Physiotherapy 107 (2020) 176–188

Systematic review

Efficacy of kinesio taping in treatment of shoulder pain and

disability: a systematic review and meta-analysis of
randomised controlled trials
Sherief Ghozy a,b,1 , Nguyen Minh Dung c,1 , Mostafa Ebraheem Morra d,1 ,
Sara Morsy e,1 , Ghadeer Gamal Elsayed f , Linh Tran g , Le Huu Nhat Minh h ,
Alzhraa Salah Abbas i , Tran Thai Huu Loc j , Truong Hong Hieu h ,
Truong Cong Dung k , Nguyen Tien Huy l,m,∗
aFaculty of Medicine, Mansoura University, Mansoura, Egypt
bNeurosurgery Department, El Sheikh Zayed Specialized Hospital, Giza, Egypt
c Department of Sport Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
d Faculty of Medicine, Al-Azhar University, Cairo, Egypt
e Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
f Faculty of Medicine, Benha University, Benha, Egypt
g Institute of Research and Development, Duy Tan University, Da Nang, Viet Nam
h University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
i Faculty of Medicine, Minia University, Minia, Egypt
j School of Medicine, Viet Nam National University, Ho Chi Minh City, Viet Nam
k Bonne Lan Anh Clinic, Ho Chi Minh City, Viet Nam
l Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, Viet Nam
m Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Viet Nam

Abstract
Background Kinesio tape is an elastic therapeutic tape used for treating sports injuries and various other disorders. A systematic review and
network meta-analysis approach was used to synthesise all related evidence on the clinical effectiveness of kinesio taping for the treatment of
shoulder pain.
Methods A literature search was performed using 10 major databases. Randomised clinical trials reporting usage of kinesio taping for shoulder
pain have been included. Quality and risk of bias were assessed using the Cochrane Collaboration’s quality assessment tool. Meta-analysis was
conducted to calculate standardised mean differences and corresponding 95% confidence intervals (CI). The corresponding 95% CI of pooled
effect size were calculated using a fixed-effects or random-effects model based on the level of heterogeneity. In addition, meta-regression was
used to assess the influence of underlying shoulder disease on the efficacy of kinesio taping.
Results This systematic review and meta-analysis included 12 studies, with a total of 555 participants. Pairwise comparisons inferred that
kinesio taping only showed significant improvement of shoulder pain and disability when combined with exercise. However, kinesio taping
did not produce better results than placebo or treatment with steroids. The duration of treatment and underlying shoulder pathology did not
influence the efficacy of kinesio taping.

∗ Corresponding author at: Evidence Based Medicine Research Group & Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Viet

Nam.
E-mail address: nguyentienhuy@tdtu.edu.vn (N.T. Huy).
1 These authors contributed equally to this work.

https://doi.org/10.1016/j.physio.2019.12.001
0031-9406/© 2019 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

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 S. Ghozy et al. / Physiotherapy 107 (2020) 176–188 177

Conclusion There is insufficient evidence to support the use of kinesio taping in clinical practice as a treatment for shoulder pain. However,
there is limited evidence of its benefit as a complementary treatment in shoulder pain syndromes.

Clinical trial registration number PROSPERO CRD42017065881.

© 2019 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Keywords: Kinesio taping; Clinical trials; Meta-analysis; Systematic review; Shoulder pain

