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The effect of medial patellar taping on pain,

strength and neuromuscular recruitment in
subjects with and without patellofemoral pain

Article in Physiotherapy · March 2007

DOI: 10.1016/j.physio.2006.06.006

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 Physiotherapy 93 (2007) 45–52

The effect of medial patellar taping on pain, strength and neuromuscular

recruitment in subjects with and without patellofemoral pain
Janet H.L. Keet ∗ , Janine Gray, Yolande Harley, Mike I. Lambert
MRC/UCT Research Unit for Exercise Science and Sports Medicine, P.O. Box 115, Newlands 7725, South Africa

Abstract

Objectives Patellar taping is used by clinicians to reduce pain, increase strength and enhance neuromuscular recruitment in patients with
patellofemoral pain. This study explored the effect of medial patellar taping on these parameters in physically active subjects with and without
patellofemoral pain.
Study design A placebo-controlled clinical trial with randomised interventions.
Setting Sport Science Institute of South Africa.
Participants Fifteen subjects with patellofemoral pain (experimental group) and 20 subjects without patellofemoral pain (healthy cohort).
Methods Pain perception, quadriceps force output and electromyographic (EMG) data were collected during maximal quadriceps strength
testing and submaximal step testing for each intervention.
Intervention Subjects were tested during three different knee taping conditions: (1) no tape; (2) placebo tape; and (3) medial tape, in a
randomised order.
Main outcome measures Visual analogue scale (VAS), isokinetic and isometric force output, and EMG analysis.
Results Medial patellar tape did not result in a significant reduction in pain during the step testing (step-up) in the group with patellofemoral
pain (no tape condition: mean VAS 1.0, 95% confidence interval 0.30–1.70; taped condition: mean VAS 1.07, 95% confidence interval
0.22–1.91) or an increase in quadriceps force output. However, there was a significant decrease in EMG activity of the vastus medialis oblique
in both groups during the closed chain step test (e.g. group with patellofemoral pain, no tape condition: mean 77%, 95% confidence interval
62–92%; taped condition: mean 64%, 95% confidence interval 53–75%, P < 0.05).
Conclusion Although taping did not reduce pain in the patellofemoral pain group, it did enhance the efficiency of the vastus medialus oblique.
Future studies should determine whether there are clinical benefits to these findings.
© 2006 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Keywords: Knee; Quadriceps; Force; Electromyography

Introduction A wide variety of disorders may fall under the umbrella

Patellofemoral disorders are amongst the most common
clinical conditions encountered in the sporting and general
population [1,2]. Patellofemoral pain is usually described
as diffuse, peripatellar, anterior knee pain [1,3]. Symptoms
are typically aggravated by activities such as ascending or
descending stairs, squatting, kneeling, running and prolonged
sitting [1,4].
∗ Corresponding author at: P.O. Box 765, Somerset West 7129, South
Africa. Tel.: +27 21 8471577; fax: +27 21 8524837.
E-mail address: janet@keet.co.za (J.H.L. Keet).
term of patellofemoral pain. As a result, a thorough
systematic evaluation of the patient’s lower extremity
alignment, patellar mobility and alignment, muscle flex-
ibility, strength, co-ordination, soft tissue and articular
pain is important in determining the possible causes of
patellofemoral pain and prescribing an optimal rehabil-
itation programme. Management of patellofemoral pain
syndrome often includes reduction of pain and inflammation
through cryotherapy, heat therapy, massage therapy, muscle
flexibility and strength training (especially quadriceps),
patellar taping, bracing, orthotics, correction of abnormal
biomechanics or other causative factors, acupuncture and
surgery.

