New Approaches in Joints Pain Patellofemoral Syndrome

Transcription

1 Lublin, 2014 New Approaches in Joints Pain Patellofemoral Syndrome Edited by Lana Ramazan

2 Reviewer: Joanna Fidut, MSc, CPT Edited by: Lana Ramazan Copyright 2014 Karolina Janikowska. All rights reserved. Published by Medunio 2014, Lubartowska 38/19, Lublin Photo: Karolina Janikowska ISBN : First edition 2

3 Content The role of Kinesio taping application in pain reduction in patients with patellofemoral syndrome... 4 The taping applications for the patellofemoral syndrome part The taping applications for the patellofemoral syndrome part The taping applications for the patellar lateralization The taping applications for the patellofemoral syndrome part Kinesio taping applications in patellar malaligment part Kinesio taping applications in patellar malaligment part Kinesio taping applications in patellar malaligment part The role of Kinesio taping application in patients with iliotibial syndrome The taping applications in Osgood - Schlatter Disease Advanced applications for the patellofemoral syndrome

4 Karolina Janikowska The role of Kinesio taping applications in pain reduction in patients with patellofemoral syndrome Background Patellofemoral syndrome is one of the most common condition, especially among adolescents and young adults. It is still one of the most challenging pathologies to manage. The basic symptom of the patellofemoral syndrome is pain localized in the area of anterior and lateral knee aggravating with everyday life activities like stairs climbing or sports performance requiring extensive knee flesiox and extensions. Palpation over the patella during knee flexion and extension will often reveal crepitus, which is of debatable significance. The conservative therapy is based on use of ultrasound, cryotherapy, heat, electrical and laser stimulation. The other possible treatment is based of pharmacological preparates e.g. non- steroidal anti-inflammatory drugs (NSAID). Modern therapies require new approach and techniques focusing on the core of the patients problem. Factors that may contribute to abnormal patella tracking include quadriceps weakness, quadriceps muscle imbalances, excessive knee soft tissue tightness, an increased quadriceps angle (Q-angle), hip weakness, and altered foot kinematics. Based on this clinical theory, the aim for interventions used for the treatment of PFPS is to improve patella tracking and reduce abnormal stress to patellofemoral joint structures. More and more studies indicates the need of attention to kinematics of the patella and changing its tracking. One of the most common intervention is the mobilization of the patella. Another new approach to this condition can be realized with use of the Kinesio taping developed by Kenzo Kase. The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over- 4

5 contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Aim of the study The aim of the was to estimate the influence of the manual Kinesio taping application on pain and the functional status of the patients with patellofemoral syndrome of the knee. Material and methods The study was conducted on group of patients (15 men and 8 women) diagnosed with patellofemoral syndrome of the knee who suffered for at least three months and failed to the conventional therapy. The exclusion criteria for the study was: previous injury injury of this knee in anamnesis, structural changes after injury in the area of affected knee, receiving any physical or manual therapy for patellofemoral syndrome during last 4 weeks, wounds and skin changes in the area of the planned application, allergy observed after tape application, inflammation in this knee area. During the study the patients underwent physical examination of the lower limbs and pelvic girdle. The standardized questionnaires e.g. Patellofemoral Functional Scale were used to assess the functionality in this condition. To determinate the severity of the pain the visual-analog scale (VAS) was applied. Patellofemoral Functional Scale Patellofemoral Functional Scale is a functional assessment tool where patients mark problems or discomfort related to their knees during the following activities presented in table. 5

6 Table 1. Patellofemoral Functional Scale Symptoms Walking as far as a mile Unable to do Can do with problem No problem Unknow Climbing up 2 flights or stairs (16 steps) Squatting Kneeling sitting for prolonged periods with your knees bent in one position Climbing up 4 flights of stairs (32 steps) Running a short distance, 100 meters Walking a short distance, 500 meters Pain assessment - Visual-analog scale (VAS) Visual-analog scale is a psychometric response scale which can be used in questionnaires. This measurement instrument can be used for subjective characteristics or attitudes that are impossible to measure directly. Pain assessed in VAS scale is a unidimensional measure of pain intensity. Respondents express their level of agreement to a statement by pointing a position along a continuous line between two end-points on a 100-mm long horizontal line. Usually it takes less than 1 minute to complete the measure. Scoring on VAS is determined by measuring with ruler the distance (mm) on the 10-cm line between the no pain anchor and the patient s mark, providing a range of scores from According to the research, the visual analogue scales have superior metrical characteristics than discrete scales, therefore a wider range of statistical methods can be applied to the measured parameters.the characteristic of the instrument is based on calculated intraclass correlation coefficients (ICC) on 0.97 for acute pain and Cronbach s alpha varies depending on the studies from 0.79 to

7 The pain was assessed as a total feeling and during the activities mentioned in table 1, which are the elements of Patellofemoral Functional Scale. Therapy process All procedures where performed by one certified in Kinesio Taping Method practitioner with used of original Kinesio Tex Gold tape for application. The application were perfomed during 4 weeks. All patients were instructed to deal with the applied tape at home. The process and examples of the Kinesio Tex Gold tape application are presented on pictures (Fig. 1-8). Data collection and analysis Patients underwent the examination and fulfilled the questionnaires at the beginning of the therapy and after completing it. The data collected were taken into the statistical analysis and present in the results. All data were expressed by mean ±standard deviation. The normality of the data distribution was estimated with use of Shapiro-Wilk test. The Wilcoxon rank-sum test was used for comparison of the two related groups of the data. The alfa significance level was set at P value of less than 0.05 will be considered to indicate statistical significance. Statistical analyses was performed with use of Statistica 10.0 software (StatSoft). Results The study group consist of 21 patients, 6 men and 15 women. The mean age of the patients was 22,5 ± 4,6 years. None of the patient were professional athlete. The occupation of the patients were students. Most difficult and painful activity were associated with stairs climbing. In all patients the both knees were affected. All patients were underwent the set of conventional physical therapy and still have symptoms seriously impairing their daily activity. 7

