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Journal of
PHYSIOTHERAPY
journal homepage: www.elsevier.com/locate/jphys
Research
Kinesio Taping to generate skin convolutions is not better than sham taping
for people with chronic non-specific low back pain: a randomised trial
Patrı́cia do Carmo Silva Parreira a, Lucı́ola da Cunha Menezes Costa a, Ricardo Takahashi b,
Luiz Carlos Hespanhol Junior a,c, Maurı́cio Antônio da Luz Junior a, Tatiane Mota da Silva a,
Leonardo Oliveira Pena Costa a,d
a
Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo; b Private Practice, São Paulo, Brazil; c Department of Public & Occupational
Health and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; d Musculoskeletal Division,
The George Institute for Global Health, Sydney, Australia
K E Y W O R D S A B S T R A C T
Kinesio Taping Question: For people with chronic low back pain, does Kinesio Taping, applied according to the
Randomised controlled trial treatment manual to create skin convolutions, reduce pain and disability more than a simple application
Low back pain without convolutions? Design: Randomised trial with concealed allocation, intention-to-treat analysis
and blinded assessment of some outcomes. Participants: 148 participants with chronic non-specific low
back pain. Intervention: Experimental group participants received eight sessions (over four weeks) of
Kinesio Taping applied according to the Kinesio Taping Method treatment manual (ie, 10 to 15% tension
applied in flexion to create skin convolutions in neutral). Control group participants received eight
sessions (over four weeks) of Kinesio Taping with no tension, creating no convolutions. Outcome
measures: The primary outcome measures were pain intensity and disability after the four-week
intervention. Secondary outcomes were pain intensity and disability 12 weeks after randomisation, and
global perceived effect at both four and 12 weeks after randomisation. Results: Applying Kinesio Tape to
create convolutions in the skin did not significantly change its effect on pain (MD–0.4 points, 95% CI–1.3
to 0.4) or disability (MD–0.3 points, 95% CI–1.9 to 1.3) at four weeks. There was a small difference in
favour of the experimental group for the secondary outcome of global perceived effect (MD 1.4 points,
95% CI 0.3 to 2.5) at four weeks. No significant between-group differences were observed for the other
secondary outcomes. Conclusion: Kinesio Taping applied with stretch to generate convolutions in the
skin was no more effective than simple application of the tape without tension for the outcomes
measured. These results challenge the proposed mechanism of action of this therapy. Trial registration:
Brazilian Registry of Clinical Trials, RBR-7ggfkv. [Parreira PCS, Costa LCM, Takahashi R, Hespanhol
Junior LC, da Luz Junior MA, da Silva TM, Costa LOP (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: 90–96]
ß 2014 Australian Physiotherapy Association. Published by Elsevier B.V. This is an open access article
under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
http://dx.doi.org/10.1016/j.jphys.2014.05.003
1836-9553/ß 2014 Australian Physiotherapy Association. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://
creativecommons.org/licenses/by-nc-nd/3.0/).
Author's personal copy
Research 91
the Kinesio Tape and its application over stretched muscle will Participants, therapists, centres
create convolutions in the patient’s skin on return to the neutral
position.14 These convolutions, according to the creators of this People presenting with low back pain of at least three months’
technique,14 reduce the pressure in the mechanoreceptors that duration, aged between 18 and 80 years, of either gender, who
are located below the dermis, thereby decreasing nociceptive were seeking treatment for low back pain were included in this
stimuli. Furthermore, it has been proposed that the convolutions study. People with any contraindication to physical exercise,
alter the recruitment of muscles through inhibitory and according to the guidelines of the American College of Sports
excitatory neuromuscular mechanisms.14 According to the Medicine,20 were excluded from the study, including: serious
creators14 of the method, the mechanism is inhibitory or spinal pathology, nerve root compromise, serious cardiopulmo-
excitatory, depending on the direction of tape application. nary conditions, pregnancy or any contraindications to the use of
One study18 investigated the effect of the direction of Kinesio taping (such as skin allergy).