0031-9406/$ – see front matter © 2006 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.physio.2006.06.006
46 J.H.L. Keet et al. / Physiotherapy 93 (2007) 45–52
Patellar taping is used by clinicians during the treatment of
patellofemoral pain to reduce pain [5,6], increase quadriceps
strength [7], enhance neuromuscular recruitment [8], and
correct timing of onset of activation of the vastus medialus
oblique relative to the vastus lateralis [9]. Many hypothe-
ses for the mechanism of action of the patellar tape have
been proposed, including: (1) pain inhibition [10–12]; (2)
reduction of reflex inhibition of the quadriceps [13] with
a resultant increase in force [14,15]; (3) altered quadriceps
muscle recruitment with regard to timing of onset of the vas-
tus medialus oblique relative to the vastus lateralis [9,16,17];
(4) improved patellar tracking by repositioning the patella
within the trochlear groove with a resultant decreased load on
the patellofemoral joint [5,17], a theory as yet unsupported by
radiological studies [18–20]; (5) alteration of compensatory
gait strategies [21,22]; (6) enhanced proprioception through
directionally sensitive mechanoreceptors [23–25]; and (7) the
placebo effect of a clinical intervention.
This study examined whether patellar taping does decrease
pain, increase quadriceps strength and enhance neuromus-
cular recruitment. This study is unique as it included both
open chain testing (maximal isometric voluntary contraction,
concentric and eccentric isokinetic torque) and functional
closed chain (step) testing. In addition, testing was performed
on physically active subjects with patellofemoral pain and
healthy control subjects without symptoms of patellofemoral
pain. In this study, the authors eliminated confusion about
which components of taping provide the observed benefit by
using the first component [11,17], the medial glide, alone dur-
ing a range of weight-bearing and non-weight-bearing tests.
Furthermore, randomisation of interventions and placebo
control formed part of this study design, making it more strin-
gently controlled than much of the previous research in this
area [14,15,26].
Methods
The study design was a placebo-controlled clinical trial
with three randomised interventions for each subject: (1) with
medial patellar tape; (2) with placebo tape; and (3) with no
tape. Male and female subjects were recruited from the Sport
Science Institute of South Africa. The experimental group
consisted of 15 subjects with patellofemoral pain, and the
healthy cohort consisted of 20 subjects without symptoms of
patellofemoral pain (Table 1).
The sample size was determined through a power analysis
of data from previous studies. This calculation showed that
for a change in pain score of 2.0 ± 1.5 units (which is clin-
ically relevant), a sample size of nine in each group would
have sufficient statistical power (␣ = 0.05, power = 80%) to
detect difference between groups and treatments. This calcu-
lated sample size was increased in anticipation of subjects’
non-compliance and missing data from technical problems.
To fulfill the inclusion requirements of this study, the sub-
jects with patellofemoral pain were required to present with
Table 1
General subject characteristics for the healthy cohort (n = 20) and the
patellofemoral pain (PFP) group (n = 15)
Variables Healthy cohort PFP group
Sample size 20 15
Female 13 11
Male 7 4
Duration of PFP (weeks) N/A 5 to 624
Mean duration of PFPa N/A 124 ± 196
Sport (hour/week)a 5.3 ± 3.2 5.1 ± 3.6
Mass (kg)a 64.4 ± 11.1 65.2 ± 9.6
Age (years)a 29.4 ± 4.6 29.1 ± 5.1
a Data are expressed as mean ± standard deviation.
retropatellar or peripatellar pain, with insidious onset, of at
least 5 weeks’ duration, and to be currently participating in
a minimum of 2 hours of physical activity per week, even
though pain may be affecting their sporting activity [27]. In
addition, the subjects had a minimum of three of the follow-
ing five criteria [17,28]: retropatellar or peripatellar pain on
physical examination of the patella; pseudolocking: clicking
and a painful or painless ‘catching’; pain on ascending or
descending stairs; pain or stiffness on prolonged sitting; and
pain on squatting.
Exclusion criteria for subjects in both groups were: a his-
tory of traumatic knee injury including knee ligament or
cartilage injury, patellar subluxation or dislocation; prior knee
surgery; or any other musculoskeletal injury to either lower
extremity.
Taping technique and application
Patellar tape with the medial glide component [11,17]
was used in this study. This technique makes use of flexible
Fixomull hypoallergenic tape under the rigid leucotape (BSN
Medical, GMBH & Co., Hamburg, Germany). The placebo
patella tape was Fixomull tape alone and was applied directly
over the patella, as above, but without the medial glide
component. The tape was applied by an experienced phys-
iotherapist. The order of tape application was randomised.
The potential differences between the two taping conditions
(placebo and medial patellar tape) were not explained to the
subjects.
Electromyographic evaluation
Electromyographic (EMG) data from the bellies of the
vastus medialus oblique and vastus lateralis muscles were
collected during isokinetic, isometric and functional testing.
The subject’s skin was prepared by shaving off the hair and
the outer layer of epidermal cells and cleaning with alcohol
swabs. A surface Triode EMG electrode (Thought Technol-
ogy Triode MIEP01-00, Montreal, Canada) was placed over
the midpoint of the bellies of the vastus medialus oblique
and vastus lateralis, and orientated in line with the longitudi-
nal fibres [29,30]. The vastus medialus oblique electrode was
