Effects of Kinesio Tape vs Rigid Tape on Shoulder Muscle Strength in Healthy Tennis Players

Transcription

1 Vol.5 No.1 Received: October, 2015 Accepted: February, 2016 Available online: March, 2016 Effects of Kinesio Tape vs Rigid Tape on Shoulder Muscle Strength in Healthy Tennis Players Parisa Tanoori 1, M.Nahar. A. Mohamed 2, M.Razif M Ali 3 1. Sports Medicine Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia 2. Sports Medicine Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia 3. Orthopaedic Department, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia ABSTRACT: Background: Many athletic trainers and therapists use taping to improve the performance of their athletes however, there is limited research on how and which taping techniques influence the athletes performance. Objective: The purpose of this study was to determine the effects of applying Kinesio tape (KT) and rigid tape on shoulder isokinetic muscle strength of healthy tennis players. Methods: Forty five male tennis players (age: 24 ± 6, weight: ± 11.43kg, height: ± 7.19cm) were recruited. Shoulder isokinetic muscle strength was measured with an isokinetic dynamometer before and 30 minutes after taping in three groups: with KT, with rigid tape and no tape. Results: The results revealed that the mean peak torque in KT group was significantly higher than rigid tape and control group except external rotation at 60 /s. Power with KT was significantly higher than rigid tape and control tape for all conditions but there was no significant difference between the rigid and control group ( P<0.05). Conclusions: The results imply that for increasing the isokinetic muscle strength in athletes and as a result enhancing the athletic performance, facilitatory Kinesio taping is a more effective option rather than rigid taping. KEY WORDS: Isokinetic Dynamometer, Peak torque, Average Power, Muscle function

2 Introduction In order to improve sports performance, several intervention techniques are applied to athletes. For instance, cutaneous stimulation by taping, to enhance muscle contraction has been widely used by trainers and therapists in various sports [1]. Taping is extensively employed among athletes to facilitate their muscle function and enhance their power output [2-4, 5-7] and performance [2, 8]. The Kinesio taping (KT) technique was proposed to increase mechanoreceptor stimulation to encourage movement and correct muscle function by strengthening muscle weakness [9, 11]. To date, it appears that no study has investigated the effects of KT on the isokinetic strength of healthy shoulder muscles nor compared the effects against other alternatives such as rigid tape. KT is an innovative prevalent elastic tape, which was proposed by Kenzo Kase. KT reportedly rolls up the fascia to align tissue in its desired position, increases mechanoreceptor stimulation to encourage or limit movement, provides positional stimulus to the skin, and corrects muscle function by strengthening muscle weakness [1,10, 11]. KT is unique on account of its elasticity that permits elongation of up to 130% 140% from resting position and the fact that it has approximately the same weight and thickness of skin [10,12,13]. It has particular weave and viscosity that allow for ventilation [1, 14]. This tape imparts joints with the opportunity to increase loading and muscles to enhance activity, as well as to even out joint movement and power throughout performance [1,15,16]. However, some of the studies show positive effect of rigid taping on muscle function and joint stabilization, which most of them refer this positive changes to psychological and proprioception effects of this tape on the skin. It has been suggested that application of a tape parallel to the fibres of a muscle, may enhance the muscles activity or strength and applying tape tightly across the muscle fibres, could restrain the muscle [17]. It is acknowledged that at present, sports such as tennis have developed into global professions that require vast amounts of equipment and facilities, education, training, skill and proficiency [18] hence, increasing the muscle strength in these athletes will help them to have stronger strikes and consequently enhances the quality of their playing. It was discovered that shoulder Internal and external rotators showed marked activity during portions of the serve, forehand and backhand strokes. In this regard, investigations on defining whether taping can improve the isokinetic strength of these muscles in tennis players, are not sufficient and if taping can, in fact, produce any improvements, it is nonetheless unclear which type of tape (elastic or non-elastic) is more effective for the overhead athletes. Therefore, the objective of this study is to determine if KT and/or rigid tape can be effective on isokinetic muscle strength in asymptomatic semi-professional tennis players. Method The study was designed as a double blinded randomized controlled trial (N=45). A pre-test post-test measurement of muscle strength were carried out by a blinded assessor and was incorporated into the overall design to establish if KT 60

