Patellar Taping: Difference between revisions

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<div class="noeditbox">Welcome to [[Vrije Universiteit Brussel Evidence-based Practice Project|Vrije Universiteit Brussel's Evidence-based Practice project]]. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div> <div class="editorbox">
'''Original Editor '''- [[User:Joyce De Vos|Joyce De Vos]]
'''Original Editors ''' - [[User:Joris De Pot|Joris De Pot]]


'''Lead Editors'''  &nbsp;   
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} &nbsp;   
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== Search Strategy  ==


== Search strategy<br> ==
add text here related to databases searched, keywords, and search timeline <br>  


Databases: PEDro and Pubmed <br>I often used keywords as: - patella taping <br> - patellofemoral pain syndrome <br> - McConnell taping<br> - anterior knee pain<br> - effects of patellar taping.<br>
== Definition/Description  ==


== Description<br> ==
== Clinically Relevant Anatomy ==


Patellar taping was originally developed by Jenny McConnell and is a simple, inexpensive self management strategy.<br>The aim of patellar taping is to create a mechanical realignment in order to correct malalignments of the patella and to reduce pain.<br>
The patella needs to fit into the patella grove. A tilt or a lateral glide is when the lateral ligament is to strong and the quadriceps to weak to hold the patella in his grove. The patella is locked out of his normal position, this causes pain. When there is too much force on the lateral side of the femur and&nbsp;relaxation of cartilage,&nbsp;that's&nbsp;called chondromalacia. To increase the pain, the patella has to put into the patella grove. This can be done by a tape or a brace.


== Indications ==
== Purpose<br> ==


Patellar taping is used as a treatment of the following disorders: [[Knee Osteoarthritis]] , [[Patellofemoral Pain Syndrome]] (PFPS), chronic [[Anterior knee pain]] and [[Chondromalacia Patellae]] <sup>(</sup><sup>1,2,4,5)</sup>.
The purpose of the McConnell taping procedures is to correct abnormal patellar tracking to allow the patient to engage in physical therapy exercise pain free. Although there are several variations of the taping procedure recommended, depending on the specific needs of the patient (eg, glide, tilt, and/or rotation), as reported by McConnell, nearly all patients require a medial glide of their patellas. <ref name="een">Ronald P. Pfeiffer, Mark DeBeliso, Kevin G. Shea, Lorrie Kelley, Bobbie Irmischer and Chad Harris., Kinematic MRI Assessment of McConnell Taping Before and After Exercise, The American Journal of Sports Medicine, 2004; 32: 621 – 628</ref>  


== Clinical Presentation  ==
The McConnell taping technique was developed to correct altered patellofemoral kinematics and permit participation in normal daily activity. <ref name="twee">Aditya Derasari, Timothy J. Brindle, Katharine E. Alter, Frances T. Sheehan., McConnell Taping Shifts the Patella Inferiorly in Patients With Patellofemoral Pain: A Dynamic Magnetic Resonance Imaging Study, Physical Therapy, 2010; 90 (3): 411 – 420</ref>


The main characteristics for the above mentioned knee-diseases are: pain, (morning) stiffness, instability of the joint, swelling, decrease of muscle power and difficulties in activities of daily living.<br>In most of the cases these symptoms aggravate during physical activities such as: ascending and descending stairs, kneeling, running and squatting. <sup>(3,4,11)</sup><br>  
== Technique<br> ==


== Physical Therapy Management  ==
McConnell taping is accomplished by way of application of specialized adhesive tape applied across the anterior aspect of the patella, pulling from lateral to medial, to in effect “medialize” the patellofemoral joint (PFJ). Once applied the patients should experience a reduction in their symptoms associated with PFPS, thus enabling them to engage in physical therapy exercise. As such, the ability of the strapping procedure to maintain the medialized position of the patella is critical for the duration of the physical activity. <ref name="een">Ronald P. Pfeiffer, Mark DeBeliso, Kevin G. Shea, Lorrie Kelley, Bobbie Irmischer and Chad Harris., Kinematic MRI Assessment of McConnell Taping Before and After Exercise, The American Journal of Sports Medicine, 2004; 32: 621 – 628</ref>