8 The pain measured during different activities according to the Patellofemoral Functional Scale is presented in table 1. Table 1. The comparison of the pain measured before and after the sets of Kinesio taping application. Pain measured with VAS scale during before after Kinesio taping application Walking as far as a mile 4,5 ± 0,3 2,8 ± 0,48 Kinesio taping application Climbing up 2 flights or stairs (16 7,1 ± 0,42 4,1 ± 0,5 steps) Squatting 6,10 ± 0,51 3,07 ± 0,65 Kneeling 5,68 ± 0,5 3,25 ± 0,31 Sitting for prolonged periods with 4,05 ± 0,21 4,07 ± 0,55 your knees bent in one position Climbing up 4 flights of stairs (32 6,83 ± 0,29 4,32± 0,22 steps) Running a short distance, 100 meters 3,18 ± 0,43 2,19 ± 0,2 Walking a short distance, 500 meters 2,82 ± 0,11 2,0 ±0,2 α= 0.05, in all analyses p<0.05 Discussion The study showed that application of the Kinesio Tex Gold tape can significantly reduce the pain occurring during the every day life activities mentioned in table 1. The mechanisms of pain reduction have not completely been established following patellar taping in subjects with patellofemoral pain syndrome (PFPS); although it might be related to alteration in the kinetics of the patellofemoral joint. The previous experimental studies with use of taping bands proved the role of these application in pain reduction by changed kinetics of patellofemoral joint expressed among other by decreasing patellofemoral joint reaction force in adults. Decreased values of PFJRF may explain the mechanism of pain reduction following changed patellar tracking by taping application. 8

9 The literature about the possible ways of Kinesio taping applications and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method [45]. The study limitations The limitation of the study is small group of the patients included who underwent whole process of the examination and all sets of Kinesio taping application, therefore the study can be underpowered. Another limitation is the lack of the control group included into the process of randomization. To exactly determine the effect of Kinesio taping application in patients with patellofemoral syndrome there is a need of randomized controlled trial. The placebo taping can be included in the further studies. In this study patients reported an improvement in pain and function after the tape application, but the longer term effects are still to investige. Conclusions Kinesio taping application seems to be effective as supportive therapy of patients with patellofemoral syndrome. It leads to decrease of the severity of the pain, improve patients functionality assessed with standardized questionnaires. 9

10 Fig.1. Patellar application of the Kinesio Tex Gold tape Fig.2. Patellar stabilization with use of the Kinesio Tex Gold tape 10

11 . Fig.3 Patellar stabilization with use of the Kinesio Tex Gold tape with additional tape. Fig.4 Patellar stabilization with use of the Kinesio Tex Gold tape. 11

12 Fig.5. Patellar stabilization with use of the Kinesio Tex Gold tape. Fig.6. Patellar stabilization with use of the Kinesio Tex Gold tape. 12

13 Fig.7. Patellar stabilization with use of the Kinesio Tex Gold tape. Fig.8. Spider web application of the Kinesio Tex Gold tape. 13

14 Summary Background: Patellofemoral syndrome is one of the most common and challenging pathologies to manage among adolescents and young adults. Recently the Kinesio taping method is more often applied in patients with symptoms of this condition. The elastic properties of Kinesio Tex Tape applied according to the Kinesio Taping Method can enhance the function of muscle fibers and decrease the pain. Aim of the study : The aim of the was to estimate the influence of the manual Kinesio taping application on pain and the functional status of the patients with patellofemoral syndrome of the knee. Material and methods: The study was conducted on group of patients (15 men and 8 women) diagnosed with patellofemoral syndrome of the knee who suffered for at least three months and failed to the conventional therapy. The exclusion criteria for the study was: previous injury injury of this knee in anamnesis, structural changes after injury in the area of affected knee, receiving any physical or manual therapy for patellofemoral syndrome during last 4 weeks, wounds and skin changes in the area of the planned application, allergy observed after tape application, inflammation in this knee area. During the study the patients underwent physical examination of the lower limbs and pelvic girdle.the standardized questionnaires e.g. Patellofemoral Functional Scale were used to assess the functionality in this condition. To determinate the severity of the pain the visual-analog scale (VAS) was applied. Results: The study group consist of 21 patients, 6 men and 15 women. The mean age of the patients was 22,5 ± 4,6 years. None of the patient were professional athlete. The occupation of the patients were students. Most difficult and painful activity were associated with stairs 14

15 climbing. In all patients the both knees were affected. All patients were underwent the set of conventional physical therapy and still have symptoms seriously impairing their daily activity. Conclusions: Kinesio taping is a promising and effective method in decreasing symptoms of patellofemoral syndrome, mostly the pain during walking and stairs climbing 15

16 References Kase K, Hashimoto T, Tomoki O. Development of kinesio taping perfect manual. Kinesio Taping Association 1996; 6-10: Reips UD, Funke F. "Interval level measurement with visual analogue scales in Internetbased research: VAS Generator." doi: /brm Grant S, Aitchison T, Henderson E, Christie J, Zare S, et al. A comparison of the reproducibility and the sensitivity to change of visual analogue scales, Borg scales, and Likert scales in normal subjects during submaximal exercise. Chest. 116(5): McCaffery M, Pasero C. Pain: Clinical Manual, St. Louis, 1999, P. 16. Bijur PE, Silver W, Gallagher J. Reliability of the Visual Analog Scale for Measurement of Acute Pain. Academic Emergency Medicine Volume 8, Issue 12, pages , December McCormack HM, Horne DJ, Sheather S. Clinical applications of visual analogue scales: a critical review. Psychol Med 1988;18: Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain 1986;27: Kase K, Wallis J. The latest kinesio taping method. Ski-J Reid DC, Sports Injury Assessment and Rehabilitation. New York: Churchill Livingstone; Fulkerson JP. Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med. 2002;30(3): Dye SF. Patellofemoral pain current concepts: An overview. Sports Med Arthrosc Rev. 2001;9: Murray IR, Murray SA, MacKenzie K, Coleman S. How evidence based is the management of two common sports injuries in a sports injury clinic? Br J Sports Med. 2005;39:

17 Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996;312:71 72 Doucette SA, Goble EM. The effect of exercise on patellar tracking in lateral patellar compression syndrome. Am J Phys Med Rehabil. 1992;20(4): Bizzini M, Childs JD, Piva SR, Delitto A. Systematic review of the quality of randomized controlled trials for patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2003;33(1):4 20 Natri A, Kannus P, Jarvinen M. Which factors predict the long-term outcome in chronic patellofemoral pain syndrome? A 7-yr prospective follow-up study. Med Sci Sports Exerc. 1998;30: Barton CJ, Webster KE, Menz HB. Evaluation of the scope and quality of systematic reviews on the nonpharmacological conservative treatment of patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2008;38(9): Callaghan MJ, Selfe J. Patellar taping for patellofemoral pain syndrome in adults. Cochrane Database Syst Rev Yeung SS, Yeung EW, Gillespie LD. Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database Syst Rev Arroll B, Ellis-Pegler E, Edwards A, Sutcliffe G. Patellofemoral pain syndrome. A critical review of the clinical trials on nonoperative therapy. Am J Sports Med. 1997;25(2): Lun VM, Wiley JP, Meeuwisse WH, Yanagawa TL. Effectiveness of patellar bracing for treatment of patellofemoral pain syndrome. Clin J Sports Med. 2005;15(4): Sahrmann SA. Movement impairment syndromes at the hip. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis: Mosby, Inc.; 2002: Barton CJ, Munteanu SE, Menz HB, Crossley KM. The efficacy of foot orthoses in the treatment of individuals with patellofemoral pain syndrome: a systematic review. Sports Med. 2010;40(5):

