meridians… you could start another discussion
    - on your question ‘However, if the measures you are using are fairly subjective don ‘t think your expectations and the expectation of caregivers may be affected the results? Again I understand that you do not know these patient groups. The measures I use can be observation (based on 37 yrs of experience and training and yes subjective) and it can be a standardized test such as the GMFM, AIMS, Bayleys etc etc. I Always test, tape and retest in some way.
    Regarding expectations: my own thoughts into a new possibility will not be different to the thoughts I had about the possibilities I had before regarding any other modalitiy. My personallity will be of importance in my treatment. It is always positive and professional, no more…
    Regarding the patients/ or parents expectations…they should be very comfortable with me as a professional… their expectations have nothing to do with what I do, just with how I present.

    As far as I am concerned we are completely off the original question. I wonder if you do treat patients?
    I would like to get back to what the important issues on this question were.
    1. John and others…please do you know of any more papers or presentations (also in other languages) on HOW authors think that the tape works
    2. Leo, could you tell us what you know about the spiral taping?
    3. is there interest in what T.Ben Fukui has to say?
    4. is anyone interested to know more about the s-tape?
    5. I have not been able to find ANY tape studies have looked at the effects of taping for a longer period of time…does anyone know of any?
    I am speaking of the length of tape application time, not so much follow-up time.

    Hoping we stay focussed on the primary question = is tape effective.

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  27. EBM is the best system we have to defeat anecdote but it is fragile to abuse. Adding ‘prior plausibility’ makes it more robust but the benefits of not drowning in SCAM come at a cost of not accepting ‘weird science’ until it passes some Bayesian type test along the lines of ‘the more implausible the claim the higher the burden of proof it requires’.

    Broadly I like your approach – not that you need my validation – I agree that placebo is unlikely in your treatment population as it relies on frontal lobe development but that it might work through parents and carers the way it does through owners and pets. And you are demonstrating good use of the GMFM so you are measuring – great – and few of us have the facility to measure through a blind so our own biases are always present and to be counted in. But to drop the ‘meridian’ idea on a thread that is on a ‘hard science’ site. Sorry to pick it up and run with it away from the core of the thread but one should not let that sort of thing go.

    So taping – more than sensory activation? Does it need to be to generate your experiences?

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  28. Esther de Ru says:

    sorry Steven,

    Do not understand your question exactly
    ‘So taping – more than sensory activation? Does it need to be to generate your experiences?’

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  29. Placebo! The mind is powerful, and if you can either convince yourself or your patient well enough that it works, then it will have some effect. But what are those effects, and is it really the tape? or just the neural input on the skin of your joint position? it could be a number of other factors too. Yet it was still found ‘in-effective’! Now there is many treatment options that HAVE been proven effective, so we should stick to those before using colorful tape!

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  30. Great Post. Good to see a proper SR finally finding that the evidence does not support this colorful tape. So let’s stop wasting time and money clinicans, and stick to whats proven effective. Only keep using it with athletes if its for their ‘fashion’!

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  31. Jamie Thorpe says:

    I understand all of the arguments that have been put forward above, but am still thinking that we as clinicians are asking the wrong questions! I know we all have a medical background and therefore as scientist want black and white answers to whether a treatment modality is of a positive effect to our patients, however this should not be the question. Your question should be does this improve the symptoms of the patient standing in front of me? This may be a placebo, sensory, lymphatic or confidence/performance effect, any which way you look at it, if the dynamic/Kinesio tape allows the patient to progress and achieve their goals then why are we still arguing amongst ourselves its effectiveness. For me I have had a large amount of success using Kinesio tape as part of an overall therapy programme in elite sport but this doesn’t mean it is right for every clinician. I feel if you are using it you have to believe in the theory of why you are using it and be able to clinically reason this theory.
    Thats my thoughts anyway.

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  32. stuart miller says:

    Jamie, well said. From a neuroplasticity perspective, adding a compensatory technique (whether it is kinesiotape, tinted glasses for people with photosensitivity, an AFO) will reduce the chance of adaptation long-term. It may allow the person to remain active for the next match etc. due to the reasons suggested There is still the need for weaning from the intervention at some point and long-term strategies for dealing with stressors. It starts with the education and the research. Thanks.

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  33. simulacrum says:

    > Kinesio Tape is proven to be effective even probably before you started your practice as a Physiotherapist.

    - Citation needed. You see to be proven effective someone needs to run double blind, controlled trials on a large sample size.