Introduction
Shoulder pain is a common health issue that can have
a marked effect on the daily life of patients [1]. It is usu-
ally a symptom of underlying pathology. The most common
cause of shoulder pain is rotator cuff tendonitis [2]. How-
ever, there are many other causes of shoulder pain, such as
degenerative diseases, inflammatory diseases, tumours, poor
posture and trauma [3]. Treatment ranges from surgery to
pharmacotherapy to simple shoulder immobilisers. In terms
of management, several determinants lead the treatment plan,
with the most significant being the cause of pain; physi-
cians usually investigate the pain and establish a diagnosis
to choose the most appropriate approach [2]. The severity of
pain is also important when making a decision regarding ther-
apy. For instance, minor occupational pain can be treated at
home by applying ice bags and resting the affected shoulder
[4]. Whatever treatment is chosen, the two main outcomes
that interest researchers are reduction in pain and improve-
ment in function or disability. However, research suggests
that conservative treatment for shoulder pain is favourable
because it is easier to administer, less invasive and more effec-
tive than surgery, except in the case of severe subacromial
impingement/compression [1,2].
Kinesio taping is a physiotherapeutic approach used to
support and stabilise muscles and joints without restricting
their range of motion (ROM) [5]. The elastic properties of
kinesio tape are similar to the features of human skin [6].
Kinesio tape recoils after application, causing a pulling force
that serves as the main stabiliser of the targeted area [6]. It
is widely used by athletes and physiotherapists. For the past
few decades, kinesio taping has played a role in the man-
agement plan for various musculoskeletal disorders, such as
shoulder pain, knee pain, ankle injuries, plantar fasciitis and
tennis elbow [7]. It is also used in the rehabilitation of sys-
temic diseases that affect the musculature, such as poststroke
hemiplegia [8].
Kinesio tape is a well-marketed product with no firm
evidence-based conclusion of its effectiveness. Concerns
have been raised about the widespread use of kinesio tap-
ing relative to its effectiveness [9,10]. Kinesio taping is still
suggested as a suitable and manageable treatment for shoul-
der pain as several trials have studied its clinical efficacy in
reducing pain and shoulder disability [6,11,12]. Other sys-
tematic reviews have studied the efficacy of kinesio taping
for shoulder conditions. However, the results of these studies
were variable and there is still no firm evidence on the role
of kinesio taping in the treatment of shoulder pain. Decisive
evidence regarding the role of kinesio taping in the treat-
ment of shoulder pain is needed [3,4], and it has previously
been the subject of systematic reviews and meta-analyses.
This study aimed to systematically review and meta-analyse
all related evidence on the clinical effectiveness of kinesio
taping compared with other treatments in terms of pain and
disability.
Methods
Search strategy and selection criteria
A systematic review of the medical literature was con-
ducted, and data that were sufficiently comparable were
meta-analysed according to the PRISMA statement for sys-
tematic reviews and meta-analyses, as presented in the
PRISMA checklist (Table A, see online supplementary mate-
rial) [5]. The protocol of this review was registered in
the international prospective register of systematic reviews
(PROSPERO) with registration number CRD42017065881.
On 15 May 2017, an electronic search of 10 major databases
was undertaken: PubMed, Scopus, ISI Web of Science,
POPLINE, Virtual Health Library, System for Information on
Grey Literature in Europe, Global Health Library, The New
York Academy of Medicine, ClinicalTrials.com and Google
Scholar. The following MeSH terms were used: [Athletic
Tape] AND [Shoulder]. These keywords include all possi-
ble synonyms for kinesio tape and shoulder. In databases
that do not support MeSH terms, combinations of all possi-
ble synonyms were used. The reference lists of all included
articles were searched for additional studies. No restrictions
were applied on the basis of language or publication period.
In terms of selection criteria, randomised clinical trials that
investigated kinesio taping in the treatment of shoulder pain
were included, regardless of whether they compared kine-
sio taping with another intervention, placebo or control (no
taping). For the included patients, all patients with shoulder
pain syndromes were included with no restrictions on race,
place, sex, age or ethnicity. The outcomes measured were pain
and disability, with no restriction on the scale used. In gen-
eral, there was no restriction on publication date or language.
Observational studies, case reports, case series, letters, edito-

