Meralgia Paresthetica

Transcription

1 Kinesio Taping: A Literary Review Adam Lucassian, Central Michigan University Athletic Training Student Dr. René R. Shingles, PHD, ATC, AT, Faculty Advisor There are many different methods that are used by Athletic Trainers, Physical Therapists, and other health care professionals to treat and care for athletes and the general population. One method that recently has received much attention is Kinesio Taping. The purpose of this literary review is (i) to explain what Kinesio Tape is, (ii) what conditions and benefits does it help, (iii) what conditions and benefits does it not help, (iv) and where further research on Kinesio Tape needs to focus on. 1

2 There are many different methods that are used by Athletic Trainers, Physical Therapists, and other health care professionals to treat and care for athletes and the general population. One method that recently has received much attention is kinesio taping. The purpose of this literary review is (i) to explain what kinesio tape is, (ii) what conditions and benefits does kinesio tape help, (iii) what conditions and benefits does kinesio tape not help, (iv) and where further research on kinesio tape needs to focus on. What is Kinesio Tape? Kinesio tape was introduced to the United States in the 1990s from Japan (Osterhues, 2004, p. 54). Dr. Kenzo Kase, the inventor of Kinesio Tape, was a US trained chiropractor that was interested in kinesiology, and how it could be used to help with soft tissue injuries (Osborn, 2009, p. 54). While prominent figures in the athletic community, such as Tiger Woods and Lance Armstrong, publically endorsed Kinesio Tape (Osborn, 2009, p. 54), it was not until United States Volleyball Olympian Kerri Walsh wore kinesio tape on her shoulder that the public at large knew the existence of kinesio tape. According to the director of the Kinesio Taping Association, John Jarvis, kinesio taping was difficult to incorporate into use by athletic trainers, and was primarily used by physical therapists and occupational therapist. His reasoning behind this was, The technique itself is almost backward to what they re [athletic trainers] using. The technique Jarvis is referring to involves traditional athletic tape that offers a strapping, immobilization process, which differs from the kinesio tape method, which involves a flexible, water-resistant, latex-free Kinesio Tex Tape that encourages movement of fluids (Osborn, 2009, p. 54). Another concept that makes kinesio tape different than traditional white tape is kinesio tape is designed to facilitate movement while offering some support and preventing over contraction while. These things are all claimed to happen while the kinesio tape allows the body to heal itself biomechanically (Osborn, 2009, p. 55). In addition, kinesio tape can be stretched to 140% of its length, be applied to the skin, and therefore apply a shearing force to the skin (Kalichman, Vered, Volchek, 2010, p.55). What conditions and benefits does kinesio tape help? There are many conditions and benefits that kinesio tape has claimed to help. The conditions include helping with impingement of the shoulder, patellar tracking problems, relieving symptoms of Meralgia Paresthetica, and increasing strength. The purpose of this section is to report on studies that show kinesio tape is effective for specific conditions. Meralgia Paresthetica One condition that kinesio tape has shown to have some benefits with is meralgia paresthetica. Meraliga paresthetica is described as symptoms that include numbness, paresthesias, and pain in the anterolateral thigh resulting from either entrapment neuropathy or neuroma of the lateral femoral cutaneous nerve (Kalichman, Vered, Volchek, 2010, p. 1137). The researchers of this study believed that kinesio tape may help with meralgia paresthetica because the tape may affect the fascia around 2

