journal of orthopaedic & spor ts physi cal ther apy | volume 39 | number 7 | jul y 200 9 | 515 [ RESEARCH REPORT ] 1 Clinical Consultant, Centro de Fisioterapia Integr al, Candas, Asturias, Spain. 2 Proessor, Department oPhysical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Clinical Researcher, Esthesiology Laboratory oUniversidad Rey Juan Carlos, Alcorcón, Spain. 3 Proessor, Department oPhysical Therapy, Franklin Pierce University, Concord, NH; Physical Therapist, Rehabilitation Services, Concord Hospital, NH; Faculty, Manual Therapy Fellowship Program, Regis University, Denver, CO. 4 Assistant Proessor, Online Education, University oSt Augustine or Health Sciences, St Augustine, Florida; Clinical Consultant, Shelbourne Physiotherapy Clinic, Victoria, British Columbia, Canada. The protocol or this study was approved by The Human Research Committee othe Escuela de Osteopatia de Madrid. Address correspondence to César Fernández de las Peñas, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain. E-mail: cesar.[email protected]JAVIER GONZÁLEZ-IGLESIAS, PT¹PT, PhD²PT, PhD³ PT, MSc, DPT, OCS, FAAOMPT, FCAMT 4 PT¹ Short-Term Efects oCervical Kinesio Taping on Pain and Cervical Range oMo tion in P atients With Acute Whiplash Injury: A Randomized C linical T rial W hiplash injuries or whiplash-associated disorders (WADs) oten occur with motor vehicle accidents. 3 The Quebec Task Force adopted the ollowing definition owhiplash: “Whiplash is an acceleration- deceleration mechanism oenergytranser to the neck. It may result rom rear-end or side- impact motor vehicle collisions, but can also occur during diving or other mishaps. The impact may result in bony or sot tissue injuries (whiplash), which in turn may lead to a variety oclinical maniestations (whiplash- associate d di sorders). ” 19 The incidence rate varies across diferen t studi es and countries, but it may be as high as 677 per 100000 habitants. 4 While it has Randomized clinical trial. T o determine the short-term efects oKinesio T aping, applied to the cer vical spine, on neck pain and cervical range omotion in individuals with acute whiplash-associated disorders (WADs). Researchers have begun to inves- tigate the efects oKinesio T aping on diferent mus- culoskeletal conditions (eg, shoulder and trunk pain). Considering the demonstrated short-term efectiveness oKinesio Tape or the management oshoulder pain, it is suggested that Kinesio Tape may also be beneficial in reducing pain associated with WAD. Forty-on e pa- tients (21 emales) were randomly assigned to 1 o2 groups: the experimental group received Kinesio T aping to the cervical spine (applied with tension) and the placebo group received a sham Kinesio T aping application (applied without tension). Both neck pain (11-point numerical pain rating scale) and cervical range-o-motion data were collected at baseline, immediately ater the Kinesio T ape application, and at a 24-hour ollow-up by an assessor blinded to the treatment allocation othe patients. Mixed-model analyses ovariance (ANOVAs) were used to examine the efects othe treatment on each outcome variable, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. The group-by-time interaction or the 2-by-3 mixed-model ANOVA was statistically signifi- cant or pain as the dependent variable (F = 64.8; P.001), indicating that patients receiving Kinesio Taping experienced a greater decrease in pain im- mediately postapplication and at the 24-hour ollow- up (both, P.001). The group-by-time interaction was also significant or all directions ocervical range omotion: flexion (F = 50.8; P.001), exten- sion (F = 50.7; P.001), right (F = 39.5; P.001) and let (F = 3.8, P.05) lateral flexion, and right (F = 33.9, P.001) and let (F = 39.5, P.001) rota- tion. Patients in the experimental group obtained a greater improvement in range omotion than those in the control group (all, P.001). Patients with acute W AD receiving an application oKinesio Taping, ap- plied with proper tension, exhibited statistically significant improvements immediately ollowing application othe Kinesio Tape and at a 24-hour ollow-up. However, the improvements in pain and cervical range omotion were small and may not be clinically meaningul. Future studies should investigate iKinesio Taping provides enhanced outcomes when added to physical therapy inter- ventions with proven ecacy or when applied over a longer period. Therapy, level 1b. J Orthop Sports Phys Ther 2009;39(7):515-521. doi:10.2519/jospt.2009.3072 cervical spine, neck, taping, WA D SUPPLEMENTAL VIDEO ONLINE