placed approximately 4 cm superior to and 3 cm medial to the
 J.H.L. Keet et al. / Physiotherapy 93 (2007) 45–52
superomedial patella border, orientated 55◦ to the long axis of
the patella. The vastus lateralis electrode was placed approx-
imately 10–15 cm superior to and 6 cm lateral to the superior
border of the patella, orientated 15◦ to the long axis of the
patella. The quadriceps muscles were contracted isometri-
cally prior to electrode placement to identify the midpoint of
the muscle belly. The electrode was linked to an amplifier
box that was connected via a fibre-optic cable to a com-
puter with Flexcomp/DSP software (Thought Technology,
Montreal, Canada) for recording of data.
EMG readings were sampled at 1984 Hz and were passed
through a 50-Hz line filter to remove interference from elec-
trical sources to yield raw data. Movement artefact was
removed from these raw signals with a high-pass second-
order Butterworth filter with a cut-off frequency of 15 Hz.
The means of the EMG signals were then removed and
the signals were full-wave rectified. The signals were then
smoothed with a linear envelope using a low-pass second-
order Butterworth filter with a cut-off frequency of 5 Hz.
Filtering procedures were performed using MATLAB soft-
ware (The MathWorks Inc., Natick, MA, USA). After
filtering, EMG data were processed to yield amplitude and
frequency compression data using software courtesy of H.
Mullany (University College Dublin, 2000). EMG amplitude
was calculated using the root mean square method. Inte-
grated EMG data have shown to be a reliable method to study
strength qualities of muscle during maximal and submaximal
contractions [31].
Normalisation of the data was performed by expressing
each subject’s isokinetic and functional test EMG data as
a percentage of the isometric EMG data obtained whilst
the subject performed the maximal isometric strength test
[32] with no tape applied. This EMG normalisation pro-
cess, as opposed to working with raw EMG data, negates
the potentially confounding effects of differences in lean
muscle mass and percentage body fat between subjects, and
the individual variation introduced as a result of electrode
placement.
Open chain tests
The KinCom Isokinetic Dynamometer (Chattanooga
Group, Inc., Chattanooga, USA) was used to test the
muscle strength of the quadriceps during maximal isokinetic
(concentric and eccentric) and isometric tests whilst EMG
data were recorded. The subjects were seated with the
hip in 90◦ flexion and were stabilised in the chair with
a strap across the chest and waist. Isokinetic tests were
performed with the knee extending or flexing between 85◦
and 5◦ at testing velocities of 120◦ second−1 . Previous
isokinetic studies have produced higher pain scores at
lower testing velocities (60◦ second−1 ) and lower pain
scores at higher testing velocities (180◦ second−1 ) [14,15].
Therefore, 120◦ second−1 velocity was used in this study to
be representative of walking or jogging and so as not to cause
undue exacerbation of pain. The coefficient of variation
47
of these measurements has been shown to be less than
10% [33]. This test was followed by isometric quadriceps
tests, which were performed at 60◦ knee flexion. Subjects
were given consistent verbal encouragement by the same
tester.
All subjects were familiarised with the equipment and test-
ing procedure prior to the start of data collection. Subjects
were asked to perform 10 submaximal concentric and eccen-
tric actions of the quadriceps, gradually progressing from 50
to 90% of their maximum, as part of the warm-up. Thereafter,
three maximal voluntary concentric and eccentric actions of
the quadriceps were performed. This test was followed by a
warm-up of five submaximal isometric actions of the quadri-
ceps with a 5-second hold and 5-second rest period between
each action. This was followed by three maximal voluntary
isometric quadriceps contractions of 5 seconds duration. For
all these tests, the action producing the greatest peak force
was recorded for analysis. EMG data were recorded simulta-
neously.
Closed chain tests
The functional test consisted of a step-up followed imme-
diately by a step-down with the same leg, over a 20-cm step,
performed in time to a recorded voice counting 3 seconds for
the step-up and 3 seconds for the step-down, and repeated
three times. EMG data were recorded simultaneously. EMG
amplitude was sampled over a 0.5-second period during
the greatest burst of EMG activity. EMG values were aver-
aged for the three tests. All testing was performed with
bare feet to prevent the confounding effect of differences in
shoe type.
Pain evaluation
A 10-cm visual analogue scale (VAS) was used after
each test to record the subjects’ perceived pain [34]. The
VAS has proven to be a reliable method of assessing pain
[35].
Statistical analysis
Appropriate statistical tests were performed on the data
using the Statistica 6.1 software package (StatSoft Inc., Tulsa,
OK, USA). An analysis of variance with repeated measures
was used to determine whether the interactions of the main
effects (group X taping conditions) were significant. Any
differences between the interactions or main effects were
analysed with a Tukey post hoc test. The coefficient of vari-
ation was calculated for the maximal voluntary isometric
contractions for each subject for each of the three condi-
tions (no tape, placebo and tape). The ratio of the coefficient
of variation was calculated as an estimation of whether the
experimental group and the healthy cohort had similar or
different variation during the measurement of maximal vol-
untary isometric contraction [36]. All data were expressed
48 J.H.L. Keet et al. / Physiotherapy 93 (2007) 45–52