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178 S. Ghozy et al. / Physiotherapy 107 (2020) 176–188
rials, theses, reviews, book chapters, news and any paper with
non-available full text (abstract only or not publicly avail-
able) were excluded, as were studies with data that cannot be
extracted and studies with overlapping data sets.
Three reviewers screened all selected titles and abstracts
independently to identify articles for potential inclusion.
When an abstract was included by at least one reviewer,
the full-text article was retrieved and evaluated for inclu-
sion by two investigators. Discrepancies and disagreements
were resolved by discussion and consensus with the senior
reviewer (NTH).
Data extraction
Data were extracted by three reviewers working inde-
pendently and were checked by another blinded reviewer.
An Excel template (Microsoft Corp., Redmond, WA, USA)
was developed to extract data. Controversies were resolved
through discussion and consensus among the reviewers.
Statistical analysis
All data were analysed using R Version 3.4.3 to compute
the pooled standardised mean difference (SMD) for pain and
disability outcomes. In cases where studies reported the effec-
tiveness of kinesio taping at multiple time points, the last
time point was used in the analyses. The corresponding 95%
confidence intervals (CI) of pooled effect size were calcu-
lated using a random-effects model due to the presence of
different conditions within the same outcome. Heterogeneity
was assessed with Q statistics and was considered significant
when I2 > 50% or P < 0.1 [6]. Publication bias was assessed
with Egger’s regression test [7,8] and represented graphically
by Begg’s funnel plot [11] when there were ≥10 studies.
On Egger’s regression test, P < 0.10 was considered signifi-
cant. Whenever publication bias was found, the trim and fill
method of Duvall and Tweedie was applied to add studies
that appeared to be missing [12] to enhance the symmetry.
The included studies assessed shoulder pain using a visual
analogue scale (VAS), with the highest value indicating the
most severe pain. For shoulder disability, two scores were
used: range of movement (ROM) and the Shoulder Pain and
Disability Index (SPADI). For each comparison, the effect
of underlying shoulder pathology on the efficacy of kine-
sio taping was assessed through meta-regression when there
were more than three studies. Individual diseases could not
be assessed due to the low numbers of outcomes per disease.
Quality assessment of included studies
Three reviewers assessed the quality and risk of bias in
included studies independently using the Cochrane Collabo-
ration’s quality assessment tool [9]. All discrepancies were
resolved by discussion with the senior reviewer (NTH) (Table
B, see online supplementary material).
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Results
Search results and baseline characteristics of included
trials
Systematic searching of the literature yielded 522 articles,
98 of which were duplicates and were removed. Follow-
ing abstract screening, 26 articles were selected for full-text
screening, which found that seven articles fulfilled the inclu-
sion criteria. A manual search was performed to ensure that
all potentially relevant studies were included, including ref-
erences of included studies and references of any reviews
related to the topic. Related papers were checked using
PubMed and by checking all citations for the included papers.
Finally, five further articles were retrieved, so a total of 12
articles met the inclusion criteria. The flowchart of article
screening and selection is presented in Fig. 1.
Characteristics of included trials
This systematic review included 12 studies, with a total
of 555 participants. Five studies compared the effectiveness
of kinesio taping with placebo, two studies compared kine-
sio taping with steroid treatment, and four studies compared
kinesio taping plus exercise with exercise alone. The mean
age of participants in the treatment group and the control
group ranged from 15 to 62 years. This study included fewer
male than female patients (33% and 67%, respectively). How-
ever, two studies did not specify sex. The characteristics of
included studies are shown in Table 1.
Quality assessment
There was a low risk of bias among all included studies
in terms of selective reporting and incomplete outcome data.
Additionally, random sequence generation was of low risk
of bias, except for one trial which had unclear risk of bias
[20]. Blinding of outcome assessment was a high risk of bias
in three studies [16], and low risk of bias in the remaining
studies. Blinding of participants and personnel was a high risk
of bias in four studies [24], unclear risk of bias in two studies
[15,19], and low risk of bias in the remaining studies. Risk of
bias has been detailed in Table B (see online supplementary
material).
Quantitative meta-analysis
Kinesio taping vs placebo
Shoulder pain. Based on the random-effect model meta-
analysis, there was a non-significant decrease in the visual
analogue scale score (SMD -0.10, 95% CI −0.34 to 0.15,
P = 0.45). Subgroup analysis to assess the timing of the reduc-
tion in pain revealed that the greastest reduction in pain
occurred during activity (SMD −0.10, 95% CI −0.34 to
0.15), P = 0.14), at night (SMD −0.07, 95% CI −0.64 to 0.5,
P = 0.19) and at rest (SMD −0.04, 95% CI −0.46 to 0.39,
 S. Ghozy et al. / Physiotherapy 107 (2020) 176–188 179

Fig. 1. PRISMA flow chart of study selection and screening.