3 the femoral cutaneous nerve, it is a potentially effective method for relieving symptoms in patients with meralgia paresthetica (Kalichman et al., 2010, p. 1137). Therefore, the purpose of the study was to assess the effect that kinesio taping has on the symptoms of meralgia paresthetica. The study consisted of a population that experienced a pain or burning sensation in the lateral aspect of the though and diagnosed by a board-certified neurologist with meralgia paresthetica. The researchers were able to gather ten individuals that met this requirement and other criteria. The researchers measured four parameters; 1. Meralgia paresthetica symptoms were evaluated by using a 100-mm visual analog scale (VAS) ranging from 0, meaning no symptoms, and 100, indicating unbearable symptoms. 2. The influence of meralgia paresthetica of the quality of life which was also measured on a VAS scale, which had 0 indicating no influence and 100 indicating a very low quality of life. 3. The length of the affected area. 4. The width of the affected area (Kalichman et al., 2010, p. 1138). The measures were taken twice, once before the intervention started, and once after all treatment was complete. The treatment of all ten of the participants was an application of kinesio tape, applied by a research physiotherapist who was certified as a kinesio tape practitioner, to the affected area of the thigh as depicted on the following picture. The taping was applied twice a week for 8 weeks. After the 4 weeks of testing, all the outcome measures were found to be significantly improved. The figures include a VAS quality of living decrease from to , a mean VAS of symptoms decreasing from to In addition, the length and width of the affected area decreased from cm to cm and cm to Other outcomes that were found after the kinesio taping method that showed a benefit of using kinesio tape to help treat the symptoms of meralgia paresthetica was that 2 participants reported a full recovery, and one individual who suffered from symptoms lasting more than 36 months reported being almost symptom free. While most of the participants did report positive outcomes, four of the participants reported almost no change (Kalichman et al., 2010, p ). 3

4 Overall, I find that this study was not well performed. First, I believe that the number of participants (10) was not enough to properly draw outcomes. Also, as the researchers stated, no control group was used. By not having a control, a placebo effect may have been a driving force for the results. Patella Dislocation Another case study focused on the use of kinesio tape to help with problems associated with a patella dislocation including pain, problems with the quadriceps muscle, and issues of stability related to the patellar dislocation. In this study, the researcher focused on one 49 years old who sustained a traumatic left knee patella lateral dislocation while cross country skiing (Osterhues, 2004, p ). The subject was evaluated and diagnosed with this injury three days after the event occurred. The main problems that the subject suffered during a self-prescribed four-week rehabilitation program were inhibition of her quadriceps as well as a feeling of instability (Osterhues, 2004, p. 268). For four weeks, the subject, who was also a physical therapist, used an interferential current (IFC) along with ice, elevation, 200mg of Advil two times a day, static and dynamic training, time on an exercise bike, self-massage, range of motion exercises, and core exercises for treatment to help control pain and edema. Along with these techniques, a therapist used a Y shaped pattern of kinesio tape on the quadriceps to help with contraction and to decrease pain. The kinesio tape was reapplied every 3-4 days (Osterhues, 2004, p.268). After the four weeks, another physical therapist re-evaluated the subject. At this point, the patient was able to return to spin cycling, had no pain with walking, and returned to some resistance exercises. In addition, the subject reported that there was a decrease in pain during kneeling and eccentric weight bearing activities, which was reported as the most painful activities, when the kinesio tape was applied (Osterhues, 2004, p.268). The subject s motor control, movement, and balance were assessed on the 4