    >I’ve been using this tape for more than 10 years now and I find it effective if you combined it with other treatment approach.
    - People have given similar anecdotal evidence in relation to other treatments that have subsequently been proven not to work. This is why scientists don’t trust any individuals (including their own) perceptions of effectiveness. You see scientists know that they are subject to biases they may not be consciously aware of. Hence they only trust trials that have been carefully designed to control for cognitive biases (for a decent list see http://bit.ly/1vycprT)

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  34. No further comments I think this conversation will just keep on going and going… Simple solution: If you don’t believe it, don’t use it and for those who believe and proved it’s effective and helpful, keep on! Personally, this article will not stop me from using it. Thanks everybody and enjoy your practice with the techniques that you believe you are more effective!:) PEACE;)

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  35. Torticollis says:

    My daughter was born with congenital torticollis and at one point her PT had I use kinesio tape on her neck. I don’t remember any positive results but I do remember it pulling the skin off her little baby neck and her tears while it healed up. I’m not a fan.

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  36. Esther de Ru says:

    dear parent, I am so sorry to hear this. Removing tape has to be done very carefully especially in very young children. I can imagine you will think twice before using again. Wishing you and your daughter well.

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  37. Is there any evidence that it is better than more traditional rigid taping techniques? As far as I am aware there isn’t and until that comes out I will stick with what I know works.

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  38. Esther de Ru says:

    Hi Rodney,
    Articles comparing both ridig and this tape that I know of are listed below. I would say comparing Kinesio to traditional rigid taping is like comparing it to bracing or orthesis. What can be achieved using is essentiale different and sometimes the same :)
    Outcomes depend on research questions (example Briem study) and of course in that case, the rigid tape will be better.

    *Baslik Paralel (2008) Comparison of the instant effect of Kinesio and MacConnell patellar taping on performance in patellofemoral pain syndrome. Fizyoterapi Rehabilitasyon 2008,19(3) 103-109
    *Bayrakci Tunay V et al (2008) Comparison of the instant effects of kinesio and McConnell patellar taping on performance in patellofemoral pain syndrome [Turkish] Fizyoterapi Rehabilitasyon [Turkish Journal of Physiotherapy Rehabilitation] 2008 Dec;19(3):104-109 PEDro rating ongoing
    *Batra Vijay & Batra Meenaski (2007) To study and compare the efficacy of VM functional dynamic taping protocol/technique over conventional treatment protocol in Bell’s Palsy. Ind. Jof OT vol 49:no 2(aug-nov2007)
    *Briem K et al (2011) Effect of Kinesio tape compared with nonelastic sports tape and the untaped ankle during a sudden inversion perturbation in male athletes. JOSPTmay2011,vol41;nr5:328-333 pedro 4
    *Campolo M et al (2013) a COMPARISON OF TWO TAPING TECHIQUES (KINESIO AND Mcconnell) and their effect on anterior knee pain during functional activities. JOSPTvol8.nr2.april2013pg105-110
    *Chia-Hsin Tsai et al (2012) Comparison of kinesio taping and sports taping in functional activities for collegiate basketball players: a pilot study 30th Ann Conf. of biomech. In sports melb. 2012
    *Moreno Sanjuan J (2009) Hallux valgus tratamiento comparative enre: kinesiotape, vendaje functional y terapie manual. (spanish) http://www.efisioterapie.net
    *Nambi Gopal S.& Rarun Bijal Shah (2012) Kinesiotaping versus Mulligan’s mobilization with movement in sub-acute lateral ankle sprain in secondary school hockey players. Comparative study. IJPScH.issue2vol2(april2012)pg 136-150
    *Tunay V. Et al (2008) Comparison of the instant effects of kinesio and mcconnel patellar taping on performance in patellofemoral pain syndrome. FR.2008,19(3):104-109

    These taping methods are completely different and complement each other. I know plenty of colleagues who are combining both now.

    Pity you are not open to trying….

    If anyone else knows of other studies PLEASE let us know.
    Esther

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  39. Esther de Ru says:

    Am glad to say that both appraisal and authors reaction to the article Leo started in this thread are in press and will be published shortly. http://www.journalofphysiotherapy.com/inpress

    To me as a clinician, the most worrysome part of the authors reactions has been that: * As responsible researchers we would never recommend something that has never been tested.*

    Not only worrysome because this would implicate that non of all the modalities we use that have not been tested should not be used. (is this even possible?)
    But also because it seems that the authors regard Randomized Controlled Trails as ‘The Only Evidence’.

    They might not be familiar with the works of Tonelli
    http://www.ncbi.nlm.nih.gov/pubmed/16722902
    and the recent publication on EBM a movement in Crisis?
    http://www.bmj.com/content/348/bmj.g3725

    This last decade more and more people have come to realize that clinical trails are but a small part of the overal evidence.

    The statement that ‘All available evidence from the five different systematic reviews of randomized controlled trails is very consistent: Kinesio taping does not work.’ is not complete in my opinion.
    More specific and correct would have been to state that:
    ‘All available evidence from the five different systematic reviews of randomized controlled trails is very consistent: Kinesio Taping (using the OI-IO and star techniques described in the reviews) does not work.’

    Still hoping that others know of more studies and will share these with us here.

    Esther

    [Reply]

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