P = 0.37) (Fig. 2). A meta-regression analysis was conducted
to test the effect of underlying disease on the efficacy of kine-
sio taping. No change in efficacy was observed (B-coefficient
0.15, P = 0.45). Furthermore, the duration of application did
not affect the efficacy of kinesio taping (B-coefficient 0.5,
P = 0.15).
Shoulder disability. The included studies assessed disabil-
ity using either SPADI or the ROM scale. Based on the ROM
scale, kinesio taping decreased disability in all directions non-
significantly compared with the placebo group. The highest
decrease in disability was seen for internal rotation (SMD
2.12, 95% CI −0.41 to 4.65, P = 0.1), followed by flexion
(SMD 2.06, 95% CI −0.27 to 4.38, P = 0.08) (Fig. 3). Fur-
thermore, underlying disease (B-coefficient 0.7, P = 0.37) and
the duration of application (B-coefficient 0.12, P = 0.23) did
not influence the efficacy of kinesio taping. For SPADI, the
same insignificant effect was found (Fig. 4).
Kinesio taping vs steroids
Shoulder pain. A comparison of kinesio taping with steroid
treatment was performed in patients diagnosed with subacro-
mial impingement syndrome in two studies. For VAS, there
was no significant difference between kinesio taping and
steroid treatment for pain during activity (SMD 0.32, 95%
CI −0.20 to 0.81, P = 0.23) or at rest (SMD 0.23, 95% CI
−0.15 to 0.62, P = 0.24) (Fig. 5).
Shoulder disability. For ROM, kinesio taping was only found
to be significantly better than steroid treatment for extension
movement (SMD −0.37, 95% CI 0.24 to 1.21, P < 0.01). No
significant difference was found between steroid treatment
and kinesio taping for other ROM components/movements

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 180
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Table 1
Baseline characteristics of included studies.
Author/year/ Treatment group Control group Follow-up Main Study summary
country duration co-morbidity
Intervention Sample Age: mean Male (%) Intervention Sample Age: mean Male (%)
size (SD) size (SD)
Huang/2017/ Kinesio taping [Nitto 11 56 (13) 8 (73) Control (no 10 59 (13) 6 (60) 3 weeks Hemiplegic Stroke patients with
Taiwan [10] Denko kinesiology tape taping) shoulder pain hemiplegic shoulder pain
(50 mm × 4 m) was (stroke can experience greater
applied using the insertion patients) reductions in SPADI and
origin muscle and space pain, and improvement in
correction technique] shoulder flexion, and

S. Ghozy et al. / Physiotherapy 107 (2020) 176–188

external and internal
rotation after 3 weeks of
kinesio taping
intervention compared
with sham kinesio taping
Gulpinar/2017/ Kinesio taping (standard 21 Median 9 (43) Placebo (a 20 Median 9 (45) 60 to Asymptomatic Kinesio taping may
Turkey [13] 5-cm Kinesio Tex tape (range) 15 standard 5 cm 15.5 72 hours overhead improve and rigid taping
was used with a (13 to 26) Kinesio Tex with (range 13 athletes may worsen GIR and PST
standardised therapeutic no force applied) to 31) in overhead athletes. For
technique with increasing TROM,
approximately 50% to kinesio taping is superior
75% tension) to rigid taping. Taping did
not affect posture
Kocyigit/2016/ Kinesio taping (Y-strip 21 50.6 (10.1) 6 (29) Placebo (Y-strip 20 49.2 (8.8) 7 (35) 1 month Subacromial Kinesio taping and sham
Turkey [14] and I-strip with and I-strip with no impingement taping generated similar
approximately 50% to force applied to syndrome results regarding pain and
75% tension) the tape during constant scores
application)
Volkan/2016/ Kinesio taping [I-type 35 53.5 (10.7) 15 (43) Steroid 35 54.3 (10.4) 8(23) 1 month Subacromial Both kinesio taping and
Turkey [15] strips were used for the [betamethasone (1 impingement steroid injection in
supraspinatus and a cc) plus prilocaine syndrome conjunction with an
Y-shaped strip was used (4 cc) was injected exercise programme were
for the deltoid muscle into the found to be effective in
with light (15% to 25%) subacromial the treatment of SIS
tension using the space]
insertion-origin muscle
technique]
 Table 1 (Continued)
Author/year/ Treatment group Control group Follow-up Main Study summary
country duration co-morbidity
Intervention Sample Age: mean Male (%) Intervention Sample Age: mean Male (%)
size (SD) size (SD)
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Pekyavas/2016/ Kinesio taping plus 20 49.4 (12.6) ND Exercise (home 20 40.6 (11.7) ND 15 days Subacromial High-intensity laser
Turkey [16] exercise [supraspinatus exercise impingement therapy and manual
and deltoid muscle programme) syndrome therapy were found to be
inhibition (10% to 15% more effective in
tension) and the minimizing pain and
glenohumeral mechanical disability and increasing
correction techniques ROM in patients with
(50% to 70% SAIS
tension) + home exercise
programme]
Huang/2016/ Kinesio taping (NITTO 21 60.4 (11.8) 15 (71) Placebo (NITTO 23 62.2 (9.6) 15 (65) 3 weeks Hemiplegic Therapeutic kinesio