18 Thijs Y, Van Tiggelen D, Roosen P, De Clercq D, Witvrouw E. A prospective study on gaitrelated intrinsic risk factors for patellofemoral pain. Clin J Sport Med. 2007;17(6): Thijs Y, De Clercq D, Roosen P, Witvrouw E. Gait-related intrinsic risk factors for patellofemoral pain in novice recreational runners. Br J Sports Med. 2008;42(6): Thomee R. A comprehensive treatment approach for patellofemoral pain syndrome in young women. Phys Ther. 1997;77(12): Hazneci B, Yildiz Y, Sekir U, Atdin T, Kalyon TA. Efficacy of isokinetic exercise on joint position sense and muscle strength in patellofemoral pain syndrome. Am J Phys Med Rehabil. 2005;84(7): McMullen W, Roncarati A, Koval P. Static and isokinetic treatments of chondromalacia patella: A comparative investigation. J Orthop Sports Phys Ther. 1990;12(6): Stiene HA, Brosky T, Reinking MF, Nyland J, Mason MB. A comparison of closed kinetic chain and isokinetic joint isolation exercise in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther. 1996;24(3): Alaca R, Yilmaz B, Goktepe AS, Mohur H, Kalyon TA. Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome. Am J Phys Med Rehabil. 2002;81(11): Dye SF. Therapeutic implications of a tissue homeostasis approach to patellofemoral pain. Sports Med Arthrosc Rev. 2001;9: Steinkamp LA, Dillingham MF, Markel MD, Hill JA, Kaufmen KR. Biomechanical considerations in patellofemoral joint rehabilitation. Am J Sports Med. 1993;21: Gigante A, Pasquinelli FM, Paladini P, Ulisse S, Greco F. The effects of patellar taping on patellofemoral incongruence. A computed tomography study. Am J Sports Med. 2001;29(1):88 92 Heintjes EM, Berger M, Bierma-Zeinstra SMA, Bernsen RMD, Verhaar JAN, Koes BW. Editorial Group: Cochrane Bone, Joint and Muscle Trauma Group. Pharmacotherapy for patellofemoral pain syndrome. Cochrane Database Syst Rev

19 Brosseau L, Casimiro L, Robinson V, Milne S, Shea B, Judd M, et al. Therapeutic ultrasound for treating patellofemoral pain syndrome. Cochrane Database Syst Rev Creighton D, Krauss J, Kondratek M, Huijbregts PA, Will A. Use of anterior tibial translation in the management of patellofemoral pain syndrome in older patients: a case series. J Man Manip Ther. 2007;15(4): McMullen W, Roncarati A, Koval P. Static and isokinetic treatments of chondromalacia patella: A comparative investigation. J Orthop Sports Phys Ther. 1990;12(6): Stiene HA, Brosky T, Reinking MF, Nyland J, Mason MB. A comparison of closed kinetic chain and isokinetic joint isolation exercise in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther. 1996;24(3): Alaca R, Yilmaz B, Goktepe AS, Mohur H, Kalyon TA. Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome. Am J Phys Med Rehabil. 2002;81(11): Dye SF. Therapeutic implications of a tissue homeostasis approach to patellofemoral pain. Sports Med Arthrosc Rev. 2001;9: Steinkamp LA, Dillingham MF, Markel MD, Hill JA, Kaufmen KR. Biomechanical considerations in patellofemoral joint rehabilitation. Am J Sports Med. 1993;21: Gigante A, Pasquinelli FM, Paladini P, Ulisse S, Greco F. The effects of patellar taping on patellofemoral incongruence. A computed tomography study. Am J Sports Med. 2001;29(1):

20 20

21 Karolina Janikowska, Katarzyna Chomiuk The taping applications for the patellofemoral syndrome part 1 Background Kinesio taping was developed by Kenzo Kase in early The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over-contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Kinesio Taping is currently being used by therapists to modify muscle tone, move lymphatic fluids, correct movement patterns, and improve body posture. The Kinesio Taping Method is a unique method of applying Kinesio Tex Tape in a specific manner to create change in the tissue under the applied tape. The literature about the Kinesio taping application and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method. Muscular and fascial Kinesio taping application (Fig ) Description and preparation of the Kinesio Tex Gold tape. The application is based parts of the tape prepared to lay in the area of the patellofemoral pain. The endings of the tapes should be rounded. All application are performed with use of Kinesio Tex Gold tapes. 21

22 Fig.1. Patellar application of the Kinesio Tex Gold tapes. Fig.2. Patellar application of the Kinesio Tex Gold tapes. 22

23 Fig.3. Patellar application of the Kinesio Tex Gold tapes. Fig.4. Patellar application of the Kinesio Tex Gold tapes. 23

24 Fig.5. Patellar application of the Kinesio Tex Gold tapes. Fig.6. Patellar application of the Kinesio Tex Gold tapes. 24

25 Fig.7 Patellar application of the Kinesio Tex Gold tapes. Fig.8. Patellar application of the Kinesio Tex Gold tapes. 25

26 Fig.9. Patellar application of the Kinesio Tex Gold tapes. Fig.10. Patellar application of the Kinesio Tex Gold tapes. 26

27 Fig.11. Patellar application of the Kinesio Tex Gold tapes. Fig.12. Finished application of the Kinesio Tex Gold tapes. 27

28 References: Kase K, Wallis J. The latest kinesio taping method. Ski-J Kase K, Hashimoto T, Tomoki O. Development of kinesio taping perfect manual. Kinesio Taping Association 1996; 6-10: Kase K, Wallis J. Clinical Therapeutic Applications of the Kinesio Taping Method 3rd Edition, Ski-J Kinesio Taping Perfect Manual by Kinesio Taping Association, 2Ed. llustrated Kinesio Taping manual, 4th Ed. Clinical Kinesio Taping - DVD. 28