as mean ± standard deviation or 95% confidence interval.

Statistical significance was accepted when P < 0.05.

Results

Subject characteristics

Subject characteristics for the healthy cohort and the

patellofemoral pain group showed no significant differences
(Table 1), except that the healthy cohort had no history or
symptoms of patellofemoral pain.
Pain
The healthy cohort experienced no pain with testing,
whereas the patellofemoral pain group experienced signif-
icantly more pain during all the tests (P < 0.05). However, no
significant differences were found in the pain scores of the
patellofemoral pain group between the no-tape, placebo and
tape conditions during all of the tests (Fig. 1).
Strength
The coefficient of variation for the maximal voluntary iso-
metric contractions was 7.1 ± 7.5% versus 6.1 ± 3.8% (no
tape), 5.5 ± 4.1 versus 6.6 ± 7.5% (placebo) and 8.7 ± 12.7
versus 7.2 ± 6.1% (tape) for the experimental group and the
healthy cohort, respectively. Based on the ratios of the coeffi-
cient of variation (experimental group versus healthy cohort),
it may be concluded that these differences in variation did not
have any clinical relevance [36].
When comparing the patellofemoral pain group with the
healthy cohort, the quadriceps mean force was 21% less
Fig. 1. Pain (as measured on the visual analogue scale, 0–10) in the
patellofemoral pain group during the maximal voluntary isometric contrac-
tion (MVIC), concentric/eccentric and step tests with no tape, placebo and
tape. Data are expressed as mean ± 95% confidence intervals.
during the maximal voluntary isometric contraction tests,
25% less during the concentric tests and 15% less during
the eccentric tests (P < 0.05) with no tape. Taping brought
about no significant difference in force production within the
patellofemoral pain group or the healthy cohort during testing
(Table 2).
Neuromuscular recruitment
EMG activity of the vastus medialus oblique was 28%
greater during the step-up test and 29% greater during the
step-down test (P < 0.05) in the patellofemoral pain group
compared with the healthy cohort with no tape. In addition,
during the step-up test with tape, EMG activity of the vas-
tus medialus oblique was decreased by 17% (patellofemoral
pain group) and 22% (healthy cohort) compared with their
respective no-tape measurements. During the step-down test
with tape, EMG activity of the vastus medialus oblique was