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Short-Term Effects of Cervical Kinesio Taping on Pain and Cervical Range of Motion in Patients With Acute Whiplash
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8/6/2019 Short-Term Effects of Cervical Kinesio Taping on Pain and Cervical Range of Motion in Patients With Acute Whiplash
journal of orthopaedic & sports physical therapy | volume 39 | number 7 | july 2009 | 515
[ RESEARCH REPORT ]
1Clinical Consultant, Centro de Fisioterapia Integral, Candas, Asturias, Spain. 2Proessor, Department o Physical Therapy, Occupational Therapy, Rehabilitation and Physical
Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Clinical Researcher, Esthesiology Laboratory o Universidad Rey Juan Carlos, Alcorcón, Spain. 3Proessor,
Department o Physical Therapy, Franklin Pierce University, Concord, NH; Physical Therapist, Rehabilitation Services, Concord Hospital, NH; Faculty, Manual Therapy Fellowship
Program, Regis University, Denver, CO. 4Assistant Proessor, Online Education, University o St Augustine or Health Sciences, St Augustine, Florida; Clinical Consultant,
Shelbourne Physiotherapy Clinic, Victoria, British Columbia, Canada. The protocol or this study was approved by The Human Research Committee o the Escuela de Osteopatia
de Madrid. Address correspondence to César Fernández de las Peñas, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón,
Short-Term Efects o Cervical KinesioTaping on Pain and Cervical Range o
Motion in Patients With Acute WhiplashInjury: A Randomized Clinical Trial
Whiplash injuries or whiplash-associateddisorders (WADs)oten occur with
motor vehicle accidents.3 The
Quebec Task Force adopted theollowing definition o whiplash:“Whiplash is an acceleration-deceleration mechanism o energy transer to the neck. It may result
rom rear-end or side-impact motor vehiclecollisions, but can alsooccur during diving
or other mishaps. Theimpact may result in bony or sottissue injuries (whiplash), which
in turn may lead to a variety o clinical maniestations (whiplash-associated disorders).”19 Theincidence rate varies across
diferent studies and countries, but it may be as high as 677 per
100000 habitants.4 While it has
Randomized clinical trial.
To determine the short-term
efects o Kinesio Taping, applied to the cervical
spine, on neck pain and cervical range o motion
in individuals with acute whiplash-associated
disorders (WADs).
Researchers have begun to inves-
tigate the efects o Kinesio Taping on diferent mus-
culoskeletal conditions (eg, shoulder and trunk pain).
Considering the demonstrated short-term efectiveness
o Kinesio Tape or the management o shoulder pain,
it is suggested that Kinesio Tape may also be beneficial
in reducing pain associated with WAD.
Forty-one pa-
tients (21 emales) were randomly assigned to 1 o
2 groups: the experimental group received Kinesio
Taping to the cervical spine (applied with tension)
and the placebo group received a sham Kinesio
Taping application (applied without tension). Both
neck pain (11-point numerical pain rating scale)
and cervical range-o-motion data were collected
at baseline, immediately ater the Kinesio Tape
application, and at a 24-hour ollow-up by an
assessor blinded to the treatment allocation o
the patients. Mixed-model analyses o variance
(ANOVAs) were used to examine the efects o the
treatment on each outcome variable, with groupas the between-subjects variable and time as the
within-subjects variable. The primary analysis was
the group-by-time interaction.
The group-by-time interaction or the
2-by-3 mixed-model ANOVA was statistically signifi-
cant or pain as the dependent variable (F = 64.8;
P .001), indicating that patients receiving Kinesio
Taping experienced a greater decrease in pain im-
mediately postapplication and at the 24-hour ollow-
up (both, P .001). The group-by-time interaction
was also significant or all directions o cervical
range o motion: flexion (F = 50.8; P .001), exten-
sion (F = 50.7; P .001), right (F = 39.5; P .001)
and let (F = 3.8, P .05) lateral flexion, and right (F
= 33.9, P .001) and let (F = 39.5, P .001) rota-
tion. Patients in the experimental group obtained a
greater improvement in range o motion than those
in the control group (all, P .001).