29 Karolina Janikowska, Katarzyna Chomiuk The taping applications for the patellofemoral syndrome part 2 Background Kinesio taping was developed by Kenzo Kase in early The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over-contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Kinesio Taping is currently being used by therapists to modify muscle tone, move lymphatic fluids, correct movement patterns, and improve body posture. The Kinesio Taping Method is a unique method of applying Kinesio Tex Tape in a specific manner to create change in the tissue under the applied tape. The literature about the Kinesio taping application and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method. Muscular and fascial Kinesio taping application (Fig. 1-7.) Description and preparation of the Kinesio Tex Gold tape. The application is based parts of the tape prepared to lay in the area of the patellofemoral pain. The endings of the tapes should be rounded. All application are performed with use of Kinesio Tex Gold tapes. 29

30 Fig.1. Patellar application of the Kinesio Tex Gold tapes. Fig.2. Patellar application of the Kinesio Tex Gold tapes. 30

31 Fig.3. Patellar application of the Kinesio Tex Gold tapes. Fig.4. Patellar application of the Kinesio Tex Gold tapes. 31

32 Fig.5. Patellar application of the Kinesio Tex Gold tapes. Fig.6. Patellar application of the Kinesio Tex Gold tapes. 32

33 Fig.7. Finished application of the Kinesio Tex Gold tapes. 33

34 References: Kase K, Wallis J. The latest kinesio taping method. Ski-J Kase K, Hashimoto T, Tomoki O. Development of kinesio taping perfect manual. Kinesio Taping Association 1996; 6-10: Kase K, Wallis J. Clinical Therapeutic Applications of the Kinesio Taping Method 3rd Edition, Ski-J Kinesio Taping Perfect Manual by Kinesio Taping Association, 2Ed. llustrated Kinesio Taping manual, 4th Ed. Clinical Kinesio Taping - DVD. 34

35 Karolina Janikowska, Katarzyna Chomiuk The taping applications for the patellar lateralization Background Kinesio taping was developed by Kenzo Kase in early The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over-contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Kinesio Taping is currently being used by therapists to modify muscle tone, move lymphatic fluids, correct movement patterns, and improve body posture. The Kinesio Taping Method is a unique method of applying Kinesio Tex Tape in a specific manner to create change in the tissue under the applied tape. The literature about the Kinesio taping application and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method. Muscular and fascial Kinesio taping application (Fig. 1-9.) Description and preparation of the Kinesio Tex Gold tape. The application is based parts of the tape prepared to lay in the area of the patellofemoral pain. The endings of the tapes should be rounded. All application are performed with use of Kinesio Tex Gold tapes. 35

36 Fig.1. Application of the Kinesio Tex Gold tapes for patellar lateralization Fig.2. Application of the Kinesio Tex Gold tapes for patellar lateralization 36

37 Fig.3. Application of the Kinesio Tex Gold tapes for patellar lateralization Fig.4. Application of the Kinesio Tex Gold tapes for patellar lateralization 37

38 Fig.5. Application of the Kinesio Tex Gold tapes for patellar lateralization Fig.6. Application of the Kinesio Tex Gold tapes for patellar lateralization 38

39 Fig.7. Application of the Kinesio Tex Gold tapes for patellar lateralization Fig.8. Application of the Kinesio Tex Gold tapes for patellar lateralization 39

40 Fig.9. Finished application of the Kinesio Tex Gold tapes for patellar lateralization 40

41 References: Kase K, Wallis J. The latest kinesio taping method. Ski-J Kase K, Hashimoto T, Tomoki O. Development of kinesio taping perfect manual. Kinesio Taping Association 1996; 6-10: Kase K, Wallis J. Clinical Therapeutic Applications of the Kinesio Taping Method 3rd Edition, Ski-J Kinesio Taping Perfect Manual by Kinesio Taping Association, 2Ed. llustrated Kinesio Taping manual, 4th Ed. Clinical Kinesio Taping - DVD. 41

42 Karolina Janikowska, Katarzyna Chomiuk The taping applications for the patellofemoral syndrome part 3 Background Kinesio taping was developed by Kenzo Kase in early The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over-contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Kinesio Taping is currently being used by therapists to modify muscle tone, move lymphatic fluids, correct movement patterns, and improve body posture. The Kinesio Taping Method is a unique method of applying Kinesio Tex Tape in a specific manner to create change in the tissue under the applied tape. The literature about the Kinesio taping application and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method. Muscular and fascial Kinesio taping application (Fig. 1-9.) Description and preparation of the Kinesio Tex Gold tape. The application is based parts of the tape prepared to lay in the area of the patellofemoral pain. The endings of the tapes should be rounded. All application are performed with use of Kinesio Tex Gold tapes. 42

43 Fig.1. Application of the Kinesio Tex Gold tapes Fig.2. Application of the Kinesio Tex Gold tapes 43

44 Fig.3. Application of the Kinesio Tex Gold tapes Fig.4. Application of the Kinesio Tex Gold tapes 44

45 Fig.5. Application of the Kinesio Tex Gold tapes Fig.6. Application of the Kinesio Tex Gold tapes 45

46 Fig.7. Application of the Kinesio Tex Gold tapes Fig.8. Application of the Kinesio Tex Gold tapes 46

47 Fig.9. Finished application of the Kinesio Tex Gold tapes 47

48 References: Kase K, Wallis J. The latest kinesio taping method. Ski-J Kase K, Hashimoto T, Tomoki O. Development of kinesio taping perfect manual. Kinesio Taping Association 1996; 6-10: Kase K, Wallis J. Clinical Therapeutic Applications of the Kinesio Taping Method 3rd Edition, Ski-J Kinesio Taping Perfect Manual by Kinesio Taping Association, 2Ed. llustrated Kinesio Taping manual, 4th Ed. Clinical Kinesio Taping - DVD. 48

49 Karolina Janikowska, Katarzyna Chomiuk Kinesio taping applications in patellar malaligment part1 Background Kinesio taping was developed by Kenzo Kase in early The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over-contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Kinesio Taping is currently being used by therapists to modify muscle tone, move lymphatic fluids, correct movement patterns, and improve body posture. The Kinesio Taping Method is a unique method of applying Kinesio Tex Tape in a specific manner to create change in the tissue under the applied tape. The literature about the Kinesio taping application and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method. Muscular and fascial Kinesio taping application (Fig ) Description and preparation of the Kinesio Tex Gold tape. The application is based parts of the tape prepared to lay in the area of the patellofemoral pain. The endings of the tapes should be rounded. All application are performed with use of Kinesio Tex Gold tapes. 49