Table 2
Results of healthy subjects and subjects with patellofemoral pain (PFP) during maximum voluntary isometric contraction (MVIC), concentric, eccentric and
step tests with no tape, placebo tape and tape, expressing mean quadriceps force output and percentage electromyographic (EMG) activity of the vastus medialus
oblique (VMO) and VMO to vastus lateralis (VL) ratio
Healthy subjects PFP group

No tape Placebo Tape No tape Placebo Tape

Mean force
MVIC (N) 458 (419 to 497) 451 (400 to 503) 453 (412 to 494) 362a (311 to 414) 348a (307 to 390) 376a (316 to 436)
Concentric (J) 112 (100 to 124) 109 (97 to 121) 113 (102 to 125) 84a (71 to 97) 77a (64 to 90) 82a (66 to 99)
Eccentric (J) 156 (137 to 175) 156 (136 to 175) 154 (134 to 174) 132a (107 to 158) 119a (97 to 142) 131a (113 to 149)
EMG VMO (%)
MVIC 100 (0) 103 (93 to 113) 105 (82 to 127) 100 (0) 107 (87 to 127) 93 (78 to 108)
Concentric 138 (122 to 154) 134 (114 to 155) 135 (112 to 159) 138 (111 to 165) 129 (112 to 146) 141 (101 to 180)
Eccentric 108 (95 to 121) 114 (95 to 133) 111 (80 to 141) 122 (101 to 143) 118 (96 to 140) 136 (88 to 184)
Step-up 60 (49 to 71) 62 (51 to 72) 47b (40 to 54) 77a (62 to 92) 77a (62 to 93) 64a,b (53 to 75)
Step-down 66 (55 to 76) 65 (55 to 75) 55b (45 to 65) 85a (70 to 101) 81a (68 to 93) 72a,b (60 to 85)
VMO/VL
Step-up 1.4 (1.1 to 1.6) 1.5 (1.2 to 1.7) 1.1b (1.0 to 1.3) 1.5 (1.1 to 2.0) 1.5 (1.1 to 1.9) 1.3b (1.0 to 1.6)
Step-down 1.3 (1.1 to 1.5) 1.2 (1.1 to 1.4) 1.1b (0.9 to 1.2) 1.4 (1.1 to 1.7) 1.4 (1.1 to 1.6) 1.2b (1.0 to 1.5)
Data expressed as mean (95% confidence interval).
a PFP group vs. healthy cohort (P < 0.05).
b Tape vs. no tape and placebo (P < 0.05).
 J.H.L. Keet et al. / Physiotherapy 93 (2007) 45–52
Fig. 2. Percentage electromyographic (EMG) activity of vastus medialus
oblique (VMO) comparing the healthy cohort and the patellofemoral pain
(PFP) group during step-up and step-down tests with no tape, placebo and
tape. Data are expressed as mean ± 95% confidence intervals. (*) PFP group
vs. healthy cohort: P < 0.05; (•) tape vs. no tape and placebo: P < 0.05.
decreased by 15% (patellofemoral pain group) and 17%
(healthy cohort) compared with their respective no-tape mea-
surements (Fig. 2, Table 2). Furthermore, vastus medialus
oblique/vastus lateralis ratios were significantly (p < 0.05)
lower during the step tests with tape compared with their
respective no-tape measurements, in both groups. No signifi-
cant differences were evident between groups with regard to
EMG activity of the vastus lateralis or the vastus medialus
oblique/vastus lateralis ratio with and without tape.
Discussion
The main findings of this study were that medial patellar
tape did not result in a significant reduction in pain or an
increase in quadriceps force output. However, there was a
significant decrease in EMG activity of the vastus medialus
oblique in both groups during the closed chain step test.
Pain
Medial patellar tape did not significantly reduce pain in the
patellofemoral pain group during any of the tests. This finding
is in contrast to previous studies [9,11,14] which also made
use of placebo tape as a control. The method of tape applica-
tion in many studies [10,15,18,26] followed the McConnell
method [17], which requires tape to be applied according
to the McConnell classification of patellar orientation. How-
ever, this assessment has been proven unreliable [37,38]. In
the present study, the authors eliminated confusion about
49
which components of taping provide the observed benefit by
using the first component [11,17], the medial glide, alone
during a range of weight-bearing and non-weight-bearing
tests. However, another technique or additional taping may
have produced a different effect. Wilson et al. [12] showed
that neutral and lateral glide taping techniques produced a
greater degree of pain relief for patellofemoral pain suffer-
ers during a step-down test than the medial glide technique.
In other studies [39,40], a rehabilitation exercise programme