S. Ghozy et al. / Physiotherapy 107 (2020) 176–188

Taiwan [17] medical adhesive tape was medical adhesive shoulder pain taping may limit the
used with a standardised tape was used with (stroke development of HSP and
therapeutic technique and a standardised patients) improve shoulder flexion
20% to 30% tension) therapeutic in subacute stroke
technique and no patients with flaccid
tension applied) shoulders during inpatient
rehabilitation
Tantawy/2016/ Kinesio taping plus 33 43.3 (3.8) 0 (0%) Exercise 33 42.8 (3.9) 0 (0%) 2 weeks Shoulder The experimental group
Egypt [18] exercise (four strips of (active-assistive disability in showed significant
standard 5-cm Kinesio range of motion postmastec- differences in all outcome
Tex tape with inhibition exercises, active tomy measures both within and
technique with 15% to stretching and females between groups. The
25% strengthening control group only
tension + active-assistive exercises) showed a significant
range of motion exercises, within-group difference in
active stretching and shoulder flexion
strengthening exercises)
Hamit/2015/ Kinesio taping [standard 30 42.6 (6.9) 5 (17) Steroid 31 43.5 (6.4) 8(26) 4 weeks Subacromial Improvement in pain
Turkey [19] 5-cm beige Kinesio Tex (subacromial 1 cc impingement intensity at rest, ROM and
tape with light tension triamcinolone syndrome disability were better with
(15% to 25%)] acetonide - 40 mg local injection. Kinesio
and 4 cc taping may be an
bupivacaine alternative non-invasive
combination) method to local
subacromial injection
Jin-Gu/2014/ Kinesio taping plus 8 22.5 (0.7) ND Exercise 8 22.80 ND 8 weeks Shoulder Mix of the two
Korea [20] exercise [taping of [rehabilitation (0.88) subluxation programmes (both
supraspinatus, deltoid and exercises for rehabilitation exercise
latissimus 40 minutes group and kinesio taping
dorsi + rehabilitation (main)] group) offers the best
exercises for 40 minutes improvement for

181
(main)] subluxation patients
 182
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Table 1 (Continued)
Author/year/ Treatment group Control group Follow-up Main Study summary
country duration co-morbidity
Intervention Sample Age: mean Male (%) Intervention Sample Age: mean Male (%)
size (SD) size (SD)
Shakeri/2013/ Kinesio taping 15 46.6 (14.2) 8 (53) Control (no 15 46.5 (13.3) 7 (47) 1 week Subacromial No significant difference
Iran [21] (standardised taping taping) impingement in pretest scores between
procedure) syndrome two groups. A significant
decrease in DASH after 1
week of kinesio taping in

S. Ghozy et al. / Physiotherapy 107 (2020) 176–188

treatment group and
control group compared
with pretreatment score
Simsek/2013/ Kinesio taping plus 19 48 8 (42) Exercise + placebo 19 53 5 (26) 12 days Subacromial The addition of kinesio
Turkey [22] exercise (a 5-cm Kinesio (5-cm Kinesio Tex impingement tape application to the
Tex Gold tape with 50% tape with no syndrome exercise programme
to 75% stretched I-band additional stretch appears to be more
was applied using the applied + exercises effective than the exercise
mechanical correction as defined by programme alone for the
technique + exercises as Hughston and treatment of SIS
defined by Hughston and Riivald)
Riivald)
Thelen/2008/ Kinesio taping (standard 21 21.3 (1.7) 19 (90) Placebo (standard 21 19.8 (1.5) 17 (81) 6 days Subacromial The therapeutic kinesio
USA [23] 5-cm beige Kinesio Tex 5-cm beige impingement taping group showed
tape with a standardised Kinesio Tex tape syndrome immediate improvement
therapeutic kinesio taping with a in pain-free shoulder
application) standardised, abduction after tape
neutral kinesio application. No other
taping application) differences between
groups regarding ROM,
pain or disability scores at
any time interval were
found
SD, standard deviation; SPADI, Shoulder Pain and Disability Index; ROM, range of motion; SAIS/SIS, subacromial impingement syndrome; VAS, visual analogue scale; DASH, disabilities of the arm, shoulder
and hand; GIR, glenohumeral internal rotation; TROM, total rotation range of motion; PST, posterior shoulder tightness; HSP: Hemiplegic shoulder pain.
 S. Ghozy et al. / Physiotherapy 107 (2020) 176–188 183

Fig. 2. Random-effect model meta-analysis of the efficacy of kinesio taping (KT) on the visual analogue scale for pain measurement. SD, standard deviation;
SMD, standardised mean difference; CI, confidence interval.