3 or rigid tape would make any difference in shoulder Internal and External rotation at the speeds of 60 /sec and 180 /sec. Advertisements were placed at University of Malaya Sport science center, University of Putra sports Centre, local tennis clubs and Courts and Sports and tennis shops. Respondents to the advertisements were contacted telephonically or by and then been interviewed to assured their qualification for this study. The subjects were randomly assigned to three groups by a third person: group 1. Kinesio tape (N:15); group 2. Rigid tape (N:15); and group 3. No tape (N:15) (the control group). All subjects completed a baseline and endpoint trial and all outcomes were compared within and among the three groups. Main shoulder external rotators are Infraspinatus, Posterior Deltoid and Teres Minor. Main shoulder internal rotators are Pectoralis Major, Teres Major and Lattisimus Dorsi. Outcome evaluation included the peak torque and average power of the Pectoralis Major as the main shoulder internal rotator and Infraspinatus as the primary shoulder external rotator. Each outcome was tested prior to, and after tape application. Subjects Forty five male tennis players between 18 and 30 years old (age: 24 ± 6, weight: ± 11.43kg, height: ± 7.19cm, shoulder girth diameter: ± 5.83cm) volunteered to participate in this study. They were semi-professional players with average playing of 1 to 3 years. Their demographic particulars are shown in Table 1. Test Procedure Ethical approval was obtained from the Ethics Committee at the Scientific Research Centre, University of Malaya, and written informed consent was given by all subjects. The subjects were financially compensated for participating. A 5-minute warm up was carried out to promote performance and prevent injury. Before taping, the subjects muscle strength was assessed using a Biodex isokinetic dynamometer (Biodex multi-joint system-pre, USA). Concentric contraction of Internal and 61

4 External rotation were assessed at 60 /s and 180 /s. Taping was performed by a certified Kinesio tape trainer. The second measurement was performed after 30minutes of rest. According to the Kase technique [10,19]. KT should be applied at least 30 minutes before vigorous activity. This period of time allows the tape to stimulate the neuromuscular system as well as the joints sense of proprioception. It is assumed that the adhesive nature of the rigid tape begins to deteriorate after 30 minutes [1]. Taping Methods 1. Group one (Kinesio taping): Subjects were taped according to the Kenzo Kase s KT manual [19]. For the Pectoralis Major muscle, a Y-shaped strip of (Kinesio Tex KT-X-050, Tokyo, Japan) was measured and cut. An anchor was attached with no tension at the cartilage surface in the shoulder s neutral position, after which the muscle was stretched (90 o flexion, horizontal adduction and external rotation with slight elbow flexion). The tape was stretched 25%, and again, the end was placed with no tension at the Greater Tubercle of the Humerus (Figure 2). For the Infraspinatus muscle a single strip of KT was measured and cut. The anchor was attached with no tension 2cm lateral to the Scapula s medial border just below the scapular spine in neutral shoulder position. The muscle was then placed in stretched position (shoulder in 90 o flexion, horizontal adduction and internal rotation with slight elbow flexion), and the tapes were stretched by 25%. Again was positioned with no tension at the tubercle of the Humerus (Figure 3).. 2. Group two (Rigid Taping): Mueller Athletic tape was applied to enhance the force production of the scapular muscles. For this technique, due to the tape s non-elasticity, Morrissey [17] suggested that if a lengthened underactive muscle is held in a shortened position, there will be a change in the length-tension relationship of that muscle, with greater force development in the inner range through optimized overlap of actin and myosin during the cross-bridge cycle. Therefore tape was applied according to Morrissey techniques, by holding the muscle in shorten position and applying the tape along the muscle length. 62

5 3. Group three (No Taping): This group has been given 30 minutes rest before endpoint measurement. Statistical Analysis The distribution of dependent variables in both groups was subjected to a normality test (Skewness &Curtesis). To evaluate the changes in power and peak torque among the three types of tape (KT, rigid tape and no tape), a one way analysis of covariance (ANCOVA) was applied. The mean comparisons were assessed with the Bonferroni method. P value was set at P<0.05. Results Table 2 shows the result of analysis of covariance. According to these results there were significant differences for all research variables in the three types of tape except for peak torque of external rotation at 60 /s. The highest effect size for peak torque was observed at internal rotation of 60 /s ( 2 =0.314) followed by internal rotation of 180 /s ( 2 =0.246), however the highest effect size for power was observed at external rotation of 60 degree ( 2 =0.296) followed by external rotation of 180 /s ( 2 =0.207). variables; hence a mean comparison was done for the three tape types. Table 3 presents the results of the Bonferroni Post Hoc test on the adjusted mean of post-test using pre-test values as covariate. The results revealed that the mean peak torque in KT was significantly higher than rigid tape and control group except external rotation at 60 /s. Table 4 indicates that the power with KT was significantly higher than rigid tape and control tape for all conditions but there was no significant difference between the rigid and control. The percentage of peak torque and power changes for all variables in the post-test compare to the pre-test is presented in Figure 1. Clearly the highest changes were observed with KT. According to the analysis of variance results, the difference among the three kinds of tape was significant for all 63

