Proprioceptive taping

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Two studies attempted to assess the effect of tape on proprioception and performance in the shoulder.

The ability to reposition the scapula during active shoulder flexion and abduction was studied by Zanella et al (2001) with and without a scapular tape. The scapular tape was not found to increase the ability to reposition the scapula in normal subjects or subjects with a 'winging' scapula.

In another study, a scapular tape retracting both scapulae was applied in an attempt to improve scapular position and muscular performance in professional violinists without shoulder pathology. The EMG activity of the trapezii and scapular retractor muscles and the quality of music performance were assessed. Contrary to the authors' expectations, when compared to a no-tape control condition, the tape significantly increased the EMG activity of the upper trapezius muscle and there was a decrease in quality of the music performance (Ackermann et al 2002).

INHIBITORY VASTUS LATERALIS TAPE

The patellofemoral joint has been described as the most researched small joint in the body, producing pain and disability far out of proportion to its shape and size (Gerrard 1995). One of the underlying theories behind the cause of patellofemoral pain syndrome (PFPS) is that there is an imbalance between the contraction of vastus lateralis (VL) and vastus medialis obliquus (VMO) muscles (McConnell 1986).

Patella taping is a common technique used for patients with PFPS and aims to realign the patella and increase the activity of the VMO (McConnell 1996). Another approach is to attempt to decrease the muscle activity of the VL and thereby address patellar pathomechanics (Tobin & Robinson 2000).

There are currently only two studies published on inhibitory taping of the VL and its effect on muscle activity, both studies investigating surface EMG during stair descent (lanwantankul & Gaogasigam 2005, Tobin & Robinson 2000). Stair walking has been described as one of the most challenging and pain-provoking activities in individuals with PFPS (Gilleard et al 1998). Tobin & Robinson (2000) applied the tape perpendicular to the fibres of the VL muscle with enough tension to form a furrow in the skin (Fig. 4.2). Electromyographic data were collected from the VMO and the VL muscles. The authors reported a significant decrease in EMG activity of the VL while the VMO remained unchanged. However, there are some concerns raised about the methodology of this study in that the pace of stair walking was not controlled and the EMG data were sampled at very low frequency (Herrington 2000, Scott 2000).

Janwantankul & Gaogasigam (2005) attempted to repeat and improve the methodology of Tobin & Robinson (2000). The authors assessed mean EMG activity during stair descent with tape applied perpendicular to the VL muscle fibres but also parallel to the muscle fibres, aiming to facilitate muscle activity (Morrissey 2000). There was no significant difference in the EMG activity of the VMO and VL compared with the no-tape condition. Unfortunately elastic tape was used rather than the rigid tape which has been used in all other similar studies assessing inhibitory tape techniques.

What Vmo Muscle 2019
Figure 4.2 Vastus lateralis inhibitory tape applied firmly, perpendicular to the muscle fibres.

These two studies differ to such an extent that it is difficult to draw direct comparisons and identify how this type of inhibitory tape affects the muscle activity.

To achieve a greater understanding of the effects of the VL inhibitory tape, a repeatable application procedure has been established (McCarthy Persson et al 2007a) and the effects during stair ascent and descent assessed (McCarthy Persson et al 2008). The results from this study concur with Tobin & Robinson's (2000) results that a selective inhibition of the VL can occur during stair descent but also during ascent.

Two studies have assessed the effects of tape applied to increase or decrease the muscle activity of the calf muscle (Alexander et al 2008, McCarthy Persson et al 2007b). Both these studies used the H-reflex to assess the effects of the tape applications on the muscle. While McCarthy Persson et al (2007b) noted an increase in the soleus H-reflex, Alexander et al (2008) found no such change in the H-reflex with the tape applied perpendicular to the muscle fibres. The latter study found that application of a rigid tape parallel to the muscle fibre decreased the H-reflex of the medial gastrocnemius muscle (Alexander et al 2008). These results are again conflicting, and the tape application varies with a greater reported tension application in the McCarthy Persson (2007b) study, and a different angulation of the tape.

PROPOSED MECHANISM OF ACTION

From the published literature there is some evidence that rigid tape applied across the muscle fibres of the upper trapezius and VL can inhibit the muscle activity during functional movements. There is also evidence that tape applied parallel to the muscle fibres of the lower trapezius and medial gastrocnemius decreases the motor neurone excitability during static conditions.

It has been suggested that the inhibition caused by tape parallel to the muscle fibres may be due to the tape shortening the muscle (Morrissey 2000). If the tape was able to shorten the muscle, it may off-load the muscle spindle and thereby decrease its tonic discharge and reduce the H-reflex (Alexander et al 2008).

