Patellar Taping: Difference between revisions

No edit summary
No edit summary
Line 1: Line 1:
<br>
<div class="editorbox">
<div class="editorbox">
'''Original Editor '''- [[User:Joyce De Vos|Joyce De Vos]]  
'''Original Editors ''' - [[User:Joris De Pot|Joris De Pot]]  


'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}  
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} &nbsp;
</div>  
</div>  
== Description  ==
<br>


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.
== Clinically Relevant Anatomy  ==


== Indications  ==
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.


Patellar taping is used as a treatment of the following disorders.<ref name="1">Lori A. Bolga, Michelle C. Boling. 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.</ref><ref name="2">K. Crossley, S.M. Cowan, K.L. Bennell, J. McConnell. 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.</ref><ref name="4">Stuart J. Warden, Rana S. Hinman, Mark A. Watson,JR., Keith G. Avin, Andrea E. Bialocerkowski, Kay M. Crossley. Patellar taping and bracing for the treatment of chronic knee pain: a systematic review and meta-analysis, Arthritis &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Rheumatism (Arthritis Care &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Resaerch) Vol.59, No. 1. 2008 January; 73-83.</ref><ref name="5">Rana S. Hinman, Kay M. crossley, Jenny McConnell, Kim L. Bennell. 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.</ref>
== Purpose<br> ==


[[Knee Osteoarthritis]]
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>


[[Patellofemoral Pain Syndrome]]
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>


[[Anterior knee pain]]
== Technique<br>  ==


[[Chondromalacia Patellae]]
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>


== Clinical Presentation  ==
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>


The main characteristics for the above mentioned knee-diseases are:
<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" />


*pain,  
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;amp;amp;amp;amp;amp;ref=135246</ref>
*(morning) stiffness,  
*instability of the joint,  
*swelling,  
*decrease of muscle power and
*difficulties in activities of daily living.


In most of the cases these symptoms aggravate during physical activities such as: ascending and descending stairs, kneeling, running and squatting.<ref name="3" /><ref name="4" /><ref name="11">Gilleard W., McConnell J., Parsons D.. The 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.</ref><br>
<br> {{#ev:youtube|lEyYWIwyv0I}}


== Physical Therapy Management  ==
{{#ev:youtube|y4bYD6bv3PA}}


Patellar taping is a useful treatment to reduce the main symptoms, mentioned in the clinical presentation.<ref name="1" /><ref name="2" /><ref name="3">Brian Quilty, Marian Tucker, Rona Campbell, Paul Dieppe. 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.</ref><ref name="4" /><ref name="5" /><ref name="6">H. Mokhtarinia, I. Ebrahimi-takamjani, M. Salavati, S. Goharpay, A. Khosravi. The 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.</ref><ref name="7">Sallie M. Cowan, Kim L. Bennell, Paul W. Hodges. 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.</ref><ref name="8">Michael J. Callaghan, James Selfe, Alec McHenry, Jacqueline A. Oldham. Effects of patellar taping on knee joint porprioception in patients with patellofemoral pain syndrome, Manual Therapy. 2006.</ref><ref name="9">C.G. Ryan, P.J. Rowe. 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.</ref><ref name="10">Ernst GP., Kawaguchi J., Saliba E.. 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.</ref><ref name="11" /><ref name="12">Worrel T., Ingersoll CD., Bockrath-pugliese K., Minis P.. 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.</ref><ref name="13">Hunter DJ., Zhang YQ., Niu JB., Felson DT., Kxoh K., Newman A., Kritchevsky S., Harris T., Carbone L., Nevitt M.. 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.</ref><ref name="14">Crossley KM., Marino GP., Macilquham MD., Schache AG., Hinman RS.. 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.</ref><ref name="15">Pfeiffer RP., DeBeliso M., Shea KG., Kelley L. Irmischer B., Harris C.. 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.</ref>&nbsp;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>  


{| width="100%" cellspacing="1" cellpadding="1"
<br>
|-
| {{#ev:youtube|jBRdsK3zRyk|300}}
| {{#ev:youtube|gqfjOLcdhfQ|300}}
|}


== Main advantages of patella taping ==
== Key Research ==


=== Pain reduction  ===
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>


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.<ref name="1" /><ref name="2" /><ref name="3" /><ref name="4" /><ref name="5" /><ref name="7" />
== Resources <br> ==


=== Improvement in disability  ===
add appropriate resources here <br>


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.<ref name="3" /><ref name="5" />
== Clinical Bottom Line  ==


=== Effect on quadriceps function  ===
add text here <br>


Patellar taping demonstrated significantly greater concentric and eccentric quadriceps torque.<ref name="2" /><ref name="10" />&nbsp;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.<ref name="10" />&nbsp;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.<ref name="2" /><ref name="7" /><ref name="11" /><br>
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==


=== Effect on knee joint during gait  ===
see tutorial on [[Adding PubMed Feed|Adding PubMed Feed]]  
 
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.<ref name="2" /><ref name="6" />
 
=== Effect on the activation/timing of the vastii  ===
 
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. This benefit should be further explored in order to be more confident of the results.<ref name="8" /><ref name="9" /><ref name="11" />'''''<br>'''''
 
=== Re-align the patella  ===
 
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.<ref name="2" /><ref name="12" /><ref name="13" /><ref name="14" /><ref name="15" /><br>
 
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
<div class="researchbox">
<div class="researchbox">
<rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1Di1IZzM0R4NRlKtvPYT1Y4uEI9nG7Fpa9KeYjXsLrWfkLSQFO|charset=UTF-8|short|max=10</rss>  
<rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1BMD4lHClobBr3Ufpd6UqdyNdjNwdAvxWTmPuuWDtjciRUPcQw|charset=UTF-8|short|max=10</rss>  
</div>  
</div>  
== References  ==
== References  ==


<references />  
<references />  
<div><br></div>
 
[[Category:Musculoskeletal/Orthopaedics|<span>&nbsp;</span>Musculoskeletal/Orthopaedics]] [[Category:Knee]]
[[Category:Knee]][[Category:Musculoskeletal/orthopaedics|orthopaedics]][[Category:Interventions]][[Category:Vrije_Universiteit_Brussel_Project]]

Revision as of 19:54, 27 September 2014


Original Editors - Joris De Pot

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



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

Failed to load RSS feed from http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1BMD4lHClobBr3Ufpd6UqdyNdjNwdAvxWTmPuuWDtjciRUPcQw|charset=UTF-8|short|max=10: Error parsing XML for RSS

References[edit | edit source]

  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;amp;amp;amp;amp;amp;ref=135246
Retrieved from "https://www.physio-pedia.com/index.php?title=Patellar_Taping&oldid=100300"