6 Figure1. Percentage of muscle strength changes after tape application 64

7 Discussion The purpose of this study was to compare KT versus rigid tape usefulness to shoulder muscle strength. The main findings of this research show significant differences in shoulder muscle isokinetic strength before and after KT application but no effective change with the other groups (Rigid tape and Control). KT and its strength enhancing features have been the focus of attention in recent studies in view of the neuromuscular facilitatory theory. There has been controversial evidences to either support or disprove this theory. Vithoulka [11] displayed that KT application could enhance Quadriceps strength during isokinetic exercise in healthy normal females as they believed that KT might be a muscular tone regulator. Similarly, Lee et al. demonstrated a significant increase in grip strength of the flexor muscles of the dominant hand subsequent to the application of KT [20] and they relate this change to stimulation of the skin afferent receptors and consequently affecting the muscle activity which leading to an increase in grip strength. In our research, KT was applied to the skin in order to provide tactile stimulation to the examined muscles. This tactile stimulation seems to interact with the kinetic control at the central nervous system. The effects of KT in this study were similar to the positive reports by a number of others. For instance, Nelson [23] discovered that KT enhances variety of motion, facilitates muscle function and regularizes muscle length/tension ratios creating optimal force. KT is also hypothesized to facilitate small immediate increases in muscle strength by producing a concentric pull on the fascia, which may stimulate increased muscle contraction. Fascia plays an important role as force transmitter in movement regulation and human posture and is usually seen as having a passive role in transmitting mechanical tension from external forces to the muscle or vice versa. However, fascia may be able to actively contract in a smooth muscle-like manner and consequently affect musculoskeletal dynamics. It is not clear yet, if the results presented in this study, are related to skin or fascia mechanoreceptors, or to the biomechanical support of the muscle through the application of the tape at the direction of the fascia. In any case, positive change in muscle strength in tennis player will lead to: 1) stronger strikes during the game, or 2) helps to maintain the strength of the shoulder muscles during the game for longer time (as the shoulder muscles fatigued, KT may have an effect on recruiting additional motor units to the contracting muscle), which both may enhance the performance of the player and functionally improve the game quality. However, our result are in conflict with Fu s study outcomes which showed that KT was not effectual on the isokinetic peak torque of participants Quadriceps and Hamstring [21]. In our view, the cause of the divergence in results may be the small samples size of their study (14 subjects) and also the KT tension they applied (120%) to facilitate the muscles. In our study we have applied 25% tension according to the KT facilitation technique, as it is claimed that KT loses its recoil feature beyond 50% stretching [10]. In a study by Chang et al. no statistically significant difference was found in maximal grip strength measured under three conditions (without taping, with placebo taping and with KT) [22]. According to Dr Kase the facilitation technique applying from 65

8 the origin to the insertion of the muscles enhances muscle power, while in this study, KT was applied in reverse direction of the forearms muscles, which can be a reason of their negative results. In our study tape was applied from origin to insertion of the muscle so that the recoil property of the tape can help the fibres to contract easier and guide them in the direction of the contraction. Kinesio tape researchers such as Callegari claims that KT has strength enhancing properties [25]. KT was proven to facilitate muscle function where the tape was applied. Since KT has an elastic property; it offers a means to increase joint loading and activity of the taped muscle, as well as to even out the movement and power of the joint. The result of our study suggest facilitated muscle activity and improved muscle alignment that may contribute to marginal increases in muscle strength [24]. Another justification for the positive results of the current study is that the elastic taping causes minimal movement restriction while providing some degree of support and cutaneous inputs, which would be a better choice for treating the over arm athletes such as baseball or tennis players. However these results are in conjecture with Breim s results that had compared the non-elastic versus elastic properties of the two types of tapes and stated that rigid tape might have pulled more aggressively on the skin than the KT and it may further enhance muscle response of the Fibularis Longus by maintaining greater levels of muscle activation [14]. This study only examined the immediate change in muscle activity as a result of taping. However, it is plausible that repeated tape application is required to allow for the development of new neural pathways for more appropriate levels of muscle activation. Performance tests (such as testing serve speed or muscle fatigue) in future studies could provide more evidence in this area of interest. Conclusion The results of the current study demonstrate positive changes in isokinetic muscle strength after KT application. It is not possible to say that Rigid tape was effective or ineffective in producing strength changes greater than no application of the tape based on the results from this study, as neither group showed a change in strength over time. Therefore, for increasing the isokinetic muscle strength in athletes and consequently enhancing their performance, KT is recommended as an adjunction to the shoulder muscles, rather than rigid tape. Based on the varied effects of KT, different intervention techniques are recommended for different purposes. The findings may implicate benefits for shoulder muscle strength and rotation force when using KT. Acknowledgement I would like to extend my gratitude to Medi Lifesports (M) Sdn Bhd for supplying Kinesio tape and Advance Sportscare Sdn Bhd, the Mueller tape supplier for this research and finally Ms. Nicole C. Dabbs for her assistance in edition. Funding Support Statement This study was supported by research grants from the Postgraduate Research Grant Department from University Malaya (BG D). 66