5 NeuroCom Balance Master while performing two trials of three functional tests, one with and one without the application of kinesio tape (Osterhues, 2004, p. 269). The NeuroCom Balance Master provides objective assessment and retraining of the sensory and voluntary motor control of balance with visual biofeedback (NeuroCom, 2011, Balance Master, para 1). When looking at the results of the tests, all the results when tape was applied proved more beneficial than without the tape (Osterhues, 2004, p. 268). From the results, the author supports the use of kinesio tape to provide decreased pain, enhanced quadriceps activity, and weight bearing stability during functional activities (Osterhues, 2004, p. 270). The author does recognize that the mechanism of the kinesio tape that produced positive results is unknown. Therefore the author suggests that further research is necessary to determine how and why the kinesio tape works (Osterhues, 2004, p. 270). When evaluating Osterhue s study, overall I believe the research method is flawed due to the fact that only one individual was evaluated. I believe the method of testing, the NeuroCom Balance Master, though provided very good and objective data supporting the use of kinesio tape to help with decreasing pain and facilitating quadriceps activity. Myofascial Pain This case study focused on the treatment of myofascial trigger points (MTPs) with the use of kinesio tape. The subject was a 20-year-old female patient with pain in her right shoulder that lasted two days. During the evaluation of the shoulder, the researchers determined that the subject had a suffered from rotator cuff pathology, but the issue had been resolved with rest. Upon further evaluation that involved goniometry, Apley s Scratch Test, a visual analog scale (VAS) for pain, and palpation, the researchers concluded that active MTPs along the anterior and medical deltoid region were present (García-Muro, Rodríguez-Fernández, Herrerode-Lucas, 2010, p ). For treatment, the authors placed kinesio tape on the deltoid, along with another transverse strip over the region were the MTPs were located (García-Muro et al., 2010, p. 293). Immediately after application of the kinesio tape, an assessment was taken. The results showed an improvement in the range of motion but no decrease in the VAS. Two days following the treatment, the subject was assessed again. During this assessment the subject s tests showed great improvement, including an increase of 160 in abduction from an initial 35 and a decrease in the VAS at motion from a 10 to a 2.7 (García-Muro et al., 2010, p. 294). Full results are available in the following chart. During the session, the kinesio tape was removed. 5

6 A follow up via telephone was conducted 9 days after the initial treatment with the subject. She reported that she had no pain, and shoulder movement was almost normal. No other kinesio taping sessions were performed after the tape was removed after the second assessment (García-Muro et al., 2010, p. 294). The authors noted that the value of pain did not change significantly the day after treatment, but did change two days after the application of kinesio tape (García-Muro et al., 2010, p. 294). The researchers concluded that kinesio tape might be an appropriate technique for the treatment of MTPs. The researchers also suggest that more research is needed to clarify the specific effects and techniques kinesio tape possess (García-Muro et al., 2010, p. 295). This study, much like the previous case study, does demonstrate the promise of kinesio taping may have on treating patients. Still, the evaluation of only one individual puts this study in question. I believe that this study should be repeated with multiple subjects. In addition, because the patient was not monitored after the second assessment, the researchers did not know if the subject performed any other interventions to help with the MTPs. Range of Motion The researchers of another study focused of the effects kinesio taping had on the range of motion of the lower trunk The purpose of the study was to determine what affect kinesio tape has upon lower trunk flexion, extension, and right lateral flexion. The study included 30 subjects with no history of back pain or lower trunk injury in the previous six months. The participants had lower trunk flexion, extension, and right lateral flexion measured using a tape measure method that was reported to have a high reliability with repeated measurements (Yoshia, Kahanov, 2007, p ). Initially, the measurements were taken on all 30 participants without the application of kinesio tape. After the first round of measurements, kinesio tape was applied to a random 15 participants, and their 6

7 measurements were retaken. The method of kinesio taping can be viewed in the following graphic ((Yoshia, Kahanov, 2007, p When the measurements with and without kinesio tape were evaluated, a significant increase in lower trunk flexion was found, 63.7 to However, no other significant data was found to suggest kinesio tape helped with any other lower trunk motions tested (Yoshia, Kahanov, 2007, p. 108). The authors suggest two theories as to why the kinesio tape may have aided in the increase of lower trunk flexion. One of the theories claims that kinesio tape helps increase the circulation of blood in the taped areas, which could help increase the function of muscle and myofascial tissues in the affected area (Yoshia, Kahanov, 2007, p 108). The other theory suggested is that [kinesio tape] stimulates cutaneous mechanoreceptors at the taped area, and this stimulation may affect the ROM (Yoshia, Kahanov, 2007, p ). When evaluating this study, a few red flags are evident. One issue found in this research is that the placebo effect may have affected the results. The 15 chosen participants all had the kinesio tape applied to them, and no placebo tape was used. Another problem in this study was that after the initial 7