Other proposed mechanisms have been suggested such as alterations in muscle activity from the tape causing mechanoreceptor stimulation in the skin. It has been found that the mechanoreceptor activation is dependent on the direction of tension applied to the skin (Olausson et al 2000). It has furthermore been demonstrated that application of tension on the skin in a particular direction will cause a particular change in muscle activity (MacGregor et al 2005). It was found that when tape was applied with tension over the patella in subjects with PFPS, a selective increase in activity of the VMO occurred. This increase in muscle activity was greatest when the skin was stretched in a lateral direction (MacGregor et al 2005). Research involving these relatively new taping techniques is still scarce. There is need for further exploration of the effects and mechanisms of actions underlying taping techniques to alter muscle activity and proprioception.

REFERENCES

Ackermann B, Adams R, Marshall E 2002 The effect of scapula taping on electromyographic activity and musical performance in professional violinists. Australian Journal of Physiotherapy 48:197-204 Alexander CM, Stynes S, Thomas A et al 2003 Does tape facilitate or inhibit the lower trapezius? Manual Therapy 8(1):37-41 Alexander MA, McMullan M, Harrison PJ 2008 What is the effect of taping along or across a muscle on a motorneurone excitability? A study using the triceps surae. Manual Therapy 13:57-62

Cools AM, Witvrouw EE, Dannieels LA et al 2002 Does taping influence electromyographic muscle activity in the scapular rotators in healthy shoulders? Manual Therapy 7(3):154-162

Gerrard B 1995 The patellofemoral complex. In: Zuluaga M (ed.) Sports physiotherapy. Churchill Livingstone, Melbourne, pp 587-611

Gilleard W, McConnell J, Parsons D 1998 The effect of patellar taping on the onset of vastus medialis oblique and vastus lateralis muscle activity in persons with patellofemoral pain. Physical Therapy 78:25-32 Herrington L 2000 Electromyographic problems. Physiotherapy 86(7):390-392 Janwantankul P, Gaogasigam C 2005 Vastus lateralis and vastus medialis obliquus muscle activity during the application of inhibition and facilitation taping techniques. Clinical Rehabilitation 19:12-19 McCarthy Persson JU, Hooper ACB, Fleming HE 2007a Repeatability of skin displacement and pressure during 'inhibitory' vastus lateralis muscle taping. Manual Therapy 12:17-21 McCarthy Persson U, Boland S, Ryan S et al 2007b The effects of an inhibitory muscle tape on the soleus H-reflex. Journal of Orthopaedic and Sports Physical Therapy 37(3): abstract

McCarthy Persson U, Fleming HF, Caulfield B 2008 The effect of a vastus lateralis tape on muscle activity during stair climbing. Man Ther Jul 8 (Epub ahead of print) McConnell JS 1986 The management of chondromalacia patella: a long term solution.

Australian Journal of Physiotherapy 32:215-223 McConnell J 1996 Management of patellofemoral problems. Manual Therapy 1:60-66 MacGregor K, Gerlach S, Mellor S et al 2005 Cutaneus stimulation from patella tape causes a differential increase in vasti muscle activity in people with patellofemoral pain. Journal of Orthopedic Research 23:351-358 Morin GE, Tiberio D, Austin G 1997 The effect of upper trapezius taping on electromyographic activity in the upper and middle trapezius region. Journal of Sport Rehabilitation 6:309-318 Morrissey D 2000 Proprioceptive shoulder taping. Journal of Bodywork and Movement

Therapies 4(3):189-194 Olausson H, Wessberg J, Kakuda N 2000 Tactile directional sensibility: peripheral neural mechanisms in man. Brain Research 866(1-2):178-187 Schieppati M 1987 The Hoffmann reflex: a means of assessing spinal reflex excitability and its descending control in man. Progress in Neurobiology 28:345-376 Scott M 2000 Room for improvement in study design. Physiotherapy 86(7):391-392 Selkowitz DM, Chaney C, Stuckey SJ et al 2007 The effects of scapular taping on the surface electromyographic signal amplitude of shoulder girdle muscles during upper extremity elevation in individuals with suspected shoulder impingement syndrome. Journal of Orthopedic and Sports Physical Therapy 37(11):694-702 Tobin S, Robinson G 2000 The effect of vastus lateralis inhibition taping technique on vastus lateralis and vastus medialis obliquus activity. Physiotherapy 86(4):173-183 Zanella PW, Willey SM, Seibel SL et al 2001 The effect of scapular taping on shoulder repositioning. Journal of Sport Rehabilitation 10(2):113-123

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Foot

Turf toe strap 42 Hallux valgus 44 Antipronation taping 46 Plantar fasciitis 48 Low dye taping 52 Plantar fasciitis support 54 Medial arch support 56 Cuboid subluxation in dancers 58 Heel pain 60 Heel contusion 62

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