Patients with acute WAD
receiving an application o Kinesio Taping, ap-
plied with proper tension, exhibited statistically
significant improvements immediately ollowing
application o the Kinesio Tape and at a 24-hour
ollow-up. However, the improvements in pain and
cervical range o motion were small and may not
be clinically meaningul. Future studies should
investigate i Kinesio Taping provides enhanced
outcomes when added to physical therapy inter-
ventions with proven ecacy or when applied over
a longer period.
Therapy, level 1b.
J Orthop Sports Phys Ther 2009;39(7):515-521.
doi:10.2519/jospt.2009.3072
cervical spine, neck, taping, WAD
SUPPLEMENTALVIDEO ONLINE
8/6/2019 Short-Term Effects of Cervical Kinesio Taping on Pain and Cervical Range of Motion in Patients With Acute Whiplash
518 | july 2009 | volume 39 | number 7 | journal of orthopaedic & sports physical therapy
[ RESEARCH REPORT ]
diagram o patient recruitment and re-
tention. Baseline characteristics between
tion. The reasons or ineligibility can be
ound in , which provides a flow
the groups were similar or all variables
( P .40) ().
The group-by-time interaction or the
2-by-3 mixed-model ANOVAs was sta-
tistically significant or neck pain as thedependent variable (F = 64.8; P .001).
Planned pairwise comparisons indicated
that patients receiving the real Kinesio
Taping intervention experienced greater
reduction in neck pain immediately po-
stapplication and at 24-hour ollow-up
(both, P .001). The group-by-time inter-
action or the 2-by-3 mixed-model ANO-
VA was also statistically significant or all
directions o the cervical range o motion:
flexion (F = 50.8; P .001), extension (F
= 50.7; P .001), right (F = 39.5; P .001)
and let (F = 3.8, P .05) lateral flexion,
and right (F = 33.9, P .001) and let (F
= 39.5, P .001) rotation. Planned pair-
wise comparisons showed that patients
in the experimental group obtained a
greater improvement in cervical range o
motion than those in the control group
(all, P .001). and 3 summarize
within- and between-group diferences,
with associated 95% confidences inter-
vals or immediate posttreatment and 24-
hour ollow-up or both pain and cervical
range-o-motion measurements.
he results of the current study
demonstrated that patients with
WAD who received Kinesio Tap-
ing exhibited statistically significantly
greater improvements in neck pain and
cervical range o motion both immedi-
ately ollowing application o the tape
and at a 24-hour ollow-up, when com-
pared to a group receiving a placebo non-tensioned Kinesio Tape application. But
these changes were small and possibly
o minimal clinical significance. Our re-
sults agree with previous case series that
also ound a decrease in pain and im-
provement in range o motion ater the
application o Kinesio Taping.10,17,28 Fur-
ther, the improvements in cervical range
o motion demonstrated in the current
study are similar in magnitude to those
Baseline Demographics for Both Groups*
* Data are mean SD except or gender. No diference between groups ( P.40).† Measured with an 11-point numerical pain rating scale (0, no pain; 10, worst pain imaginable).‡ Range o score is 0 to 50, with higher scores indicating greater disability.
P
Gender (male/emale) 10/10 10/11 .912
Age (y) 32 7 33 6 .474
Days rom accident (d) 24 8 22 9 .398
Neck pain† 4.2 0.7 4.3 0.9 .780
Neck Disability Index‡
29.0
4.4 29.8
3.5 .881Cervical range o motion
Flexion 56.6° 4.9° 55.8° 5.7° .638
Extension 48.8° 4.7° 46.7° 8.3° .458
Right lateral flexion 43.3° 4.6° 42.3° 5.1° .574
Let lateral flexion 42.9° 4.1° 41.8° 3.7° .457
Right rotation 55.2° 5.3° 56.1° 7.1° .677
Let rotation 55.5° 5.9° 55.7° 6.9° .886
Patients with whiplash screenedor eligibility criteria (n = 52)
Excluded (n = 11):
y
)
Allocated to real KinesioTaping (n = 21)
o
Flow-diagram o subjects throughout the course o the study.
8/6/2019 Short-Term Effects of Cervical Kinesio Taping on Pain and Cervical Range of Motion in Patients With Acute Whiplash