Taping, but showed that the direction of the tape is unimpor- Three physiotherapists, who were not involved in the initial
tant. Nevertheless, the question of whether the convolutions assessments, treated the participants. The physiotherapists were
generated by the tape are important remains because the theory extensively trained to deliver the Kinesio Taping intervention by
that skin convolutions are the mechanism for the Kinesio Taping two certified Kinesio Taping Method practitioners. These practi-
effects has never been tested in a high-quality, randomised tioners audited the interventions over the course of the study. The
controlled trial. trial was conducted in two outpatient physiotherapy clinics in the
Therefore, the research questions for this study were: cities of São Paulo and Campo Limpo Paulista, Brazil.
[(Figure_1)TD$IG]
92 Parreira et al: Kinesio Taping for low back pain
Figure 1. I-shaped Kinesio Tape over each erector spinae muscle with 10 to 15% of tension (paper-off tension) with the treated muscles in stretched position according to
Kenzo Kase’s Kinesio taping manual.19
professionally translated, cross-culturally adapted into Brazilian after treatments (four weeks). The secondary outcomes were pain
Portuguese, and tested for their measurement properties for intensity and disability associated with low back pain, which were
people with low back pain in Brazil.23–25 measured 12 weeks after randomisation, and global impression of
The primary outcomes were pain intensity and disability recovery, which was measured immediately after treatments (four
[(Figure_2)TD$IG]
associated with low back pain, which were measured immediately weeks) and 12 weeks after randomisation.
Figure 2. I-shaped Kinesio Tape over each erector spinae muscle with no tension (0% tension) and with the treated muscle in a non-stretched position.19
Author's personal copy
Research 93
Table 2
Mean (SD) for continuous outcomes at all study visits for each group, mean (SD) difference within groups, and mean (95% CI) difference between groups.
Exp Con Exp Con Exp Con Exp Con Exp Con Exp minus Exp minus
(n = 74) (n = 74) (n = 74) (n = 74) (n = 74) (n = 74) Con Con
Pain, (0 to 10) 7.0 6.8 4.4 4.6 5.4 5.7 2.6 2.2 1.6 1.1 0.4 0.5
(2.0) (2.0) (2.8) (2.5) (2.4) (2.5) (3.1) (2.7) (2.9) (2.7) ( 1.3 to 0.4) ( 1.4 to 0.4)
Disability, (0 to 24) 11.5 10.4 8.3 7.4 8.8 7.4 3.2 3.0 2.7 3.0 0.3 0.3
(6.2) (5.3) (6.9) (6.4) (7.5) (6.3) (5.4) (4.6) (5.6) (4.8) ( 1.9 to 1.3) ( 1.3 to 1.9)
Global Perceived 1.0 0.1 2.4 1.9 1.2 1.6 3.4 2.0 2.1 1.7 1.4 0.4
Effect, ( 5 to 5) (3.2) (2.9) (2.4) (2.7) (2.8) (2.5) (3.7) (3.8) (3.4) (3.6) (0.3 to 2.5) ( 0.7 to 1.5)
a
Between-group differences are adjusted. Shaded cells = primary outcomes. Exp = experimental, con = control.
Author's personal copy
[(Figure_3)TD$IG]
94 Parreira et al: Kinesio Taping for low back pain
Excluded (n = 36)
nerve root compromise (n = 11)
other comorbidities (n = 10)
refused to participate (n = 5)
decompensated cardiovascular disease (n = 3)
allergy to test of Kinesio Taping (n = 3)
reported allergy to adhesive tape (n = 2)
receiving physiotherapy treatment (n = 1)
serious spinal pathology (n = 1)
Randomised (n = 148)
Week 0
(n = 74) (n = 74)
Lost to
follow-up Lost to
(n = 0) follow-up
(n = 0)
Research 95
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