has been shown to reduce pain in subjects with patellofemoral
pain whether tape was applied or not, suggesting no addi-
tional benefit of adding tape to rehabilitation exercises in the
treatment of patellofemoral pain.
The fact that tape did not alter pain in this study may be
due to the level of physical activity of this sample of subjects.
Taping may not be an appropriate treatment technique for
these subjects. In addition, the subjects in this study reported
little pain at baseline prior to testing (2–2.5/10 reported on the
VAS pain scale), so any change may have been too small to
be of any significance. However, this amount of pain prior to
and during exercise did affect this sample’s physical activity.
Strength
Previous studies have shown that subjects with
patellofemoral pain have a reduced quadriceps torque [41,42]
and decreased explosive strength compared with control sub-
jects [41,43]. Similarly in this study, the force output from
the quadriceps of the patellofemoral pain group was 15–25%
weaker than that in the healthy cohort.
Interestingly, tape had no significant effect on force pro-
duction in either the healthy cohort or the patellofemoral pain
group. This is in contrast to previous studies that showed an
increase in torque [14,15] and an increase in the knee extensor
moment [22] and power [44] in subjects with patellofemoral
pain with patellar tape. However, many of these studies
lacked randomisation or placebo control in their study design
[15,17,22]. In addition, subjects in most studies were only
included if they experienced a 50% reduction in pain with
tape [8,14,17]. As pain relief did not occur with tape in this
study, it is not surprising that force output was not increased
with tape due to possible reflex quadriceps inhibition with
the presence of pain [13]. In addition, reasons for the lack of
effect of tape on force production in this study may include the
possibility that the medial glide technique or taping may not
be an appropriate treatment choice for this physically active
population. A rehabilitation programme aimed at improving
quadriceps strength deficits may be more appropriate. This is
supported by a study showing no additional benefit of adding
tape to a rehabilitation programme of this nature [40].
EMG activity with tape
The literature does not appear to support the theory [17]
that tape enhances the amount of activity of the vastus medi-
alus oblique [11,26,45]. In accordance with the literature,
50 J.H.L. Keet et al. / Physiotherapy 93 (2007) 45–52
this study showed that tape produced no significant differ-
ences in EMG activity of the vastus medialus oblique during
the open chain tests in both groups. However, tape produced
a decrease in EMG activity of the vastus medialus oblique
during the step-up and step-down tests in both groups. This
means that fewer vastus medialus oblique fibres were acti-
vated in order to perform the same task, hence the muscle
appears to be working more efficiently.
It is unknown if the action of this medial tape is different
for maximal voluntary effort tests as opposed to submaximal
tests, but it is possible that the tape exerts a greater effect
during less intense activity. In addition, the open chain tests
were performed in, or moved through, a range of knee flex-
ion greater than 40◦ , whereas the closed chain tests moved
through a knee flexion range less than 40◦ . The patella
has most medial and lateral mobility prior to engaging in
the femoral trochlear groove at approximately 30◦ [46–48].
Therefore, the closed chain test may have allowed for a
greater action of the tape on the patella due to increased
patellar mobility at this range of knee flexion.
How does the tape reduce the activity of the vastus medi-
alus oblique in those with patellofemoral pain and those
without pain? The tape may play a stabilising role producing
a medial force, thus substituting for some of the activity of
the vastus medialus oblique. Therefore, when tape is applied,
less vastus medialus oblique fibres are activated to perform