8 measurements of the 30 participants, only the 15 participants in the kinesio tape group were measured again. It is unknown how the other 15 participants with kinesio tape would have tested a second time. Quadriceps Strength This study addressed kinesio tape aiding in increased quadriceps strength. The researcher s purpose was to investigate how kinesio tape affects the strength of the quadriceps muscle at maximum concentric and eccentric contractions. In addition, the researchers concluded that the results of this study could help enhance the performance of athletes concerning their strength. Twenty healthy and random females participated in the study (Vithoulka, Beneka, Aggelousis, Karatsolis, Diamantopoulos, 2010, p.1-2). The subjects peak muscle torque of the knee extensors were measured using an isokinetic dynamometer. The testing included a warm up, consisting of a 10 minute warm-up on bike, three submaximal trials and two maximal trials on the isokinetic device. The testing included one bout of 5 concentric maximal knee extension/flexion repetitions at 60 and 240 /s (CON/CON) and one bout of 3 eccentric maximal knee flexion repetitions at 60 /s (CON/ECC) on the same order, separated by 2 minute rest intervals (Vithoulka et al., 2010, p.2). The researchers recorded the best peak torque result from the different trials. To test the effect of kinesio tape on strength, the subjects performed the isokinetic trials three times, with kinesio tape, with a placebo tape, and without tape. The researchers did not specify the timeframe of the kinesio and placebo tape application. The method in which the researchers applied the kinesio tape and placebo tape are visible in the following images. The subjects performed the trials every three days until they completed all three trials. The method of which the subjects were tested was done in a random order (Vithoulka et al., 2010, p.4). 8

9 After analyzing the test results, the researchers found no significant differences in the CON/CON tests. A significant difference in the maximal eccentric availability was discovered with the use of kinesio taping as compared to no tape and a placebo tape. Full results are available in the following table. The authors suggest that the increase in eccentric ability may be due to a muscle toning quality of kinesio tape (Vithoulka et al., 2010, p. 5). The authors also discuss that the direction of the kinesio tape has an influence on muscle tone. The application of kinesio tape from the origin to insertion offers support, helps improve the contractions, and increases muscle strength (Vithoulka et al., 2010, p.5-6). Another effect of kinesio tape that the authors discuss is its tactile stimulation. This tactile stimulation seems to interact with the kinetic control at the central nervous system (Vithoulka et al., 2010, p.6). This is important in regards to the 9

10 study because it is unknown if the tape activated mechanoreceptors in the skin or the receptors found in the fascia of the muscle. The researchers also suggest that further research be performed on how kinesio tape can help weak muscles (Vithoulka et al., 2010, p. 6). When looking at this study, there are a few good things and a few bad things. One positive thing the researchers did was evaluate all 20 participants on an isokinetic dynamometer with kinesio tape, with a placebo tape, and without tape. Another positive aspect of the study was that the researchers brought all the participants in before the study began to allow them to become familiar with the dynamometer (Vithoulka et al., 2010, p. 4). One negative aspect is that I believe the tests should have also included a one rep max of an the extensors to see the difference between the strength with and without the kinesio tape. This would show definite results showing how the kinesio tape can increase, decrease, or maintain strength. Secondly, the researchers did not clarify when the tape was applied in relation to the testing time. I believe it would be beneficial to dictate if the tape was applied immediately before testing, or if the tape was applied a few days before testing. Treating Shoulder Problems The researchers that investigated the use of kinesio tape compared to standard modalities used 55 patients that complained of pain before 150 of active shoulder elevation, positive empty can and Hawkins-Kennedy test, and difficulty performing activities of daily living. The researchers did not include any subjects that had surgery in the previous 12 weeks or shoulder pain that has lasted for more than six months (Kaya, Zinnuroglu, Tugcu, 2011, p. 202). The 55 subjects were assigned to either to a physical therapy (PT) group or the kinesio tape group. The subjects were placed in the group based upon when they arrived at the meeting, the first 30 patients in the PT group, and the rest of the participants in the kinesio tape group (Kaya et al., 2011, p ). The subjects in the kinesio tape group applied tape on three muscles, the supraspinatus, deltoid, and teres minor. The authors claimed that this method helps to maintain the scapulothoracic stability via the mechanical correction (Kaya et al., 2011, p. 203). The kinesio tape group also was given a home exercise program (HEP), which consisted of isometric, range of motion, and strengthening exercises, along with stretching of the posterior shoulder and pectoralis minor muscles (Kaya et al., 2011, p. 204). The PT group s treatment consisted of the same HEP and standard physical therapy modalities (ultrasound, transcutaneous electrical nerve stimulation [TENS], and heat) (Kaya et al., 2011, p.204). The results of the study were based upon the Disability of Arm, Shoulder, and Hand (DASH) scale and a 100-mm visual analog scale (VAS). The DASH Outcome Measure is a 30-item, self-report questionnaire designed to measure physical function and symptoms in people with any of several musculoskeletal disorders of the upper limb. The tool gives clinicians and researchers the advantage of having a single, reliable instrument that can be used to assess any or all joints in the upper extremity (Institute for Work & Health, 2011, Home Page). A higher score on the DASH indicates greater disability (Institute for Work & Health, 2011, Scoring the DASH). The function and pain of the subject s shoulder were measured for pain at night, rest, and with active shoulder movements (Kaya et al., 2011, p. 204). The DASH scale and VAS were also assessed before any treatment was given to gain baseline measurements. 10

