The influence of short-term Kinesiology Taping on ...

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Journal of Back and Musculoskeletal Rehabilitation 00 (2013) 1–7 DOI 10.3233/BMR-130382 IOS Press

The influence of short-term Kinesiology Taping on force-velocity parameters of the rectus abdominis muscle A. Ptak, G. Konieczny∗ and M. Stefańska Department of Physiotherapy, University School of Physical Education, Wrocław, Poland

Abstract. PURPOSE: The purpose of the study was to evaluate the influence of Kinesio-Tex tape on force-velocity parameters (F-V) of the rectus abdominis muscle immediately following application. METHODS: The study group selected consisted of 52 women with a BMI below 23 [kg/m2 ]. The study involved measuring the force-velocity parameters of trunk flexor muscles twice using the Biodex System 3 Pro Set. Analyzed parameters included peak torque [N/m], total work [J], power [W] and percentage ratio of trunk flexor and extensor peak torque. RESULTS: Comparing the results obtained in both tests, for a majority there were no statistically significant differences found in both the study group and control group. CONCLUSIONS: 1. Short-term Kinesiology Taping on the rectus abdominis muscle does not cause a change in force-velocity parameters of trunk flexors. 2. Isolated application on the rectus abdominis muscle may be insufficient to cause a change in force-velocity parameters following such a short application time. Keywords: Kinesiology taping, physiotherapy, isokinetics, rectus abdominis muscle

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1. Introduction

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Kinesiology Taping (KT) is an effective and noninvasive therapeutic method based on support for selftreatment processes of the body [1–4]. At the core of the method is Kinesio Tex, an elastic tape with a thickness, specific weight and elasticity (elasticity 130– 140%) similar to human skin [2–4]. The tape is made of cotton, with acrylic in the shape of a sine curve used as an adhesive [2]. The waterproof and air-permeable structure of the tape enables it to remain in contact with the skin for several days [1,5]. Kinesiology Taping is a European version of Japanese Kinesio Taping, the creator of which is the chiropractor Dr Kenzo Kase. The first Kinesio Taping

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∗ Address

for correspondence: Grzegorz Konieczny, Department of Physiotherapy, University School of Physical Education, al. Ignacego Jana Paderewskiego 35, 51-612 Wrocław, Poland. Tel.: +48 71 3 47 30 76; E-mail: [email protected].

course in Poland took place in 2004. In May 2007 Kinesio Taping instructors from Germany and Poland decided to create a new association – “K-Active Association”, aimed at promoting this method in both countries. At the same time they decided to modify the name of the method and based the concept of Kinesiology Taping on muscle chain theory [6]. The therapy is a sensory technique which influences the normalization of muscle tension [3,4,7–9], activation of the lymphatic, circulatory [3,4,8,10] and endogenous analgesia systems [3] and support for joint functions [3,8,11]. Kinesiology Taping has also proven effective in improvement of proprioreception [3,8,12], correction of faulty posture [8,12–14] and stimulation of skin mechanoreceptors [3,8,9]. In a majority of cases KT tape applications are not corrective, but rather aim to improve local function or affect dysfunctions emerging beyond the symptom area [2]. Due to these benefits, the therapy can be utilized in several branches of physiotherapy, such as or-

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A. Ptak et al. / The influence of short-term Kinesiology Taping on force-velocity parameters of the rectus abdominis muscle

thopaedics, paediatrics, neurology and gynaecology [1, 10,13–17]. One of the greatest advantages of Kinesiology Taping is a twenty-four-hour therapy beginning with the placement of the tape on the skin [16]. Subjective effects of KT therapy are visible as early as the following day, depending on dysfunction [3,8,11]. In addition, cases have even been described in which a particular application provides apparent results immediately following contact with the skin [11]. There are, however, no objective analyses which confirm these results or explain such occurrences clearly [3,8,11]. Also knowledge about influence of Kinesio-Tex tape on force-velocity parameters (F-V) of muscles is still incomplete with only a small number of publications focused on velocity parameters referred to in this paper [7–9,18]. What is more, results of the studies are inconclusive and researchers emphasize the need for further observation [7–9]. As such, taking into account the characteristics of the KT method and its influence on muscles, it has been assumed that the effects on supporting muscle appear immediately following application to the skin and may, therefore, affect isokinetic parameters. The purpose of the study was to evaluate influence of Kinesio-Tex tape on force-velocity parameters (F-V) of the rectus abdominis muscle immediately following application. It was believed that if Kinesio taping improved muscle performance, then the appropriate application of a plaster on a large anterior muscle such as the rectus abdominis would influence the change of its parameters such as speed and strength.

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2. Materials and methods

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2.1. Materials

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52 female students of the University School of Physical Education in Wrocław participated in the Study. A condition of selection for the study was a body mass index (BMI) below 23 kg/m2 . Those students who practised sports professionally or had any counterindications for participation in the study were also disqualified. The students were divided randomly into two groups: a study group (32 persons) and a control group (20 persons). The groups did not differ to a statistically significant degree with regard to basic anthropological parameters. A detailed characterization of the groups studied is located in Table 1.