Patellar taping is a useful treatment to reduce the main symptoms, mentioned in the clinical presentation<sup>(1-15)</sup>. A well-known taping technique is the McConnell patellar taping technique. To demonstrate this technique I added the first movie. The second movie shows another taping technique especially for knee instability .<br><br>[http://www.youtube.com/watch?v=jBRdsK3zRyk&feature=related http://www.youtube.com/watch?v=jBRdsK3zRyk&amp;feature=related]<br>[http://www.youtube.com/watch?v=gqfjOLcdhfQ&feature=related http://www.youtube.com/watch?v=gqfjOLcdhfQ&amp;feature=related]<br>  
Begin lying on your back, with the knee slightly bent, but completely relaxed and a foam roller or rolled up towel under the knee. <br>Start the tape in line with the middle of the knee cap at the outer aspect of the knee. Using your thumb on top of the sports tape, gently push the knee cap towards the inner aspect of the knee whilst simultaneously using your fingers to pull the skin at the inner aspect of the knee towards the knee cap. Finish this taping technique at the inner aspect of the knee ensuring you have created some wrinkling of the skin at the inner aspect of the knee. Repeat this process 1 - 3 times depending on the amount of support required. <ref name="drie">http://www.physioadvisor.com.au/11343550/patella-taping-mcconnell-taping-physioadvisor.htm</ref>  


==== <u>Main advantages of patella taping<br><br></u> ====
<br>McConnell taping medialized the patella in participants who demonstrated lateral displacement at baseline and lateralized the patella in participants who demonstrated medial patellar displacement at baseline. <ref name="twee" />


<u></u>  
The McConnell taping technique can also help keep the kneecap in alignment. This can help reestablish normal movement and allow the muscles that hold the kneecap in place to redevelop properly. <ref name="vier">eMedecineHealth, Judy Dundas, Maria Essig, Pat Truman, William H. Blahd, Jr. McConnell taping technique, Updated: January 19, 2010. http://www.emedicinehealth.com/script/main/art.asp?articlekey=138626&amp;amp;amp;amp;ref=135246</ref>


<u>''1. Pain reduction:''<br></u>Almost all studies have demonstrated an immediate decrease in pain during provocative exercise. Studies also found that medial patellar tape induced a significantly greater pain reduction than the lateral patellar tape. Especially patients who suffer from knee osteoarthritis, patellofemoral pain syndrome and chronic knee pain experience a significant pain reduction.<sup>( 1,2,3,4,5,7)</sup><u>'''''<br><br>'''2. Improvement in disability:''<br></u>On patients with knee osteoarthritis research demonstrated that therapeutic patellar tape improves the disability of the knee. This advantage of therapeutic tape was maintained until three weeks after stopping treatment. Up until now, the long-term effects are not scientifically proven. Differences have been found between the experimental and the control group, however, the results are insignificant.<sup>(3,5)</sup><u>'''''<br>'''<br>3. Effect on quadriceps function:''<br></u>Patellar taping demonstrated significantly greater concentric and eccentric quadriceps torque. <sup>(2,10)</sup> Another article found significantly greater knee extensor moments and power during weight-bearing activities such as vertical jump and lateral step up in taped conditions in PFPS subjects.<sup>(10)</sup> There are several possible explanations but they need to be explored in further studies. This benefit is important for patients with PFPS, because decreased quadriceps contractions may lead to a diminution of the shock absorption during weight bearing thus further increasing the load on the patellofemoral joint. An increase in quadriceps muscle force can directly heighten the patellofemoral joint reaction force during gait, so patellar taping is very important for the treatment of PFPS.<sup>(2,7,11)</sup><u></u><br><br><u>''4. Effect on knee joint during gait:''<br></u>Patients with PFPS have significantly less knee flexion during gait and walk significantly slower. These factors will reduce the load on the patellofemoral joint and will decrease the demand on the quadriceps function. Patellar taping demonstrated a small but significant increase of knee flexion while the patients walk at two different speeds, up and down ramps and stairs. <sup>(2,6)</sup><br>'''<br>'''<u>''5. Effect on the activation/timing of the vastii:''</u><br>Patients with PFPS demonstrate decreased activation levels of the vastus medialis and the vastus lateralis. Coordinated contraction of these muscles is important for the patellar alignment during activity ( walk up and down the stairs). The benefit of the patella tape is the raise of the activation or timing of the vastus medialis relative to the vastus lateralis or conversely, the decrease activation of the vastus lateralis relative to the vastus medialis. During step down tasks the contraction of the vastus medialis occurred earlier in taped conditions. This earlier activation may alter the movement of the patella. <br>This benefit should be further explored in order to be more confident of the results. <sup>(8,9,11)</sup><u>'''''<br><br>'''6. Re-align the patella:''<br></u>The three most common radiographic measurements alignments of the patella are: the patellofemoral congruence angle (PFCA), the lateral patellofemoral angle (LPFA) and the lateral patellar displacement (LPD). The PFCA represents lateral patellar glide and lateral tilt, the LPFA represents lateral patellar tilt, while the LPD quantifies the position of the patella in the frontal plane relative to the medial femoral condyle in millimeters. A few studies have provided the evidence that medial patellar taping can confer a radiographic positional change of the patella in PFPS subjects. Researchers found a significant change in LPFA and LPD with patellar tape in PFPS subjects They suggest that this may be sufficient to create a subtle alternation in intra-articular or inter-osseous pressure. So patellar tape can influence patellar position in LPFA and LPD. The benefit of taping on the PFCA is not proven. <sup>(2,12,13,14,15)</sup><u><br></u>
== Key Research  ==