11 The results showed a significant decrease in DASH score in the kinesio tape group after two weeks. At night, rest, and during active movements showed significant results in regards to the DASH and VAS for both groups after the first week of treatment. There was no significant difference between the two groups at the second week (Kaya et al., 2011, p. 205). 11

12 The results of this study indicate that kinesio tape is an effective treatment method to treat impingement syndrome. More specifically, the use of kinesio tape may be more beneficial when immediate effect is needed (Kaya et al., 2011, p. 206). The researchers also indicated some flaws in their study. One flaw indicated is the lack of a placebo application to the subjects. Another flaw is the absence of randomization that weaken[s] the power of this study (Kaya et al., 2011, p. 206). Overall, this study was performed well. By having the only difference in the groups be the application of modalities, the researchers were able to get a accurate picture on the effect of kinesio tape vs. modality use. However, I agree with the researchers about the lack of a placebo group. This group would have made this study much stronger and possibly verify that kinesio tape is a better/worse/equal method to treat shoulder impingement than traditional modalities. What conditions and benefits does kinesio tape not help? With the studies that have been done that promote the use of kinesio taping, some indicate that kinesio tape does not provide positive benefits. Two conditions that are claimed to have no benefits from kinesio tape are muscle strength and ankle proprioception. The purpose of this section is to discuss conditions that have been studied and concluded to show no benefits with kinesio tape. Quadriceps and Hamstring Muscle Strength The authors of this study acknowledged that while there have been studies on how kinesio tape biomechanically increases or reduce muscle strength. However, they point out that the few studies that study the effect kinesio tape has on strength often provide inconsistent results. Therefore, the main goal of the study was to determine if muscle power is affected by kinesio tape, and if the timing of application has any effect (Fu, Wong, Pei, Wu, Chou, Lin, 2008, p ). The subjects in the study were 14 healthy college athletes. If a subject reported knee pain, trauma in the lower leg within three months, or any lower leg surgery they were excluded. The subject s hamstring and quadriceps strength was measured using a Cybex NORM isokinetic dynamometer. The testing protocol was as followed: concentric quadriceps contraction at 60 /s; eccentric quadriceps contractions at 60 /s; concentric quadriceps contraction at 180 /s and eccentric quadriceps contraction at 180 /s 12