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2.2. Study methods The research involved measuring the force-velocity parameters of trunk flexors on the lumbar region using the Biodex System 3 Pro Set. The isokinetic mode of the equipment was utilised. The test included five consecutive trunk flexions and extensions in the sagittal plane with an angular velocity of 60 and 120◦ /s. Tests were performed in a semi-sitting position. Each subject was seated such that the rotation axis of the joint and that of the dynamometer were parallel. The point of rotation was the L5/S1 segment of the spine. In order to eliminate any additional movements and to stabilize the position of the subject, trunk and thighs were fastened to the chair with belts. On average, the range of movement was 90◦ (35◦ for trunk extension and 55◦ for trunk flexion). Before each test the subject had to perform three movements so as to familiarize herself with a particular strain and the form of an activity (Fig. 1). There was break of 30 seconds between tests. For each measurement it was necessary for the subject to develop the peak torque within the shortest possible time. The average break between the measurements was 31 minutes. Subject to analysis were peak torque [N/m], max work [J], average power [W] and percentage ratio of trunk flexor and extensor [%] in the range of measured parameters.

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2.3. Tape application

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Between the first and second test Kinesio Tex tape was applied to the rectus abdominis muscle in the study group. The area was cleaned thoroughly with Skinsept preparation prior to each application. The tape was placed using the muscle technique on stretched abdominal muscles such that the tape wrinkled characteristically (Fig. 2).

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2.4. Statistical analysis

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The distribution of all parameters studied was checked. It transpired that the distribution was close to the normal, allowing the calculation of average values and standard deviations. On account of the normal distribution the parametric T-test was used to determine the significance of differences between results obtained in the first and second measurement in both groups. For the purpose of checking the significance of differences in anthropological parameters between the study group and control group, the T-test for independent groups test was used.

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Table 1 Characterization of the groups studied, average values, standard deviations (SD) and values for the coefficient p in the T-test for independent group Parameters analyzed N Age [years] Body height [m] Body mass [kg] BMI [kg/m2 ]

Study group Average 32 22.0 1.68 58.1 20.7

SD 2.2 0.05 5.7 1.4

Control group Average SD 20 20.4 1.7 1.67 0.08 58.5 7.1 20.8 1.5

Study group vs. control group Coefficient p 0.776 0.941 0.832 0,723

Fig. 1. Range of motion during the tests; A – maximum flexion; B – maximum extension.

ences found in both study group and control group. In the study group statistically significant differences were recorded only in the size of max work for extensor muscles and average power for flexor muscles with an angular velocity of 60◦ /s in both situations. In the control group statistically significant changes were recorded in average power for extensor muscles with angular velocities of 60◦ /s and 120◦ /s. Detailed results are given in Table 2 and in Figs 1, 2 and 3.

Fig. 2. Example applications for the rectus abdominis muscle. 129

3. Results

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Comparing the results obtained in both tests, for a majority there were no statistically significant differ-

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4. Discussion

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Over the few past years there has been a growing interest in muscle strength, potential for normalization of muscle tension and restoration of the balance between agonistic and antagonistic muscles. Current technology and the capabilities of contemporary computer systems allow muscle functions in dynamic conditions

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Table 2 Values for the coefficient p in the T-test and percentage ratio values of peak torque (Pt), maximum work (W), average power (P) and ratio of antagonistic muscle peak torque (E/F) obtained by trunk flexor muscles in successive tests (1, 2) Tests test 1 vs. test 2

∗ Statistically

Parameters analyzed Pt F60 [Nm] Pt F120 [Nm] Pt E60 [Nm] Pt E120 [Nm] E/F 60 [%] E/F 120 [%] W F60 [J] W F120 [J] W E60 [J] W E120 [J] P F60 [W] P F120 [W] P E60 [W] P E120 [W]

Study group Coefficient p 0.79 0.91 0.36 0.18 0.10 0.49 0.26 0.33 0.00* 0.64 0.01* 0.19 0.94 0.48

% ratio 99.1 99.7 103.0 103.7 95.4 97.4 97.6 104.7 94.0 101.1 95.7 95.8 99.7 96.6

Control group Coefficient p % ratio 0.07 104.0 0.66 102.4 0.19 103.8 0.49 103.8 0.68 98.8 0.57 96.5 0.34 102.1 0.19 110.0 0.36 104.1 0.28 108.9 0.09 104.8 0.11 114.2 0.02* 109.5 0.02* 122.16

significant values of p < 0.05, angular velocity of 60 or 120.