<u><br></u>  
add links and reviews of high quality evidence here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br>  


<u></u><br>  
== Resources <br> ==


== References  ==
add appropriate resources here <br>


1. L<u>'''ori A. Bolga, Michelle C. Boling.'''</u> ''An update for the conservative management of patellofemoral pain syndrome: a systematic review of the literature from 2000 to 2010'', Int J Sports Phys Ther. 2011 June; 6(2): 112-125. (evidence level: A1)<br><br>2. <u>'''K. Crossley, S.M. Cowan, K.L. Bennell, J. McConnell'''</u>. ''Patellar taping: is clinical success supported by scientific evidence?'', Centre for Sports Medicine Research and Education, School of Physiotherapy, The University of Melbourne, Australia; McConnell an Clements Physiotherapy, Sydney, Austalia, Manual Therapy. 2000; 5(3): 142-150. (evidence level: A1)<br><br>3. <u>'''Brian Quilty, Marian Tucker, Rona Campbell, Paul Dieppe'''</u>. ''Physiotherapy, including quadriceps exercises and patellar taping, for knee osteoarthritis with predominant patella-femoral joint involvement: randomized controlled trial'', The Journal of Rheumatology. 2003; 30:6. (evidence level: A1 )<br><br>4. <u>'''Stuart J. Warden, Rana S. Hinman, Mark A. Watson,JR., Keith G. Avin, Andrea E. Bialocerkowski, Kay M. Crossley'''</u>. ''Patellar taping and bracing for the treatment of chronic knee pain: a systematic review and meta-analysis'', Arthritis &amp; Rheumatism (Arthritis Care &amp; Resaerch) Vol.59, No. 1. 2008 January; 73-83. (evidence level: A1)<br><br>5. <u>'''Rana S. Hinman, Kay M. crossley, Jenny McConnell, Kim L. Bennell'''</u>. ''Efficacy of knee tape in the management of osteoarthritis of the knee: blinded randomized controlled trial'', Centre for Sports medicine research an Education, School of Physiotherapy, University of Melbourne, Victoria, 3010, Australia. 2003 July 19; 327(7407): 135 (evidence level: A1)<br><br>6. <u>'''H. Mokhtarinia, I. Ebrahimi-takamjani, M. Salavati, S. Goharpay, A. Khosravi'''</u>. T''he effect of patellar taping on knee joint proprioception in patients with patellofemoral pain syndrome'', Tehhran University of Medical Sciences, Acta Medica Iranica. 2008; 46(3): 183-190. (evidence level: B1 )<br><br>7. <u>'''Sallie M. Cowan, Kim L. Bennell, Paul W. Hodges'''</u>. ''Therapeutic patellar taping changes the timing of vasti muscle activation in people with patellofemoral pain syndrome'', Center for Sports Medicine Research and Education, School of Physiotherapy, University of Melbourne, Australia, University of Queensland, Brisbane, Australia., Clinical Journal of Sport Medicine. 2002; 12: 339-347. (evidence level: B3 )<br><br>8. <u>'''Michael J. Callaghan, James Selfe, Alec McHenry, Jacqueline A. Oldham'''</u>. ''Effects of patellar taping on knee joint porprioception in patients with patellofemoral pain syndrome'', Manual Therapy. 