13 (Fu et al., 2008, p. 199). The same protocol was used to measure hamstring muscle strength (Fu, et al.,2008, p. 199). All participants performed the protocols three times; once without tape applied (WT), once immediately after taping (IT), and once 12 hours after taping. A random number allocation table determined the order of conditions that the subjects were tested. The subjects were measured a minimum of seven days between trials (Fu et al.,2008, 199). After the trials were complete, no significant results were found to indicate kinesio tape helps with muscular strength. Though it was concluded that kinesio tape did not help muscular strength, kinesio tape did not hinder strength (Fu et al., 2008, p. 200). These results conflict with the results found in Vithoulka et al., 2010, p. 6. The authors of this study also conflict with Vithoulka, 2010 because Fu,2008 states that kinesio tape that is applied under tension in the direction of the muscle fibers facilitates the strength of the underlying muscle (Fu et al., 2008, p. 200). As stated earlier in this literary review, Vithoulka believed that the direction of application had an impact on the effect of the kinesio tape (Vithoulka et al., 2010, p.5-6). Overall, this study was done well. The issue I have with the study was the lack of a placebo group. The fact that the researchers checked the affect time had on the results was very beneficial. I believe this because kinesio tape is usually left on more multiple days. The knowledge of how kinesio tape effects are affected by time would therefore be very beneficial. Grip Strength The authors of this study were also interested how kinesio tape affects muscular strength. To determine the affect kinesio tape has, the researchers tested the grip strength of 21 healthy college athletes, who had not performed any upper extremity strength training for at least two weeks prior, blind, repeated measure study. Grip strength was used because it was determined that grip strength is an appropriate measure because of the importance grip strength has in many sports, including rock climbing, judo, baseball, and other racquet sports (Chang, Chou, J. Lin, C. Lin, Wang, 2010, p. 122). Like other studies on kinesio tape, these researchers chose to test all the subjects under three different conditions; without kinesio tape, with placebo tape (which consisted on placing a piece of kinesio tape on the proximal forearm without tension), and with kinesio tape along the forearm (Chang et al., 2010, p. 123). The subjects randomly performed all three conditions one week apart. The researchers waited a week between trials to make sure the kinesio tape had no prolonged effect on the forearm muscles (Chang et al., 2010, p. 123). To measure the grip strength of the participants, the subjects performed three five-second trials per condition on a hydraulic hand dynamometer. The researchers are measured the force of each subject by taking the strength found in the strength trial and calculated a target force. The subjects were then told to watch a computer screen connected to the dynamometer and reach their target force. At this point, they were to hold that force for three seconds. After this trial, the subjects were asked to reproduce the force produced without a visual feedback. When the subject believed they had reached the force, the researchers recorded the difference the target force and the second trial (Chang et al., 2010, p.124). 13

14 When the data was collected, no difference were found in the maximal grip strength between the condition; without tape ( kg), with placebo tape ( kg), with kinesio tape ( kg). However, a significant difference was found in the absolute and related force sense error. The kinesio tape group ( kg) had smaller errors that the group without tape ( kg). These results suggest that kinesio tape does not have an effect on muscular strength, but can promote a greater awareness of force production (Chang et al., 2010, 125). This study was performed well. The only problem I found in the study was that the placebo tape was still an application of kinesio tape, which may have caused a physiological effect on the body. If this study was to be performed again, I would use another type of tape that has been shown to have no physiological effect, such as McConnell rigid tape. Ankle Proprioception The authors of this article focused on the possible proprioceptive properties of kinesio tape. It is thought that applying pressure and stretching the skin may stimulate cutaneous mechanoreceptors, causing the receptors to be aware of joint movement (Halseth, McChesney, DeBeliso, Vaughn, Lien, 2004, p. 2). According to this study, there have been other studies documenting that traditional white athletic tape has an effect on ankle proprioception. Another study cited in this study reported that kinesio tape improved proprioceptive abilities in non-weight bearing positions following a lateral ankle sprain (Halseth, 2004, p.2). The purpose of this study was to determine the effect kinesio tape has on ankle proprioception, also described as reproduction joint position sense (RJPS) (Halseth, 2004, p. 2) The subjects were 30 healthy individuals with no history of any serious ankle injury or surgery. Ankle position was measured using an instrumented platform with a moveable footplate capable of providing measures of ankle joint position (Halseth et al., 2004, p. 3). During the trials, the subjects were blindfolded and headphones playing white noise to eliminate visual and auditory feedback. When the test began, the subject was passively moved to a target position and asked to remember that position. Then, the subject was returned to a neutral position and asked to place the ankle back into the same position as before. The angular difference between the target position and trial position was recorded. (Halseth et al., 2004, p. 3-4). The researchers used a crossover design in respect to the order of the subjects being taped or un-taped. A five-minute waiting period occurred between conditions and RJPS assessment. The subjects were taped for a lateral ankle sprain with kinesio tape, as directed by the Kenso Kase s Kinesio TM taping manual by a certified athletic trainer. There was no significant difference found between the taped ( ) and un-taped trials ( ) (Halseth et al.,2004, p. 4). The results of the trial suggest that kineso tape provides no additional proprioceptive ability to a healthy individual when attempting to perform RJPS. This study lacked a placebo group, which I believe is an important factor in determining the true effect during any study. Also, the study did not specify if the participants performed the trials more than once per condition. By allowing the subjects to have practice sessions, the results may have produced different results. 14

