Kinesio Taping for Foot Posture Problems?

Kinesio taping became all the rage after the TV images of athletes wearing the brightly colored tape on their shoulders and knees for injuries at the 2008 Bejing Olympics. So, of course if Olympic athletes are using it then it must be right and if its a pretty color then it must be even more effective. Since then the number of clinicians anecdotally swearing by the effectiveness of Kinesio taping is increasing and there are plenty of courses to go on for clinicians to learn more about it.

But, does Kinesio taping actually work? Is it any better than a placebo or another form of taping? Its taken a while for the research to catch up and you can cherry pick studies on either side of the discussion to show that it either does not work or it does work. A UK Kinesio taping website was certainly taken to task by the UK Advertising Standards authority for the unsubstantiated claims that they were making for the product. When this sort of thing happens, the ‘snake oil’ and woo alarm bells should start to go off. So when the evidence is conflicting and the quality of some of that research has issues with it, we then should start to rely on what the systematic reviews and meta-analyses are telling us. A 2012 meta-analysis of the research concluded that:

In conclusion, there was little quality evidence to support the use of KT over other types of elastic taping in the management or prevention of sports injuries. KT may have a small beneficial role in improving strength, range of motion in certain injured cohorts and force sense error compared with other tapes, but further studies are needed to confirm these findings. The amount of case study and anecdotal support for KT warrants well designed experimental research, particularly pertaining to sporting injuries, so that practitioners can be confident that KT is beneficial for their athletes.

A 2012 systematic review concluded that:

There was limited to moderate evidence that KTT is no more clinically effective than sham or usual care tape/bandage. There was limited evidence from one moderate quality RCT that KTT in conjunction with physiotherapy was clinically beneficial for plantar fasciitis related pain in the short term; however, there are serious questions around the internal validity of this RCT. There currently exists insufficient evidence to support the use of KTT over other modalities in clinical practice.

A separate 2012 systematic review concluded the same:

This systematic review found insufficient evidence to support the use of KT following musculoskeletal injury, although a perceived benefit cannot be discounted. There are few high-quality studies examining the use of KT following musculoskeletal injury.

A more recent 2013 review concluded:

Although KT® has been shown to be effective in aiding short-term pain, there is no firm evidence-based conclusion of the effectiveness of this application on the majority of movement disorders within a wide range of pathologic disabilities. More research is clearly needed.

While some individual studies show that Kinesio taping is effective and other individual studies show that it is not, the reviews of all the available evidence is not concluding that it has any substantial effects. When it comes to the foot, taping is used a lot to treat foot problems, especially for things like plantar fasciitis as methods like Low Dye strapping are effective at reducing the load in the plantar fascia. The use of the Low Dye tape method is generally with a firm inflexible tape, whereas Kinesio taping is flexible expanding tape. The evidence shows that the Low Dye tape with a firmer tape does work in conditions like plantar fasciitis.

The question then becomes, can the flexible Kinesio tape be clinically effective beyond what you get with a placebo for plantar fasciitis? I had previously raised questions if the flexible Kinesio tape would have any mechanical effect on the foot when you consider the loads that are placed on it during sporting activity. No one has done that study yet to show if it works in plantar fasciitis or not, so no one should really be claiming that it does work! Now to the purpose of todays post: we just have this study on the use of Kinesio Taping to change foot posture which is sort of what we want to try and do when taping for plantar fasciitis:

Effects of kinesiotaping on foot posture in participants with pronated foot: A quasi-randomised, double-blind study
Original Research Article

Alejandro Luque-Suarez, Gabriel Gijon-Nogueron, Francisco Javier Baron-Lopez, Maria Teresa Labajos-Manzanares, Julia Hush, Mark Jonathan Hancock
Physiotherapy In Press, Corrected Proof, Available online 23 August 2013
Objective
To investigate whether kinesiotaping improves excessive foot pronation compared with sham kinesiotaping.

Design
Quasi-randomised, double-blind study.

Setting
One primary care centre.

Participants
One hundred and thirty participants were screened for inclusion. Sixty-eight participants with pronated feet [Foot Posture Index (FPI) ≥ 6] were enrolled, and the follow-up rate was 100%.

Interventions
Participants were allocated into one of two groups: an experimental kinesiotaping group (KT1) and a sham taping group (KT2). Measures were collected by a blinded assessor at baseline, and 1 minute, 10 minutes, 60 minutes and 24 hours after taping.

Main outcome measures
The primary outcome was total FPI score, and the secondary outcome was rear-foot FPI score.

Results
There were no significant differences in total FPI score between kinesiotaping and sham taping at any time point. Similarly, there were no significant differences in rear-foot FPI score, apart from at 60-minute follow-up when the difference between groups was significant (P = 0.04) but the effect size was very small (0.85 points on the rear-foot FPI score between −6 and +6).

Conclusions
Kinesio taping does not correct foot pronation compared with sham kinesiotaping in people with pronated feet.

This was not a clinical trial on symptoms, but an experimental study to see if Kinesio taping could change foot posture or alignment given the flexible expanding nature of the tape. They found that it didn’t.

There is a couple of issues with the study:

  • the used a sequential allocation of participants to the two groups when they should have randomized them. This is not close to being a fatal issue, but does weaken the strength of the conclusion by a small amount.
  • while I am not doubting the integrity of the statistical analysis, it is a little unclear how the data was actually analysed. I would have preferred more info on that to be totally confident in the results (however, you only have to look at the raw numbers to see the results of the study are valid!)
  • The Foot Posture Index (FPI) that was used in the study is only a static measure and it is not known that if a dynamic measure was used that the results would have been any different (though Viv Chuter did show a good link between the static FPI and dynamic function).

As always, I go where the evidence takes me until convinced otherwise and this evidence tells me that Kinesio taping can not change foot posture. For a different spin on Kinesio taping, see this post on Running Physio.

Alejandro Luque-Suarez, Gabriel Gijon-Nogueron, Francisco Javier Baron-Lopez, Maria Teresa Labajos-Manzanares, Julia Hush, Mark Jonathan Hancock (2013). Effects of kinesiotaping on foot posture in participants with pronated foot Physiotherapy DOI: 10.1016/j.physio.2013.04.005

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