50 Fig.1. Precut of the Kinesio Tex Gold tapes Fig.2. Application of the Kinesio Tex Gold tapes 50

51 Fig.3. Application of the Kinesio Tex Gold tapes Fig.4. Application of the Kinesio Tex Gold tapes 51

52 Fig.5. Application of the Kinesio Tex Gold tapes Fig.6. Application of the Kinesio Tex Gold tapes 52

53 Fig.7. Application of the Kinesio Tex Gold tapes Fig.8. Application of the Kinesio Tex Gold tapes 53

54 Fig.9. Application of the Kinesio Tex Gold tapes Fig.10. Application of the Kinesio Tex Gold tapes 54

55 Fig.11. Application of the Kinesio Tex Gold tapes Fig.12. Application of the Kinesio Tex Gold tapes 55

56 Fig.13. Application of the Kinesio Tex Gold tapes Fig.14. Application of the Kinesio Tex Gold tapes 56

57 Fig.15. Application of the Kinesio Tex Gold tapes Fig.16. Finished application of the Kinesio Tex Gold tapes 57

58 References: Kase K, Wallis J. The latest kinesio taping method. Ski-J Kase K, Hashimoto T, Tomoki O. Development of kinesio taping perfect manual. Kinesio Taping Association 1996; 6-10: Kase K, Wallis J. Clinical Therapeutic Applications of the Kinesio Taping Method 3rd Edition, Ski-J Kinesio Taping Perfect Manual by Kinesio Taping Association, 2Ed. llustrated Kinesio Taping manual, 4th Ed. Clinical Kinesio Taping - DVD. 58

59 Karolina Janikowska, Katarzyna Chomiuk Kinesio taping applications in patellar malaligment part 2 Background Kinesio taping was developed by Kenzo Kase in early The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over-contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Kinesio Taping is currently being used by therapists to modify muscle tone, move lymphatic fluids, correct movement patterns, and improve body posture. The Kinesio Taping Method is a unique method of applying Kinesio Tex Tape in a specific manner to create change in the tissue under the applied tape. The literature about the Kinesio taping application and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method. Muscular and fascial Kinesio taping application (Fig. 1-15) Description and preparation of the Kinesio Tex Gold tape. The application is based parts of the tape prepared to lay in the area of the patellofemoral pain. The endings of the tapes should be rounded. All application are performed with use of Kinesio Tex Gold tapes. 59

60 Fig.1. Application of the Kinesio Tex Gold tapes Fig.2. Application of the Kinesio Tex Gold tapes 60

61 Fig.3. Application of the Kinesio Tex Gold tapes Fig.4. Application of the Kinesio Tex Gold tapes 61

62 Fig.5. Application of the Kinesio Tex Gold tapes Fig.6. Application of the Kinesio Tex Gold tapes 62

63 Fig.7. Application of the Kinesio Tex Gold tapes Fig.8. Application of the Kinesio Tex Gold tapes 63

64 Fig.9. Application of the Kinesio Tex Gold tapes Fig.10. Application of the Kinesio Tex Gold tapes 64

65 Fig.11. Application of the Kinesio Tex Gold tapes Fig.12. Application of the Kinesio Tex Gold tapes 65

66 Fig.13. Application of the Kinesio Tex Gold tapes Fig.14. Application of the Kinesio Tex Gold tapes 66

67 Fig.15. Application of the Kinesio Tex Gold tapes 67

68 Karolina Janikowska, Katarzyna Chomiuk Kinesio taping applications in patellar malaligment part 3 Background Kinesio taping was developed by Kenzo Kase in early The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over-contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Kinesio Taping is currently being used by therapists to modify muscle tone, move lymphatic fluids, correct movement patterns, and improve body posture. The Kinesio Taping Method is a unique method of applying Kinesio Tex Tape in a specific manner to create change in the tissue under the applied tape. The literature about the Kinesio taping application and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method. Muscular and fascial Kinesio taping application (Fig ) Description and preparation of the Kinesio Tex Gold tape. The application is based parts of the tape prepared to lay in the area of the patellofemoral pain. The endings of the tapes should be rounded. All application are performed with use of Kinesio Tex Gold tapes. 68

69 Fig.1. Application of the Kinesio Tex Gold tapes Fig.2. Application of the Kinesio Tex Gold tapes 69

70 Fig.3. Application of the Kinesio Tex Gold tapes Fig.4. Application of the Kinesio Tex Gold tapes 70

71 Fig.5. Application of the Kinesio Tex Gold tapes Fig.6. Application of the Kinesio Tex Gold tapes 71

72 Fig.7. Application of the Kinesio Tex Gold tapes Fig.8. Application of the Kinesio Tex Gold tapes 72

73 Fig.9. Application of the Kinesio Tex Gold tapes Fig.10. Application of the Kinesio Tex Gold tapes 73

74 Fig.11. Application of the Kinesio Tex Gold tapes Fig.12. Application of the Kinesio Tex Gold tapes 74

75 References: Kase K, Wallis J. The latest kinesio taping method. Ski-J Kase K, Hashimoto T, Tomoki O. Development of kinesio taping perfect manual. Kinesio Taping Association 1996; 6-10: Kase K, Wallis J. Clinical Therapeutic Applications of the Kinesio Taping Method 3rd Edition, Ski-J Kinesio Taping Perfect Manual by Kinesio Taping Association, 2Ed. llustrated Kinesio Taping manual, 4th Ed. Clinical Kinesio Taping - DVD. 75

76 Karolina Janikowska The role of Kinesio taping applications in patients with iliotibial syndrome Background Patellofemoral syndrome is one of the most common condition, especially among adolescents and young adults. It is still one of the most challenging pathologies to manage. The basic symptom of the patellofemoral syndrome is pain localized in the area of anterior and lateral knee aggravating with everyday life activities like stairs climbing or sports performance requiring extensive knee flesiox and extensions. Palpation over the patella during knee flexion and extension will often reveal crepitus, which is of debatable significance. The conservative therapy is based on use of ultrasound, cryotherapy, heat, electrical and laser stimulation. The other possible treatment is based of pharmacological preparates e.g. non- steroidal anti-inflammatory drugs (NSAID). Modern therapies require new approach and techniques focusing on the core of the patients problem. Factors that may contribute to abnormal patella tracking include quadriceps weakness, quadriceps muscle imbalances, excessive knee soft tissue tightness, an increased quadriceps angle (Q-angle), hip weakness, and altered foot kinematics. Based on this clinical theory, the aim for interventions used for the treatment of PFPS is to improve patella tracking and reduce abnormal stress to patellofemoral joint structures. More and more studies indicates the need of attention to kinematics of the patella and changing its tracking. One of the most common intervention is the mobilization of the patella. Another new approach to this condition can be realized with use of the Kinesio taping developed by Kenzo Kase. The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over- 76