15 Where does further research on kinesio tape need to focus on? Based upon the research articles reviewed, many aspects of kinesio tape need to be further researched. One aspect that needs to be heavily researched is the effect kinesio tape has on muscular strength. If kinesio tape could be proven to increase muscular strength, rehabilitation of an individual with strength loss could greatly benefit. Another aspect that should be researched is the effect kinesio tape has on myofascial pain. This needs to be researched more because the study reviewed looked at one individual. Also, because myofascial pain in a common complaint among active and inactive individuals, if kinesio tape is shown to help decrease myofascial pain, this could be a very helpful solution to eliminating the pain. Works Cited Chang, H.Y., Chou, K.Y., Lin, J.J., Lin, C.F., & Wang, C.H. (2010). Immediate effect of forearm kinesio taping on maximal grip strength and force sense in healthy collegiate athletes. Physical Therapy in Sport, 11, Fu, T.C., Wong, A.M.K, Pei, Y.C., Wu, K.P., Chou, S.W., & Lin, Y.C. (2008). Effect of kinesio taping on muscle strength in athletes-a pilot study. Journal of Science and Medicine in Sport, 11, García-Muro, F., Rodríguez-Fernández, A.L., & Herrero-de-Lucas, A. (2010). Treatment of myofascial pain in the shoulder with kinesio taping. a case report. Manual Therapy, 15, Halseth, T., McChesney, J.W., DeBeliso, M., Vaughn, R., & Lien, J. (2004). The effect of kinesio taping on proprioception at the ankle. Journal of Sports Science and Medicine, 3, 1-7. Institute for Work & Health. (2006). Scoring the dash. Retrieved from Institute for Work & Health. (2010, June 30). Welcome to our web site where you will find up-to-date information about the dash outcome measure, the quickdash and related dash tools and product. Retrieved from Kalichman, L., PT, PhD, Vered, E., PT, MEd, & Volchek, L., MD. (2010). Relieving symptoms of meralgia paresthetica using kinesio taping: a pilot study. Arch Phy Med Rehabil, 91, Kaya, E., Zinnuroglu, M., & Tugcu, I. (2011). Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome. Clin Rheumatol, 30, Neurocom. (2011). Balance master. Retrieved from Osborn, K. (2009). Tape it up. Massage and Body Work, 24(3),

16 Osterhues, D,J. (2004). The use of kinesio taping in the management of traumatic patella dislocation. a case study. Physiotherapy Theory and Practice, 20, Vithoulka, I., Beneka, A., Malliou, P., Aggelousis, N., Karatsolis, K, & Diamantopoulos, K. (2010). The effect of kinesio-taping on quadriceps strength during isokinetic exercise in healthy non athlete women. Isokinetics and Exercise Science, 18, 1-6. Yoshida, A., & Kahanov, L. (2007). The effect of kinesio taping on lower trunk range of motions. Research in Sports Medicine, 15,