the same task, suggesting a more efficient muscle action. Tap-
ing may be a valuable tool in rehabilitation of patellofemoral
pain subjects as it may enhance efficiency of vastus medi-
alus oblique action and aid in training motor control of the
vastus medialus oblique. In contrast, tape may have delete-
rious effects on the vastus medialus oblique, as it resulted in
a significantly lower vastus medialus oblique/vastus lateralis
ratio which may reduce the training level stimulus, result-
ing in weakening or atrophy of the vastus medialus oblique.
Rehabilitation studies have shown no additional benefit of
adding taping to exercises in the treatment of patellofemoral
pain, suggesting that perceived clinical benefits of McConnell
strapping may be due to the associated rehabilitation pro-
gramme [39,40].
The effect of tape on the time of onset of activation of
the vastus medialus oblique relative to the vastus lateralis in
patellofemoral pain subjects is not covered in this study, but
may be relevant for investigation. Two studies have shown an
earlier onset of activation of the vastus medialus oblique rela-
tive to the vastus lateralis, and a reduction in pain after patella
tape was applied to symptomatic knees [9,16]. However, in
asymptomatic subjects, tape has resulted in a significant delay
in onset of activation of the vastus medialus oblique relative
to the vastus lateralis [49], and a decrease in the performance
of normal subjects [50].
Limitations of this study
Patellofemoral pain covers a wide variety of injuries or
dysfunctions. Therefore, different groups of subjects with
patellofemoral pain may be affected differently by taping.
This study was limited to a physically active sample of
patellofemoral pain subjects, so results are only relevant
to this population. In addition, tape with a medial glide
component alone was used, so these findings are specific
to this taping technique, which may not be an appropriate
technique for all individuals in this population. Only short-
term pain relief was tested and no long-term follow-up was
performed.
Future studies are necessary to determine which patients
with patellofemoral pain, separated into different groups
according to a classification system, respond best to taping.
Research aimed towards developing a taping stratification
that can be applied accurately, in the appropriate order, to
specific patients would be valuable.
Conclusion
This study suggests that this group of physically active
subjects with patellofemoral pain exhibited weaker quadri-
ceps muscles and less efficient vastus medialus oblique
muscles. Although tape did not appear to reduce the symp-
toms of this population, it did appear to enhance the efficiency
of action of the vastus medialus oblique. Whether this is
of any clinical benefit is not evident. The clinical impli-
cation of this study is that, at this stage, taping cannot be
used as a standard form of treatment for all patients with
patellofemoral pain. The characteristics that would determine
a subject’s eligibility for treatment with tape are yet to be
determined.
This study highlights the importance of placebo-
controlled clinical trials on treatment interventions in order
to investigate popular theories on which the management
of conditions is based. This approach increases the clinical
knowledge of the mechanisms and efficacy of treatment inter-
ventions, and enhances the clinical management of disorders.
Ethical approval: Ethics and Research Committee of the
University of Cape Town, South Africa, Ref. No. 086/2002;
Dean’s circular MED04/02.
Funding: Research undertaken in the MRC/UCT Research
Unit for Exercise Science and Sports Medicine, South Africa
is funded by the Harry Crossley and Nellie Atkinson Staff
Research Funds of the University of Cape Town, the Medical
Research Council of South Africa, Discovery Health, Bro-
mor Foods, and the National Research Foundation of South
Africa through the THRIP initiative.
Conflict of interest: None.
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