The Effects of Kinesio Taping on Biomechanical and Clinical Outcomes in Runners with and without Iliotibial Band Syndrome

Abstract

Iliotibial band syndrome (ITBS) is a common repetitive injury in long-distance runners. Symptoms can lead to significant pain, functional impairment, and inability to participate in sporting activities such as running. Kinesio Taping (KT) is frequently used in the management of lower limb injuries and has been shown to improve pain, function, and running performance. However, the details of such effects remain unclear, with various hypothesised effects including; limiting the range of motion, improvements in strength and joint stability, and facilitation of muscle activity. Evidence suggests that Kinesio tape with tension (KTT) can improve abnormal biomechanics, change lower limb muscle activity and decrease pain compared to no tape or sham tape conditions and has been proposed as a potential treatment for ITBS. To date, no study has evaluated the effects of KT in runners with ITBS. Therefore, the purpose of this thesis was to investigate the effects of the application of KT on the biomechanics of running and clinical outcomes in runners with and without ITBS.
Initially the immediate effects of KT on kinematic, kinetic and EMG parameters in the lower limb; along with perceived comfort, stability of the knee joint, and running performance were recorded in 20 UK healthy participants (10 males and 10 females) and 20 Thai healthy participants (10 males and 10 females), aged between 18 and 45 years. Three conditions were tested; No Tape (NT) followed by a randomised order for Kinesio Tape with Tension (KTT), and Kinesio tape with No Tension (KTNT). The KTT consisted of three taping techniques; inhibition, space correction, and functional correction, which were applied over the ITB covering the TFL, at the lateral epicondyle of the femur, and over the thigh, respectively. The KTNT condition consisted of the same three layers of KT as in the KTT condition and was applied without tension with the participant positioned in a neutral lower limb position. Comparisons of peak hip, knee angles and moments, and EMG were analysed during the stance phase of running. The results from the healthy studies showed that this KT technique appeared to increase peak hip external rotation in both the UK and Thai healthy cohorts. Additionally, there was a decrease in peak hip internal rotation angle in the Thai healthy participants, and there was a trend towards a decrease in peak hip adduction and internal rotation angle in the UK healthy participants. Furthermore, TFL activity showed a decrease with KTT compared with NT, and Gmax activity reduced with KTNT when compared with NT in the UK healthy participants. Whereas the Thai healthy participants showed Gmax activity decreased with KTNT compared with NT, and there was a trend toward a decrease in TFL activity in the KTT condition compared to the NT condition. These results suggest that a significant change in biomechanics of running and muscle activity can be achieved with the application of KT, with the greatest effect seen with the application of KT with tension, with no participants reporting any negative important changes in comfort and perception of stability of the knee joint, although two individuals in the KTT condition reported a clinically important negative change on running performance in the UK participants, with one in the KTT indicating a clinically important negative effect on comfort and running performance.
The last study was a randomised controlled trial that was conducted on 40 Thai participants with ITBS (20 in KTT group and 20 in KTNT group). The peak hip, knee angles and moments, EMG, hip abductor and external rotator muscle strength, and TFL muscle and iliotibial band (ITB) length were measured at pre-tape and immediate-post tape. Clinical outcome measures; Numerical Pain Rating scale (NPRS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Tampa Scale for Kinesiophobia (TSK), Global Rating of Change (GROC), perceived comfort, stability of the knee joint, and running performance were measured across 7 days. Significant increases were seen in peak hip external rotation in the KTT group, with a significant decrease in average TFL muscle activity, but no main effect for group was seen. In addition, KTT group demonstrated significantly decreased peak knee external rotation moments compared to KTNT group immediate post-taping, with no significant differences between groups was seen for pre-tape. Moreover, there was a significant increase for TFL and ITB length in both KTT and KTNT groups and a decrease in the average Gmax, Gmed, and VM muscle activity. Furthermore, a significant decrease for peak Gmed muscle activity was seen in females in both groups. Participants in the KTT group reported improvements in NPRS, all domains of KOOS, GROC, and also no participant reported any negative important changes in perceive comfort, stability of the knee joint, and running performance after using KT, but no significant effects were seen for TSK.
This work provides new insights and data to support the use of KT to change running biomechanics previously associated with ITBS, with the greatest effect seen with the application of KT with tension, with important improvements in all clinical outcome measures except TSK. However, the majority of the changes were small when considering the variability in the biomechanical and EMG measurements, suggesting that there was little difference between the KTT and KTNT interventions. The clinical implications should be interpreted carefully along with the clinician's experience and expertise. Further work is required to explore the longer-term effects on the biomechanical and clinical outcome measures using KT with and without tension in the management of ITBS.