Kinesio Taping

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Introduction[edit | edit source]

Kinesio Taping Method is a therapeutic tool utilised by the rehabilitation specialists in all programs (paediatric,[1] geriatric, orthopaedic,[2] neurological, oncology and others) and levels of care (acute care,[3] inpatient rehabilitation,[4] outpatient, home care and Day Rehab). The idea of using elastic tape to mimic the therapist's hands was first presented by Dr Kenzo Kase in the 1970s. Since then it became the modality used in pain management[5], soft tissue injury[6], tissues and joints malalignment[1], oedema[7], and more. Kinesio Taping Method utilises four types of Kinesio Tex Tapes, each one with specific properties designed to use on fragile skin, sensitive skin or applied with higher tensions. Kinesio Taping Method has also been found effective in treating animals[8] and two special tapes are used: Kinesio Equine and Kinesio Canine.

Properties[edit | edit source]

Kinesio Tex Tape contains either 100% cotton and elastic fibres or it can be a blend of polyester and cotton with elastic fibres. The latter is a preferable choice for Kinesio Taping application on sensitive skin when higher tensions on the tape are needed for the desired outcome. The tape is applied on the paper backing using an acrylic adhesive and with 10-15% stretch. This amount of stretch is used with some Kinesio Taping techniques and is referred to as "paper off tension". Other characteristics of Kinesio Tex Tape include[9]:

  • Ability to stretch to 120-140% of its original length
  • Recoil back to the anchor that is applied without stretch
  • Heat activated adhesive
  • Hypoallergenic dyes that make the tape safe for most users
  • Latex-free
  • Drying time after being wet is about 5-10 minutes
  • Can be worn for several days

Type of Kinesio Tex Tapes[edit | edit source]

Currently, there are 4 types of tapes available for Kinesio Taping Method applications for humans and 2 types of tapes for animals. Each clinician can choose the most appropriate type of tape, based on the desired outcome and the client's skin condition. When taping is considered by an untrained individual it is suggested to use Classic or Performance+ Tape.

The following are tape types and their characteristic:

  1. Kinesio Tex Classic: the original tape that received several upgrades over time, the most universal as it can be used for all applications and ideally on healthy skin
  2. Kinesio Tex Performance+: different, looser pattern on the tread, polyester and cotton blend best for sensitive skin when higher tensions on the tape are desired
  3. Kinesio Tex Gold: special distribution of adhesive allowing good attachment without requiring large surface area, good for low tension applications and available only for trained professionals
  4. Kinesio Tex Gold Light Touch Plus: adhesive distributed to allow gentle grip, does not last as long as other types so it is used for short term applications and usually for children and older adults with fragile skin
  5. Kinesio Equine: developed to allow Kinesio Taping method to be used on horses, can be applied directly on horses hair and its taste prevents animals from chewing it
  6. Kinesio Canine: used on dogs and it works well with dogs' hair

Theory[edit | edit source]

Kinesio Taping theory is based on the neurophysiological mechanisms and the effect of mechanical stimuli on various systems in the body:

Central Nervous System (CNS): Kinesio Tex Tape applied on the skin with varying degrees of stretch creates a mechanical stimulus and activates an afferent pathway to CNS

[10]

Skin: Kinesio Tex Tape applied on the skin with a low degree of stretch changes the density and the concentration of the tissue in the dermis and epidermis.[11] This mechanical stimulus produces cell movement.[12][13]Kinesio Tex Tape produces pressure and stretch on the skin that may be able to stimulate mechanoreceptors. This stimulus interacts with CNS and modulates pain responses.[14]

Fascia: the application of Kinesio Tex Tape changes the tension elements in tissues to encourage homeostasis. The tension imposed from the tape frees the fascia of any movement limitations through the movement of the skin relative to the target tissue.[15] [9]

[16]

Lymphatic and Circulatory System: the application of Kinesio Tex Tape facilitates the opening of microvalves due to a dynamic pressure variation as a result of alteration in skin density. This decompression activates lymphatics in the dermis and improves lymphatic flow. The end result is tissue inflammation and swelling reduction.[14]It is also theorised that lifting the skin detaches filaments that attach the skin to endothelial cells of the lymphatic and capillary beds. This is proposed to create channels that allow for lymph to drain, thus reducing swelling and allowing increased blood flow to the area.[17]


Basics of Application[edit | edit source]