2006. (evidence level: C1 )<br><br>9. '''C<u>.G. Ryan, P.J. Rowe.</u>''' ''An electromyographical study to investigate the effects of patellar taping on the vastus medialis/ lateralis ratio in asymptomatic participants'', School of health and social care, Physiotherapy Theory and Practice. 2006; 22(6): 309-315. (evidence level: C2)<br><br>10. <u>'''Ernst GP., Kawaguchi J., Saliba E.'''</u>. ''Effect of patellar taping on knee kinetics of patients with patellofemoral pain syndrome,'' US Army-baylor University Program in Physical Therapy, Ft Sam Housten, Tex., USA., J Orthop Sports Phys Ther. 1999; 29(11): 661-667. (evidence level: C1)<br><br>11. <u>'''Gilleard W., McConnell J., Parsons D.'''</u>. T''he effect of patellar taping on the onset of vastus medialis obliquus and vastus lateralis muscle activity in persons with patellofemoral pain'', School of Exercise and Sport Science, University of Sydney, New South Wales, Australia., Physical Therapy. 1998; 78(1): 25-32. (evidence level: C1 )<br><br>12. <u>'''Worrel T., Ingersoll CD., Bockrath-pugliese K., Minis P'''</u>.. ''Effect of patellar taping and bracing on patellar position as determined by MRI in patients with patellofemoral pain'', Krannert School of Physicel Therapy, University of Indianapolis., J Athl Train. 1998; 33(1): 16-20. (evidence level: B2)<br><br>13. <u>'''Hunter DJ., Zhang YQ., Niu JB., Felson DT., Kxoh K., Newman A., Kritchevsky S., Harris T., Carbone L., Nevitt M.'''</u>. ''Patella malalignment, pain and patellofemoral progression: the health ABC study, Clinical Epidemiology Research and Training Unit'', Boston University School of Medicine, Boston, USA.,Osteoarthritis Cartilage. 2007 Oct; 15(10): 1120-1127. (evidence level: B3)
== Clinical Bottom Line  ==


<br>14. <u>'''Crossley KM., Marino GP., Macilquham MD., Schache AG., Hinman RS.'''</u>. ''Can patellar tape reduce the patellar malalignment and pain associated with patellofemoral osteoarthritis'', National ICT Australia, The University of Melbourne, Parkville, Australia, Arthritis Rheum. 2009 Dec; 15;61(12): 1719-1725. (evidence level: C2)<br><br>15. <u>'''Pfeiffer RP., DeBeliso M., Shea KG., Kelley L. Irmischer B., Harris C.'''</u>. ''Kinematic MRI assessment of McConnell taping before and after exercise, Center for Orthopaedic and Biomechanics Research'', Boise State University, Am J Sports Med. 2004 Apr-May; 32(3): 621-628. (evidence level: B3 )<br>  
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
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== References  ==
== References  ==


References will automatically be added here, see [[Adding References|adding references tutorial]].  
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Revision as of 16:45, 14 June 2013

Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Joris De Pot

Top Contributors - Admin, William Jones, Joyce De Vos, Venus Pagare, Kim Jackson, Rachael Lowe, Lore Aerts, Oyemi Sillo, WikiSysop, Joris De Pot, Naomi O'Reilly, George Prudden, Redisha Jakibanjar, Claire Knott, Wanda van Niekerk, 127.0.0.1 and Eric Robertson  

Search Strategy[edit | edit source]

add text here related to databases searched, keywords, and search timeline

Definition/Description[edit | edit source]

Clinically Relevant Anatomy[edit | edit source]

The patella needs to fit into the patella grove. A tilt or a lateral glide is when the lateral ligament is to strong and the quadriceps to weak to hold the patella in his grove. The patella is locked out of his normal position, this causes pain. When there is too much force on the lateral side of the femur and relaxation of cartilage, that's called chondromalacia. To increase the pain, the patella has to put into the patella grove. This can be done by a tape or a brace.

Purpose
[edit | edit source]

The purpose of the McConnell taping procedures is to correct abnormal patellar tracking to allow the patient to engage in physical therapy exercise pain free. Although there are several variations of the taping procedure recommended, depending on the specific needs of the patient (eg, glide, tilt, and/or rotation), as reported by McConnell, nearly all patients require a medial glide of their patellas. [1]

The McConnell taping technique was developed to correct altered patellofemoral kinematics and permit participation in normal daily activity. [2]

Technique
[edit | edit source]

McConnell taping is accomplished by way of application of specialized adhesive tape applied across the anterior aspect of the patella, pulling from lateral to medial, to in effect “medialize” the patellofemoral joint (PFJ). Once applied the patients should experience a reduction in their symptoms associated with PFPS, thus enabling them to engage in physical therapy exercise. As such, the ability of the strapping procedure to maintain the medialized position of the patella is critical for the duration of the physical activity. [1]

Begin lying on your back, with the knee slightly bent, but completely relaxed and a foam roller or rolled up towel under the knee.
Start the tape in line with the middle of the knee cap at the outer aspect of the knee. Using your thumb on top of the sports tape, gently push the knee cap towards the inner aspect of the knee whilst simultaneously using your fingers to pull the skin at the inner aspect of the knee towards the knee cap. Finish this taping technique at the inner aspect of the knee ensuring you have created some wrinkling of the skin at the inner aspect of the knee. Repeat this process 1 - 3 times depending on the amount of support required. [3]


McConnell taping medialized the patella in participants who demonstrated lateral displacement at baseline and lateralized the patella in participants who demonstrated medial patellar displacement at baseline. [2]

The McConnell taping technique can also help keep the kneecap in alignment. This can help reestablish normal movement and allow the muscles that hold the kneecap in place to redevelop properly. [4]

Key Research[edit | edit source]

add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)

Resources
[edit | edit source]

add appropriate resources here

Clinical Bottom Line[edit | edit source]

add text here

Recent Related Research (from Pubmed)[edit | edit source]

see tutorial on Adding PubMed Feed

Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10

References[edit | edit source]

see adding references tutorial.

  1. ↑ 1.0 1.1 Ronald P. Pfeiffer, Mark DeBeliso, Kevin G. Shea, Lorrie Kelley, Bobbie Irmischer and Chad Harris., Kinematic MRI Assessment of McConnell Taping Before and After Exercise, The American Journal of Sports Medicine, 2004; 32: 621 – 628
  2. ↑ 2.0 2.1 Aditya Derasari, Timothy J. Brindle, Katharine E. Alter, Frances T. Sheehan., McConnell Taping Shifts the Patella Inferiorly in Patients With Patellofemoral Pain: A Dynamic Magnetic Resonance Imaging Study, Physical Therapy, 2010; 90 (3): 411 – 420
  3. ↑ http://www.physioadvisor.com.au/11343550/patella-taping-mcconnell-taping-physioadvisor.htm
  4. ↑ eMedecineHealth, Judy Dundas, Maria Essig, Pat Truman, William H. Blahd, Jr. McConnell taping technique, Updated: January 19, 2010. http://www.emedicinehealth.com/script/main/art.asp?articlekey=138626&amp;amp;amp;ref=135246
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