77 contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Aim of the study The aim of the was to estimate the influence of the manual Kinesio taping application on pain and the functional status of the patients with patellofemoral syndrome of the knee. Material and methods The study was conducted on group of patients (15 men and 8 women) diagnosed with patellofemoral syndrome of the knee who suffered for at least three months and failed to the conventional therapy. The exclusion criteria for the study was: previous injury injury of this knee in anamnesis, structural changes after injury in the area of affected knee, receiving any physical or manual therapy for patellofemoral syndrome during last 4 weeks, wounds and skin changes in the area of the planned application, allergy observed after tape application, inflammation in this knee area. During the study the patients underwent physical examination of the lower limbs and pelvic girdle. The standardized questionnaires e.g. Patellofemoral Functional Scale were used to assess the functionality in this condition. To determinate the severity of the pain the visual-analog scale (VAS) was applied. Patellofemoral Functional Scale Patellofemoral Functional Scale is a functional assessment tool where patients mark problems or discomfort related to their knees during the following activities presented in table. 77

78 Table 1. Patellofemoral Functional Scale Symptoms Unable to do Can do with problem No problem Unknow Walking as far as a mile Climbing up 2 flights or stairs (16 steps) Squatting Kneeling sitting for prolonged periods with your knees bent in one position Climbing up 4 flights of stairs (32 steps) Running a short distance, 100 meters Walking a short distance, 500 meters Pain assessment - Visual-analog scale (VAS) Visual-analog scale is a psychometric response scale which can be used in questionnaires. This measurement instrument can be used for subjective characteristics or attitudes that are impossible to measure directly. Pain assessed in VAS scale is a unidimensional measure of 78

79 pain intensity. Respondents express their level of agreement to a statement by pointing a position along a continuous line between two end-points on a 100-mm long horizontal line. Usually it takes less than 1 minute to complete the measure [37,38]. Scoring on VAS is determined by measuring with ruler the distance (mm) on the 10-cm line between the no pain anchor and the patient s mark, providing a range of scores from According to the research, the visual analogue scales have superior metrical characteristics than discrete scales, therefore a wider range of statistical methods can be applied to the measured parameters [39,40]. The characteristic of the instrument is based on calculated intraclass correlation coefficients (ICC) on 0.97 for acute pain and Cronbach s alpha varies depending on the studies from 0.79 to 0.91 [41,42]. The pain was assessed as a total feeling and during the activities mentioned in table 1, which are the elements of Patellofemoral Functional Scale. Therapy process All procedures where performed by one certified in Kinesio Taping Method practitioner with used of original Kinesio Tex Gold tape for application. The application were perfomed during 4 weeks. All patients were instructed to deal with the applied tape at home. The process and examples of the Kinesio Tex Gold tape application are presented on pictures (Fig. 1-10). Data collection and analysis Patients underwent the examination and fulfilled the questionnaires at the beginning of the therapy and after completing it. The data collected were taken into the statistical analysis and present in the results. All data were expressed by mean ±standard deviation. The normality of the data distribution was estimated with use of Shapiro-Wilk test. The Wilcoxon rank-sum test was used for comparison of the two related groups of the data. The alfa significance level 79

80 was set at P value of less than 0.05 will be considered to indicate statistical significance. Statistical analyses was performed with use of Statistica 10.0 software (StatSoft). Results The study group consist of 21 patients, 6 men and 15 women. The mean age of the patients was 22,5 ± 4,6 years. None of the patient were professional athlete. The occupation of the patients were students. Most difficult and painful activity were associated with stairs climbing. In all patients the both knees were affected. All patients were underwent the set of conventional physical therapy and still have symptoms seriously impairing their daily activity. The pain measured during different activities according to the Patellofemoral Functional Scale is presented in table 1. Table 1. The comparison of the pain measured before and after the sets of Kinesio taping application. before after Pain measured with VAS scale during Kinesio taping application Kinesio taping application Walking as far as a mile 4,5 ± 0,3 2,8 ± 0,48 Climbing up 2 flights or stairs (16 7,1 ± 0,42 4,1 ± 0,5 steps) Squatting 6,10 ± 0,51 3,07 ± 0,65 Kneeling 5,68 ± 0,5 3,25 ± 0,31 Sitting for prolonged periods with 4,05 ± 0,21 4,07 ± 0,55 your knees bent in one position Climbing up 4 flights of stairs (32 steps) 6,83 ± 0,29 4,32± 0,22 80

81 Running a short distance, 100 meters 3,18 ± 0,43 2,19 ± 0,2 Walking a short distance, 500 meters 2,82 ± 0,11 2,0 ±0,2 α= 0.05, in all analyses p<0.05 Discussion The study showed that application of the Kinesio Tex Gold tape can significantly reduce the pain occurring during the every day life activities mentioned in table 1. The mechanisms of pain reduction have not completely been established following patellar taping in subjects with patellofemoral pain syndrome (PFPS); although it might be related to alteration in the kinetics of the patellofemoral joint. The previous experimental studies with use of taping bands proved the role of these application in pain reduction by changed kinetics of patellofemoral joint expressed among other by decreasing patellofemoral joint reaction force in adults. Decreased values of PFJRF may explain the mechanism of pain reduction following changed patellar tracking by taping application. The literature about the possible ways of Kinesio taping applications and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method [45]. The study limitations The limitation of the study is small group of the patients included who underwent whole process of the examination and all sets of Kinesio taping application, therefore the study can be underpowered. Another limitation is the lack of the control group included into the process of randomization. To exactly determine the effect of Kinesio taping application in patients with patellofemoral syndrome there is a need of randomized controlled trial. The placebo 81

82 taping can be included in the further studies. In this study patients reported an improvement in pain and function after the tape application, but the longer term effects are still to investige. Conclusions Kinesio taping application seems to be effective as supportive therapy of patients with patellofemoral syndrome. It leads to decrease of the severity of the pain, improve patients functionality assessed with standardized questionnaires. 82