  • Complete patient's assessment to identify the most appropriate application. Include Kinesio Taping Method specific assessment tools.
  • Follow contraindications and precautions when choosing Kinesio Taping Method
  • Apply the tape on dry skin, free of oils and lotion
  • Remove body hair if possible by trimming or shaving the area
  • Follow the tension guidelines
  • Round all the edges of the tape to prevent premature peeling
  • Avoid touching the adhesive side of the tape after removing the backing as this may decrease the adhesive strength on the skin
  • Once the tape is applied, activate the heat-sensitive adhesive by rubbing the surface of the tape for a few seconds 
  • Reassess to determine post-application results
  • Inform the patient to defer activities that cause perspiration for 30 minutes if possible
  • Inform the patient to remove the tape if itching or burning sensation has occurred or if the pain has increased
  • Teach the patient and caregiver how to remove the tape if needed
  • Provide the patient with informed consent and an information sheet with a description including:
    • sign and symptoms of skin irritation and skin allergy
    • instruction on tape removal
    • how long to wear the tape
    • physiotherapist contact information

Contraindications and Precautions[edit | edit source]

It is up to each physiotherapist to use their judgement when choosing Kinesio Taping Method. The decision needs to be based on the physiotherapist's clinical experience and experience with taping gained by attending Kinesio Taping Method certification courses.

General contraindications are:

  • Malignancy
  • Infection, cellulitis
  • Open wound
  • DVT
  • Previous allergic reaction to Kinesio Tex Tape

General precautions are:

  • Diabetes
  • Congestive heart failure (CHF)
  • Patient receiving dialysis/Kidney disease
  • Organ transplants
  • Pregnancy


Types of Applications[edit | edit source]

Each physiological system is targeted with a specific application that can be described by:

Type of tape used (Classic, Perfomance+, Gold, Gold Light Touch Plus)

Tape cut (Y, I, X, Fan, Web, Donut, Jelly Fish, Snowflake, EDF)

Y cut
I cut
X cut
Fan cut


Tape length and width (eg.four squares, 2.5 cm)

Technique used (EDF, Fascia Correction, Mechanical Correction, Space Correction, Lymphatic Correction, Overactive or Underactive Muscle)

Patient's position during application

Tension used on the tape (described in %)

Tape direction (proximal or distal)

Example: Kinesio Tex Performance+, one 6 squares, 5 cm I strip, Mechanical correction with 75% tension applied in the middle for patella stabilisation. Patient initial position: supine, with the knee flexed 20 degrees.

[18]

Type of Application Stretch[edit | edit source]

The target tissue should be elongated prior to the tape application.  Various amount of stretch on the tape is used and it depends on the tissue we choose to affect.

  • Ultra light 0-5% (epidermis)
  • Super light 5-10% (dermis)
  • Paper-off 10-15%(superficial fascia)
  • Moderate 25-50% (deep fascia)
  • Severe 75% (tendon)
  • Full 100% (ligament)

For percentage, stretch refer to the percentage of the available stretch.

Tape direction and Technique used[edit | edit source]

Tape direction and technique used are determined based on tissue assessment. Kinesio Taping Method suggests two assessment tools: Manual Direction Test (MDT) for the tissue and Manual Direction Test (MDT) for the muscle. MDT for the tissue includes three components: glide, decompression, and compression. MDT for the muscle has one component: glide


Clinical Implications[edit | edit source]

Level of evidence - varies[edit | edit source]

There is high inconsistency with research on Kinesio Taping Method effectiveness. Several factors contribute to this problem:

  • Research completed by untrained clinicians, lack of information about persons conducting research and their experience in Kinesio Taping Method.
  • Inconsistent protocols used or protocols based on technique described in Kinesio Taping manual. Kinesio Taping application should be chosen based on patient's assessment and finding the primary tissue effected. Example: Patellofemoral Pain Syndrome (PFPS) can have twenty different aetiologies, from problem with foot alignment to trunk muscle strength, requiring completely different taping applications.
  • Other than Kinesio Tex Tape is used for research purposes, but Kinesio Tex Tape properties are utilised when describing methodology. Each brand of elastic tape has different paper-off tension, amount and quality of adhesive varies, and the quality of elastic is different.[19]
  • Research is conducted on health subjects, when primary effect of Kinesio Taping Method is to facilitate the return to homeostasis. Kinesio Taping is a method to assist with musculoskeletal system damages.[20]

What does the evidence support?[edit | edit source]

     -Increase ROM

     -Increase in Function

     -Decrease Oedema/Swelling

Pros[edit | edit source]

  • Some evidence proves theories
  • Provides a treatment
  • Applicable to multiple patient populations
  • Feeling of treatment encourages movement
  • Versatile

Cons[edit | edit source]

  • Small body of evidence to prove theories
  • Expensive
  • Requires practice
  • Skin irritation

References[edit | edit source]