Fig. 3. Random-effect model meta-analysis of the efficacy of kinesio taping (KT) on different types of range of motion. SD, standard deviation; SMD,
standardised mean difference; CI, confidence interval.

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184 S. Ghozy et al. / Physiotherapy 107 (2020) 176–188

Fig. 4. Fixed-effect model meta-analysis of the efficacy of kinesio taping (KT) on the Shoulder Pain and Disability Index. SD, standard deviation; SMD,
standardised mean difference; CI, confidence interval.

Fig. 5. Random-effect model meta-analysis illustrating the effect of kinesio taping (KT) on shoulder pain compared with steroid therapy. SD, standard deviation;
SMD, standardised mean difference; CI, confidence interval.

(abduction, adduction, external rotation, flexion and internal
rotation). Underlying shoulder pathology did not influence
the results (Fig. 6).
No significant differences were found between kinesio
taping and steroid treatment in any domains of SPADI
(Fig. 7).
Kinesio taping plus exercise vs exercise alone
Shoulder pain. Three studies compared kinesio taping plus
exercise with exercise alone. Assessment of VAS at rest
revealed that a combination of kinesio taping and exercise
resulted in a significant reduction in pain at rest (SMD −0.50,
95% CI −0.95 to −0.06, P = 0.03) (Fig. 8).
Shoulder disability. For ROM, kinesio taping plus exer-
cise increased abduction (SMD 2.43, 95% CI 1.83 to 3.02,
P < 0.01), external rotation (SMD 2.43, 95% CI 1.83 to
3.02, P < 0.01) and flexion (SMD 2.6, 95% CI 1.26 to 3.94,
P < 0.01). The greatest increase was seen in flexion, followed
by abduction then external rotation (Fig. 9). Based on the
meta-regression results, underlying disease had no influence
on the efficacy of kinesio taping (B-coefficient 0.37, P = 0.7).
Two studies used SPADI as a scale for pain and disability;
pain and disability were shown to decrease significantly for
kinesio taping plus exercise (pain: SMD 1.32, 95% CI 0.63
to 2.01, P < 0.01; disability: SMD 0.77, 95% CI 0.13 to 1.42,
P = 0.02). However, no significant difference was seen in total
SPADI score (Fig. 10).
Qualitative synthesis
Only one study was not eligible for meta-analysis as it
had different outcomes of interest [13]. Patients were allo-
cated at random into four different groups: kinesio taping
group, rigid taping group, placebo group and control group.
The patients were assessed at three different time points:
baseline, immediately after application and 60–72 hours after
application. Six outcomes were measured for each patient:
glenohumeral internal rotation (GIR), glenohumeral external
rotation (GER), total rotation range of motion (TROM), pos-
terior shoulder tightness (PST), forward head posture (FHD)
and rounded shoulder posture (RSP). The results showed no
significant differences between all groups in aspects of GIR,
GER, PST, FHP and RSP when compared at different time
points. In contrast, a significant difference in TROM was seen
between the kinesio taping group [mean 173.32 (SD 10.51)]
and the placebo group [mean 163.71 (SD 10.55)] at the last
measurement point. Moreover, kinesio taping [mean 174.22
(SD 12.12)] was found to be significantly more effective than
rigid taping [mean 162.91 (SD 9.77)] for TROM at the second
measurement point; however, this was no longer significant
at the last measurement point.

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 S. Ghozy et al. / Physiotherapy 107 (2020) 176–188 185

Fig. 6. Random effect model meta-analysis illustrating the effect of kinesio taping (KT) compared with steroid therapy on different types of range of motion.
SD, standard deviation; SMD, standardised mean difference; CI, confidence interval.

Fig. 7. Fixed-effect model meta-analysis illustrating the effect of kinesio taping (KT) compared with steroids on different domains of the Shoulder Pain and
Disability Index. SD, standard deviation; SMD, standardised mean difference; CI, confidence interval.