83 Fig.1. Ilitibial band application of the Kinesio Tex Gold tape Fig.2. Ilitibial band application of the Kinesio Tex Gold tape 83

84 Fig.3. Ilitibial band application of the Kinesio Tex Gold tape Fig.4. Ilitibial band application of the Kinesio Tex Gold tape 84

85 Fig.5. Ilitibial band application of the Kinesio Tex Gold tape Fig.6. Ilitibial band application of the Kinesio Tex Gold tape 85

86 Fig.7. Ilitibial band application of the Kinesio Tex Gold tape Fig.8. Ilitibial band application of the Kinesio Tex Gold tape 86

87 Fig.9. Ilitibial band application of the Kinesio Tex Gold tape Fig.10. Ilitibial band application of the Kinesio Tex Gold tape 87

88 Summary Background: Patellofemoral syndrome is one of the most common and challenging pathologies to manage among adolescents and young adults. Recently the Kinesio taping method is more often applied in patients with symptoms of this condition. The elastic properties of Kinesio Tex Tape applied according to the Kinesio Taping Method can enhance the function of muscle fibers and decrease the pain. Aim of the study : The aim of the was to estimate the influence of the manual Kinesio taping application on pain and the functional status of the patients with patellofemoral syndrome of the knee. Material and methods: The study was conducted on group of patients (15 men and 8 women) diagnosed with patellofemoral syndrome of the knee who suffered for at least three months and failed to the conventional therapy. The exclusion criteria for the study was: previous injury injury of this knee in anamnesis, structural changes after injury in the area of affected knee, receiving any physical or manual therapy for patellofemoral syndrome during last 4 weeks, wounds and skin changes in the area of the planned application, allergy observed after tape application, inflammation in this knee area. During the study the patients underwent physical examination of the lower limbs and pelvic girdle.the standardized questionnaires e.g. Patellofemoral Functional Scale were used to assess the functionality in this condition. To determinate the severity of the pain the visual-analog scale (VAS) was applied. 88

89 Results: The study group consist of 21 patients, 6 men and 15 women. The mean age of the patients was 22,5 ± 4,6 years. None of the patient were professional athlete. The occupation of the patients were students. Most difficult and painful activity were associated with stairs climbing. In all patients the both knees were affected. All patients were underwent the set of conventional physical therapy and still have symptoms seriously impairing their daily activity. Conclusions: Kinesio taping is a promising and effective method in decreasing symptoms of patellofemoral syndrome, mostly the pain during walking and stairs climbing 89

90 References Kase K, Hashimoto T, Tomoki O. Development of kinesio taping perfect manual. Kinesio Taping Association 1996; 6-10: Reips UD, Funke F. "Interval level measurement with visual analogue scales in Internetbased research: VAS Generator." doi: /brm Grant S, Aitchison T, Henderson E, Christie J, Zare S, et al. A comparison of the reproducibility and the sensitivity to change of visual analogue scales, Borg scales, and Likert scales in normal subjects during submaximal exercise. Chest. 116(5): McCaffery M, Pasero C. Pain: Clinical Manual, St. Louis, 1999, P. 16. Bijur PE, Silver W, Gallagher J. Reliability of the Visual Analog Scale for Measurement of Acute Pain. Academic Emergency Medicine Volume 8, Issue 12, pages , December McCormack HM, Horne DJ, Sheather S. Clinical applications of visual analogue scales: a critical review. Psychol Med 1988;18: Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain 1986;27: Kase K, Wallis J. The latest kinesio taping method. Ski-J Reid DC, Sports Injury Assessment and Rehabilitation. New York: Churchill Livingstone; Fulkerson JP. Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med. 2002;30(3): Dye SF. Patellofemoral pain current concepts: An overview. Sports Med Arthrosc Rev. 2001;9: Murray IR, Murray SA, MacKenzie K, Coleman S. How evidence based is the management of two common sports injuries in a sports injury clinic? Br J Sports Med. 2005;39:

91 Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996;312:71 72 Doucette SA, Goble EM. The effect of exercise on patellar tracking in lateral patellar compression syndrome. Am J Phys Med Rehabil. 1992;20(4): Bizzini M, Childs JD, Piva SR, Delitto A. Systematic review of the quality of randomized controlled trials for patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2003;33(1):4 20 Natri A, Kannus P, Jarvinen M. Which factors predict the long-term outcome in chronic patellofemoral pain syndrome? A 7-yr prospective follow-up study. Med Sci Sports Exerc. 1998;30: Barton CJ, Webster KE, Menz HB. Evaluation of the scope and quality of systematic reviews on the nonpharmacological conservative treatment of patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2008;38(9): Callaghan MJ, Selfe J. Patellar taping for patellofemoral pain syndrome in adults. Cochrane Database Syst Rev Yeung SS, Yeung EW, Gillespie LD. Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database Syst Rev Arroll B, Ellis-Pegler E, Edwards A, Sutcliffe G. Patellofemoral pain syndrome. A critical review of the clinical trials on nonoperative therapy. Am J Sports Med. 1997;25(2): Lun VM, Wiley JP, Meeuwisse WH, Yanagawa TL. Effectiveness of patellar bracing for treatment of patellofemoral pain syndrome. Clin J Sports Med. 2005;15(4): Sahrmann SA. Movement impairment syndromes at the hip. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis: Mosby, Inc.; 2002: Barton CJ, Munteanu SE, Menz HB, Crossley KM. The efficacy of foot orthoses in the treatment of individuals with patellofemoral pain syndrome: a systematic review. Sports Med. 2010;40(5):