Fig. 3. Average values and standard deviations of peak torque (Pt) and ratio of antagonistic muscle peak torque (E/F) obtained by trunk flexor muscles in successive tests (1, 2). 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164

to be evaluated very thoroughly, enabling muscle condition to be assessed and the basic force-velocity parameters measured [19–21]. Among the advantages of isokinetic tests are precise estimation of dynamic muscle strength, repeatable results, correlation between isometric and isotonic contractions and detailed parameters for skeletal muscle work [19,22–24]. Repeatability of isokinetic measurements depends mostly on age, equipment type, joint type, contraction type and illness type. In order that a study is properly performed, the procedures defined should be adhered to closely. Nevertheless, a correlation coefficient for isometric, isotonic and isokinetic power of flexors and extensors of knee- and elbow- joints of the level of 0.91–0.98 may prove the reliability of isokinetic measurements [19,20]. Isokinetic tests are fairly

widely used to estimate skeletal muscle condition in both young and old with one of several illnesses. There are at present already numerous recognized studies on the subject of the effects of Kinesiology Taping therapy on various dysfunctions or disease entities [1,5,10,13,15,16]. However, the mechanisms which influence the effectiveness of the therapy or the specific changes which occur in muscle physiology have not yet been explained. An ever greater number of researchers are focusing therefore on precise identification of the mechanisms by which tape application influences muscles, utilizing a variety of measurement equipment. However, in order to identify the precise influence of Kinesiology Taping the greatest possible number of muscle groups should be analyzed. This finds support in, for instance, the diversity in structure

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Fig. 4. Average values and standard deviations of max work [J] obtained by trunk flexor muscles in successive tests (1, 2).

Fig. 5. Average values and standard deviations of average power [W] obtained by trunk flexor muscles in successive tests (1, 2). 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198

and function of particular muscle groups or individual muscles themselves. Kinesiology Taping is currently a very popular method in therapy. It was decided that isokinetic measurement equipment would be used in order to check the influence of tape application on the rectus abdominis muscle. The choice of this area for application was supported by the superficial location of the abdominal muscles and their size, as well as the phasic nature of the muscle and its weakening with age. An additional spur was the subjective feeling by patients of an increase in the tension in this muscle immediately following tape application. Analysis of these test results did not in the majority of cases reveal a statistically significant difference in the range of change in F-V parameters in the study group and control group. A similar lack of statistically significant relationships were obtained by a team

of Taiwanese researchers, who analyzed KT application on the strength of the quadriceps femoris muscle in young healthy sportspeople [7]. Fu et al. [7] did not find statistically significant changes in isokinetic testing immediately following tape application. A similar outcome was observed by HY Chang et al. [18]. The researchers registered the measurement of maximum grip strength in student sportspeople across three records, that is, immediately following KT application, following placebo application and with no tape application. The results did not reveal statistically significant differences in comparison of all three test records [18]. The analysis of the literature shows that short-term KT application on a given area does not result in changes intense enough that they were revealed in measurements of F-V parameters. Słupik et al. noted in measuring bioelectric activity in the vastus medialis

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muscle a lack of increase in peak potential 10 minutes from application. Noted too, however, was a high increase in peak potential 24 hours following application. This result would suggest a gradual change to the area concerned only after several hours had elapsed since tape application [8]. It has already been proven that Kinesiology Taping may regulate muscle and fascia tension [1,3,8]. As yet, however, the mechanisms of its influence have not been explained. One of the theories accounting for the change caused in muscle tension by application is the influence of the tape on skin mechanoreceptors. Skin mechanoreceptors activate nerve impulses under the influence of various stimuli, such as touch, pressure, vibration and stretching. Activation of skin mechanoreceptors by the appropriate stimulus leads to local depolarization and flow of nerve impulses along afferent fibres in the direction of the central nervous system, and thus changes in the area of application [3, 8]. Kinesiology Taping affects muscle indirectly through the fascia. In turn the fascia plays an important role in transmitting tension, in regulation of movement and maintenance of correct body posture. We usually attribute to the fascia the passive role of transferring mechanical tension generated by the influence of external forces or muscle activity [3,9]. There exists, however, evidence suggesting that the fascia has an active relationship with the working muscle and therefore influences musculoskeletal system dynamics [9]. Taking into account the above theories and the test results described, it is possible to suggest that we are not able through KT application to increase muscle strength in healthy individuals. This conclusion would not, however, be confirmed by the research of Vithoulka et al. (2010). The researchers compared the results of three test records – the influence of KT application, placebo application and lack of application – on the strength of the quadriceps femoris muscle. The research revealed an increase in peak torque following KT application in comparison with placebo application and lack of application, but only after a 10-minute warm-up preceding measurement. In contrast with the Taiwanese researchers, tape was applied not only to the rectus femoris muscle, but also to the vastus lateralis and medialis muscles [9]. In addition, in examining the trapezius muscle Brown observed changes in EMG immediately following tape application, but only in patients on whom a minimum of two quantities of tape were applied (Brown, 1999). The test results above would seem to encourage repeat research into the influence of Kinesiology Taping

on F-V parameters for abdominal muscles, with additional application on oblique muscles. It would be advisable also to consider extending the time of observation to a minimum of 24 hours in order to evaluate more accurately the time-frame in which application begins to influence muscle activity.

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5. Conclusions

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1. Short-term Kinesiology Taping on the rectus abdominis muscle does not cause a change in forcevelocity parameters of trunk flexors. 2. Isolated application on rectus abdominis muscle may be insufficient to cause a change in forcevelocity parameters following such a short application time.

Conflict of interest There is no conflict of interest.

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