Discussion treatment and as an adjuvant treatment to exercise, and com-

This meta-analysis sheds light on the role of kinesio taping
for the treatment of shoulder pain, not only symptomatically
but also at the level of function of the shoulder muscles. The
efficacy of kinesio taping was investigated as a stand-alone
pared with other usual treatment modalities to understand the
best treatment for shoulder pain.
The results showed that kinesio taping resulted in a sig-
nificant improvement in shoulder pain and disability when
combined with exercise. However, kinesio taping did not pro-

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186 S. Ghozy et al. / Physiotherapy 107 (2020) 176–188

Fig. 8. Random-effect model meta-analysis illustrating the effect of kinesio taping (KT) plus exercise on shoulder pain compared with exercise alone. SD,
standard deviation; SMD, standardised mean difference; CI, confidence interval.

Fig. 9. Random-effect model meta-analysis illustrating the effect of kinesio taping (KT) plus exercise on the types of range of motion compared with exercise
alone. SD, standard deviation; SMD, standardised mean difference; CI, confidence interval.

Fig. 10. Random-effect model meta-analysis illustrating the effect of kinesio taping (KT) plus exercise on the domains of the Shoulder Pain and Disability
Index compared with exercise alone. SD, standard deviation; SMD, standardised mean difference; CI, confidence interval.

duce better results than placebo or treatment with steroids.
Duration of application and underlying shoulder pathology
did not influence the efficacy of kinesio taping. These find-
ings are supported by the results of a network meta-analysis
study, which found that the best treatment for shoulder pain
in shoulder impingement syndrome was exercise combined
with other treatment including kinesio taping. However, this
study did not investigate the effect of kinesio taping on muscle
power and disability [25]. Williams et al. reported a signifi-
cant effect of kinesio taping on muscle strength with limited
improvement, but not for shoulder pain [26]. The same was
reported by Alam et al. who tested the efficacy of kinesio

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 S. Ghozy et al. / Physiotherapy 107 (2020) 176–188
taping on shoulder internal and external rotators in healthy
individuals [27]. Miller et al. found no significant differ-
ence between kinesio taping and placebo for pain during
movement, and no significant reduction in pain and disability
between the kinesio taping group and the placebo group [28].
In contrast to the present results, Hsu et al. found a sig-
nificant effect of kinesio taping on scapular pain and muscle
power [29]. In addition, other studies found beneficial effects
of kinesio taping in the early phases of disease [27]. Kaya
et al. found that kinesio taping has a better effect on shoulder
pain, but this was only clinically significant on day 7; this
was seen for pain at rest, at night and during movement [30].
Also, kinesio taping only had a significant effect on day 7
for pain at night, while the comparable group with physical
therapy modalities showed better results on day 14 [30]. This
difference in findings may be due to the momentary effect of
kinesio taping and the short duration of follow-up in many
trials [31]. These reported short-term effects may be due to a
feedback mechanism of taping or a placebo effect [14]. The
placebo effect of taping was reported in patients who received
taping as treatment for patellofemoral pain [32]. Another pos-
sible explanation is the Hawthorn effect, wherein patients are
aware of their intervention and observation [14]. In this case,
sham taping was found to have better results than kinesio tap-
ing on multiple scales and for pain improvement [14]. This
means that the effect is mainly due to taping rather than the
type of taping [14].
Three systematic reviews have come to the same con-
clusion that there is insufficient evidence for the efficacy
of kinesio taping to support its use in clinical practice
[3,4,33,34]. Even the recent systematic review which proved
some efficacy only included trials with a short duration
and had a lack of high-quality studies [35]. Similar to the
present findings, kinesio taping was recommended for use
as a complementary treatment along with exercise or differ-
ent physiotherapeutic techniques [36,37]. It should be noted
that many clinical trials of kinesio taping which reported an
improvement either did not have a control group or included
some exercise programmes in both groups [15,38,39].
This study had several limitations, including lack of
detailed reporting of the technique for application of kinesio
tape, short duration of follow-up, low quality of some studies,
and use of self-reported scales (response bias). Moreover, the
duration and severity of studied conditions were not reported
in most studies.
Conclusion
There is insufficient evidence to support the use of kine-
sio taping in clinical practice as a treatment for shoulder pain.
However, there is limited evidence of its benefit as a comple-
mentary treatment in shoulder pain syndromes.
Funding: The authors received no funding for this work.
Ethical approval: Not applicable.
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187
Conflict of interest: None declared.
Appendix A. Supplementary data
Supplementary material related to this article can be
found, in the online version, at doi:https://doi.org/10.1016/
j.physio.2019.12.001.
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