  1. ↑ 1.0 1.1 Dixit J, Roy S.Effect of Neuromuscular Taping Along with Reactive Postural Adjustment and Anticipatory Postural Adjustment in Improving Sitting Balance in Children with Spastic Diplegic Cerebral Palsy. IJHSR 2018;8(11):116-125.
  2. ↑ Arrebola LS, Teixeira de Carvalho R, Yan Lam Wun P, Rizzi de Oliveira P, Firmo dos Santos J, Gonçalves Coutinho de Oliveira V, Pinfildi CE. Investigation of different application techniques for Kinesio Taping® with an accompanying exercise protocol for improvement of pain and functionality in patients with patellofemoral pain syndrome: A pilot study. Journal of Bodywork and Movement Therapies 2020, 24 (1):47-55,
  3. ↑ Brockmann R, Klein HM. Pain-diminishing effects of Kinesio® taping after median sternotomy. Physiotherapy Theory and Practice 2018; 34(6): 433-441.
  4. ↑ Gallagher J. Anterior and posterior diaphragm Kinesio taping for intractable hiccups after ischemic stroke: A case report. Medicine (Baltimore). 2018 Aug;97(34):e11934.
  5. ↑ Donec V, Kubilius R. The effectiveness of Kinesio Taping® for pain management in knee osteoarthritis: a randomized, double-blind, controlled clinical trial. Ther Adv Musculoskelet Dis. 2019 Aug 29;11:1759720X19869135.
  6. ↑ Wang CK, Fang YD, Lin LC, Lin CF, Kuo LC, Chiu FM, Chen CH. Magnetic Resonance Elastography in the Assessment of Acute Effects of Kinesio Taping on Lumbar Paraspinal Muscles. J Magn Reson Imaging. 2019 Apr;49(4):1039-1045.
  7. ↑ Tantawy SA, Abdelbasset WK, Nambi G, Kamel DM. Comparative Study Between the Effects of Kinesio Taping and Pressure Garment on Secondary Upper Extremity Lymphedema and Quality of Life Following Mastectomy: A Randomized Controlled Trial. Integrative Cancer Therapies. January 2019.
  8. ↑ Wójcik M. The Use of Physical Therapy Procedures in the Treatment of Soft Tissue Injuries in a Horse: A Case Study. J Vet Sci Med Diagn 2017; 6:4.
  9. ↑ 9.0 9.1 Kase K, Wallis J, Kase T. Clinical therapeutic applications of the Kinesio taping method. Kinesio 2013, 3rd edition.
  10. ↑ Gustavo Mendoza. Kinesio effect on cortical brain activity fMRI . Available from:https://www.youtube.com/watch?v=k6WsoxI6nzg&t=27s[last accessed 11/11/2021]
  11. ↑ Kafa N, Citaker S, Omeroglu S, Peker T, Coskun N, Diker S. Effects of kinesiologic taping on epidermal-dermal distance, pain, oedema and inflammation after experimentally induced soft tissue trauma. Physiother Theory Pract. 2015;31(8):556-61.
  12. ↑ Lo CM, Wang HB, Dembo M, Wang YL. Cell movement is guided by the rigidity of the substrate. Biophys J. 2000 Jul;79(1):144-52.
  13. ↑ Hale NA, Yang Y, Rajagopalan P. Cell migration at the interface of a dual chemical-mechanical gradient. ACS Appl Mater Interfaces. 2010 Aug;2(8):2317-24.
  14. ↑ 14.0 14.1 Wu W-T, Hong C-Z, Chou L-W. The Kinesio Taping Method for Myofascial Pain Control. Evidence-Based Complementary and Alternative Medicine 2015; Article ID 950519.
  15. ↑ Abu-Hijleh MF, Roshier AL, Al-Shboul Q, Dharap AS, Harris PF. The membranous layer of superficial fascia: evidence for its widespread distribution in the body. Surg Radiol Anat. 2006 Dec;28(6):606-19.
  16. ↑ Ronelle Wood.Fascia Magnified 25x. Available from: https://www.youtube.com/watch?v=uzy8-wQzQMY [last accessed 11/11/2021]
  17. ↑ Lipinska A, Sliwinski Z, Kiebzak W, Senderek T, Kirenko J. Influence of kinesiotaping application on lymphoedema of an upper limb in women after mastectomy. Polish Journal of Physiotherapy 2007:7;258-269.
  18. ↑ Elsevier Australia. Length, Strength and Kinesio Tape: The Upper Trapezius. Available from: https://www.youtube.com/watch?v=3USDcUbKuKE&t=41s [last accessed 12/11/2021]
  19. ↑ Boonkerd C, Limroongreungrat W. Elastic therapeutic tape: do they have the same material properties? J Phys Ther Sci. 2016 Apr;28(4):1303-6.
  20. ↑ Pyšný L, Pyšná J, Petrů D. Kinesio Taping Use in Prevention of Sports Injuries During Teaching of Physical Education and Sport. Procedia - Social and Behavioral Sciences 2015;186:618-623.
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