92 Thijs Y, Van Tiggelen D, Roosen P, De Clercq D, Witvrouw E. A prospective study on gaitrelated intrinsic risk factors for patellofemoral pain. Clin J Sport Med. 2007;17(6): Thijs Y, De Clercq D, Roosen P, Witvrouw E. Gait-related intrinsic risk factors for patellofemoral pain in novice recreational runners. Br J Sports Med. 2008;42(6): Thomee R. A comprehensive treatment approach for patellofemoral pain syndrome in young women. Phys Ther. 1997;77(12): Hazneci B, Yildiz Y, Sekir U, Atdin T, Kalyon TA. Efficacy of isokinetic exercise on joint position sense and muscle strength in patellofemoral pain syndrome. Am J Phys Med Rehabil. 2005;84(7): McMullen W, Roncarati A, Koval P. Static and isokinetic treatments of chondromalacia patella: A comparative investigation. J Orthop Sports Phys Ther. 1990;12(6): Stiene HA, Brosky T, Reinking MF, Nyland J, Mason MB. A comparison of closed kinetic chain and isokinetic joint isolation exercise in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther. 1996;24(3): Alaca R, Yilmaz B, Goktepe AS, Mohur H, Kalyon TA. Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome. Am J Phys Med Rehabil. 2002;81(11): Dye SF. Therapeutic implications of a tissue homeostasis approach to patellofemoral pain. Sports Med Arthrosc Rev. 2001;9: Steinkamp LA, Dillingham MF, Markel MD, Hill JA, Kaufmen KR. Biomechanical considerations in patellofemoral joint rehabilitation. Am J Sports Med. 1993;21: Gigante A, Pasquinelli FM, Paladini P, Ulisse S, Greco F. The effects of patellar taping on patellofemoral incongruence. A computed tomography study. Am J Sports Med. 2001;29(1):88 92 Heintjes EM, Berger M, Bierma-Zeinstra SMA, Bernsen RMD, Verhaar JAN, Koes BW. Editorial Group: Cochrane Bone, Joint and Muscle Trauma Group. Pharmacotherapy for patellofemoral pain syndrome. Cochrane Database Syst Rev

93 Brosseau L, Casimiro L, Robinson V, Milne S, Shea B, Judd M, et al. Therapeutic ultrasound for treating patellofemoral pain syndrome. Cochrane Database Syst Rev Creighton D, Krauss J, Kondratek M, Huijbregts PA, Will A. Use of anterior tibial translation in the management of patellofemoral pain syndrome in older patients: a case series. J Man Manip Ther. 2007;15(4): McMullen W, Roncarati A, Koval P. Static and isokinetic treatments of chondromalacia patella: A comparative investigation. J Orthop Sports Phys Ther. 1990;12(6): Stiene HA, Brosky T, Reinking MF, Nyland J, Mason MB. A comparison of closed kinetic chain and isokinetic joint isolation exercise in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther. 1996;24(3): Alaca R, Yilmaz B, Goktepe AS, Mohur H, Kalyon TA. Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome. Am J Phys Med Rehabil. 2002;81(11): Dye SF. Therapeutic implications of a tissue homeostasis approach to patellofemoral pain. Sports Med Arthrosc Rev. 2001;9: Steinkamp LA, Dillingham MF, Markel MD, Hill JA, Kaufmen KR. Biomechanical considerations in patellofemoral joint rehabilitation. Am J Sports Med. 1993;21: Gigante A, Pasquinelli FM, Paladini P, Ulisse S, Greco F. The effects of patellar taping on patellofemoral incongruence. A computed tomography study. Am J Sports Med. 2001;29(1):

94 Karolina Janikowska, Katarzyna Chomiuk The taping applications in Osgood - Schlatter Disease Background Kinesio taping was developed by Kenzo Kase in early The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over-contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Kinesio Taping is currently being used by therapists to modify muscle tone, move lymphatic fluids, correct movement patterns, and improve body posture. The Kinesio Taping Method is a unique method of applying Kinesio Tex Tape in a specific manner to create change in the tissue under the applied tape. The literature about the Kinesio taping application and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method. Muscular and fascial Kinesio taping application (Fig. 1-7.) Description and preparation of the Kinesio Tex Gold tape. The application is based parts of the tape prepared to lay in the area of the patellofemoral pain. The endings of the tapes should be rounded. All application are performed with use of Kinesio Tex Gold tapes. 94

95 Fig.1. Application of the Kinesio Tex Gold tape in Osgood - Schlatter Disease Fig.2. Application of the Kinesio Tex Gold tape in Osgood - Schlatter Disease 95

96 Fig.3. Application of the Kinesio Tex Gold tape in Osgood - Schlatter Disease Fig.4. Application of the Kinesio Tex Gold tape in Osgood - Schlatter Disease 96

97 Fig.5. Application of the Kinesio Tex Gold tape in Osgood - Schlatter Disease Fig.6. Application of the Kinesio Tex Gold tape in Osgood - Schlatter Disease Disease 97

98 Fig.7. Application of the Kinesio Tex Gold tape in Osgood - Schlatter Disease 98

99 References: Kase K, Wallis J. The latest kinesio taping method. Ski-J Kase K, Hashimoto T, Tomoki O. Development of kinesio taping perfect manual. Kinesio Taping Association 1996; 6-10: Kase K, Wallis J. Clinical Therapeutic Applications of the Kinesio Taping Method 3rd Edition, Ski-J Kinesio Taping Perfect Manual by Kinesio Taping Association, 2Ed. llustrated Kinesio Taping manual, 4th Ed. Clinical Kinesio Taping - DVD. 99

100 Karolina Janikowska, Katarzyna Chomiuk Advanced applications for the patellofemoral syndrome Background Kinesio taping was developed by Kenzo Kase in early The concept is based on application of the special elastic tapes to the skin, over and around muscles in order to assist and give support or to prevent over-contraction. Kinesio Taping affects also the activation of the neurological system, the circulatory system and improve healing of overcontracted muscles. Kinesio Taping is currently being used by therapists to modify muscle tone, move lymphatic fluids, correct movement patterns, and improve body posture. The Kinesio Taping Method is a unique method of applying Kinesio Tex Tape in a specific manner to create change in the tissue under the applied tape. The literature about the Kinesio taping application and its role in patellofemoral syndrome improvement is very limited and based mostly on the application proposed by the developer of the method. Muscular and fascial Kinesio taping application (Fig ) Description and preparation of the Kinesio Tex Gold tape. The application is based parts of the tape prepared to lay in the area of the patellofemoral pain. The endings of the tapes should be rounded. All application are performed with use of Kinesio Tex Gold tapes. 100

101 Fig.1. Spider web application of the Kinesio Tex Gold tapes Fig.2. Spider web application of the Kinesio Tex Gold tapes 101

102 Fig.3. Spider web application of the Kinesio Tex Gold tapes Fig.4. Spider web application of the Kinesio Tex Gold tapes 102

103 Fig.5. Spider web application of the Kinesio Tex Gold tapes Fig.6. Spider web application of the Kinesio Tex Gold tapes 103

104 Fig.7. Spider web application of the Kinesio Tex Gold tapes Fig.8. Spider web application of the Kinesio Tex Gold tapes 104

105 Fig.9. Spider web application of the Kinesio Tex Gold tapes Fig.10. Spider web application of the Kinesio Tex Gold tapes 105