9 Conflict of Interest Statement All authors state that they do not have any commercial, financial or personal relationships which may lead to conflict of interest and that could inappropriately influence (bias) their work. Furthermore, the results of the present study do not constitute endorsement for any product by the authors or the IJAEP. REFERENCES 1.Huang, C.Y., et al., Effect of the Kinesio tape to muscle activity and vertical jump performance in healthy inactive people. Biomed Eng Online, :70. 2.Cools, A.M., et al., Does taping influence electromyographic muscle activity in the scapular rotators in healthy shoulders? Man Ther, (3): Lin, J.J., et al., Functional activity characteristics of individuals with shoulder dysfunctions. J Electromyogr Kinesiol, (6): Ludewig, P.M. and T.M. Cook, Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther, (3): Garrick, J.G. and R.K. Requa, Role of external support in the prevention of ankle sprains. Med Sci Sports, (3): Wilkerson, G.B., Comparative biomechanical effects of the standard method of ankle taping and a taping method designed to enhance subtalar stability. Am J Sports Med, (6): Williams, S., et al., Kinesio Taping in Treatment and Prevention of Sports Injuries: A Meta-Analysis of the Evidence for its Effectiveness. Sports Med, Engstrom, B.K. and P.A. Renstrom, How can injuries be prevented in the World Cup soccer athlete? Clin Sports Med, (4):755-68, vii. 9.Halseth. T, et al., The effects of kinesio taping on proprioception at the ankle.. Journal of Sports Science and Medicine, : Kase, K., Wallis J, and K. T, Clinical Therapeutic Applications of the Kinesio Taping Method. Ken i-kai Information, (2): p Vithoulka, I., et al., The effects of Kinesio-Taping on quadriceps strength during isokinetic exercise in healthy non athlete women. Isokinetics and Exercise Science, (1): Yoshida, A. and L. Kahanov, The effect of kinesio taping on lower trunk range of motions. Res Sports Med, (2): Kase K, Illustrated Kinesio-Taping 2nd.. Ken i-kai Information, (5) 6 9, Briem, K., et al., Effects of kinesio tape compared with nonelastic sports tape and the untaped ankle during a sudden inversion perturbation in male athletes. J Orthop Sports Phys Ther, (5): Dye, S.F., et al., The mosaic of pathophysiologycausing patellofemoral pain: Therapeutic implications, (2): Powers, C.M., et al., The effects of patellar taping on stride characteristics and joint motion in subjects with patellofemoral pain. J Orthop Sports Phys Ther, (6): Morrissey, Dylan, Proprioceptive shoulder taping. Journal of Bodywork and Movement Therapies, (3), Fernandez, J., A. Mendez-Villanueva, and B.M. Pluim, Intensity of tennis match play. Br J Sports Med, (5):387-91; discussion Kase, K., Hashimoto T, and O. T, Amazing taping therapy to eliminate pain and muscle disorders. Kinesio taping perfect manual, 1996.(5). 20. Lee, J.-H., W.-G. Yoo, and K.-S. Lee, Effects of Head-neck rotation and Kinesio taping of the Flexor muscles on Dominant hand grip strength. J.Phys. Ther. Sci, : Fu, T.C., et al., Effect of Kinesio taping on muscle strength in athletes-a pilot study. J Sci Med Sport, (2): Chang, H.Y., et al., Immediate effect of forearm Kinesio taping on maximal grip strength and force sense in healthy collegiate athletes. Phys Ther Sport, (4): Nelson, D.K., The effect of Kinesio tape on Quadriceps muscle power output, length/tension, and hip and knee range of motion in asymptomatic cyclists, Hsu, Y.H., et al., The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome. J Electromyogr Kinesiol, (6):

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