817804

research-article2018
CRE0010.1177/0269215518817804Clinical RehabilitationLi et al.

CLINICAL
Original Article REHABILITATION

Clinical Rehabilitation

Effects of kinesiotape on pain 1­–11

© The Author(s) 2018
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DOI: 10.1177/0269215518817804
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chronic low back pain: a systematic journals.sagepub.com/home/cre

review and meta-analysis of

randomized controlled trials

Yuejie Li1, Ying Yin1, Gongwei Jia1, Hong Chen2, Lehua

Yu1 and Dandong Wu1

Abstract
Objective: To explore the effects of kinesiotape on pain and disability in individuals with chronic low
back pain.
Data sources: PubMed, Embase and the Cochrane Central Register of Controlled Trials were searched
for English language publications from inception to 13 February 2018.
Review methods: This study was registered in PROSPERO (CRD42018089831). Our key search terms
were ((kinesio taping) OR (kinesiotaping) OR (kinesiotape)) AND (low back pain). Randomized controlled
trials evaluating the effects of kinesiotape published in English language were included in this review. The
reference lists of retrieved studies and relevant reviews were also searched. Quality of the included trials
was assessed according to 2015 updated Cochrane Back and Neck Review Group 13-Item criteria.
Results: A total of 10 articles were included in this meta-analysis. A total of 627 participants were
involved, with 317 in the kinesiotape group and 310 in the control group. The effects of kinesiotape on
pain and disability were explored. While kinesiotape was not superior to placebo taping in pain reduction,
either alone (P = 0.07) or in conjunction with physical therapy (P = 0.08), it could significantly improve
disability when compared to the placebo taping (P < 0.05).
Conclusion: Since kinesiotape is convenient for application, it could be used for individuals with chronic
low back pain in some cases, especially when the patients could not get other physical therapy.

Keywords
Kinesiotape, chronic low back pain, pain, disability

Received: 10 June 2018; accepted: 16 November 2018

1Department of Rehabilitation, The Second Affiliated Hospital Corresponding author:

of Chongqing Medical University, Chongqing, China Dandong Wu, Department of Rehabilitation, The Second
2Department of Orthopedics, The First Affiliated Hospital of Affiliated Hospital of Chongqing Medical University, 76
Chongqing Medical University, Chongqing, China Linjiang Road, Yuzhong District, Chongqing 400010, China.
Email: [email protected]
2 Clinical Rehabilitation 00(0)

Introduction the reference lists of retrieved studies and relevant

reviews were also searched. Only published studies
In recent years, kinesiotape, which is a kind of an include all participants and with the latest outcomes
elastic tape, has been applied for treating a number were included.
of musculoskeletal conditions.1–3 In contrast to tra- The inclusion criteria for screening eligible
ditional athletic tape, kinesiotape allows the joint studies were as follows: (1) studies evaluating the
to move through its full range of motion. It has also effects of kinesiotape application on pain or disa-
been reported to increase blood circulation and bility in individuals with a diagnosis of chronic low
lymphatic drainage, which leads to a reduction of back pain and (2) control group including either
pain.4 Some other studies found that kinesiotape sham/placebo-taping or some other intervention.
deforms and stimulates large-fibre cutaneous The exclusion criteria were as follows: studies
mechanoreceptors that may inhibit proprioceptive were non-randomized controlled trials, non-peer
impulses in the spinal column and decrease pain reviewed publications, opinion articles and articles
via an ascending pathway.5,6 which were not written in English. Two researchers
Previous studies provided controversial and incon- performed the search process and screened the arti-
clusive results regarding the effects of kinesiotape in cles according to the criteria independently.
chronic low back pain patients. In his systematic Disagreements between reviewers at each stage
review, Nelson7 found very limited evidence to sug- were resolved by discussion to reach a consensus.
gest that kinesiotape was more effective than sham Original data from each study were extracted
taping or conventional physical therapy in improving using a standard data recording form which
pain and disability. Likewise, Vargas Batista et al.8 included first author, year of publication, clinic
stated that, in their systematic review, there was no condition, number of participants, participant char-
effectiveness of kinesiotape in low back pain. acteristics, intervention protocol, duration of inter-
However, since there are some new well-designed vention, outcome measures and final results.
and large-numbered randomized controlled trials Quality of the included trials was assessed accord-
being published, we believe that current result would ing to 2015 updated Cochrane Back and Neck
be different from previous ones. The aim of this study Review Group 13-Item criteria.9 In order to truly
was to critically examine and evaluate the evidence of depict the function of kinesiotape, either alone or
recent randomized controlled trials regarding the in combination, two sets of comparisons were per-
effectiveness of kinesiotape on chronic low back formed in this meta-analysis. On one hand, kinesi-
pain. The hypothesis was kinesiotape application otaping group was compared with sham/placebo
would be effective in pain reduction and disability taping group. On the other hand, kinesiotape in
improvement in patients with chronic low back pain. conjunction with traditional physical therapy or
exercise was compared with traditional physical
therapy or exercise (with or without sham/placebo
Methods
taping). If there were three-intervention arms in a
This study was registered in PROSPERO single study, only the kinesiotape and sham/pla-
(CRD42018089831). Two researchers (Y.L. and cebo taping data were extracted for meta-analysis.
G.J.) independently searched PubMed, Embase and The effects of taping on pain and disability were
the Cochrane Central Register of Controlled Trials explored. If pain was assessed under various condi-
for literature on the use of kinesiotape for low back tions (e.g. actual pain, average pain, the best pain
pain from inception to 13 February 2018. Our key and the worst pain), the worst pain was the first
search terms were ((kinesio taping) OR (kinesiotap- choice for the meta-analysis. Because in all
ing) OR (kinesiotape)) AND (low back pain). included studies, disability was evaluated with
Randomized controlled trials evaluating the effects Roland Morris Disability Questionnaire and/or the
of kinesiotape published in English language were Oswestry Disability Index; these two measure-
included in this review. After a preliminary search, ments were employed in our meta-analysis.
Li et al. 3

Data analysis in this study was performed Intervention

using RevMan5.2 (Cochrane Collaboration) and
Stata 15.0. The weighted mean differences with The kinesiotape techniques differed in different
95% confidence intervals for continuous out- studies. In addition, various pain locations such as
come were applied to estimate the pooled effects. erector spinae muscle, most painful point, paraver-
Heterogeneity was assessed with chi-square tebral region, lumbosacral junction or dimples
based Q test and I2. P < 0.1 or I2 > 0.5 was con- were focussed on by different investigators. This
sidered as significant heterogeneity. The fixed- was also true for traditional physical therapies and
effect model was used at first. When significant exercises.21,25–28 The intervention duration also dif-
heterogeneity was found, random-effect model fered among the included studies, from 24 hours to
was selected. The Egger’s linear regression test 12 weeks.
was used to assess the publication bias by using
Stata 15.0. Outcome measures
Four studies measured pain intensity using a
Results Visual Analogue Scale,20,23,24,27 while the others
A total of 85 articles were identified in the primary used a Numerical Rating Scale.19,21,22,25,26,28 Four
search. After removing irrelevant studies and studies used the Roland Morris Disability
duplicates, 19 articles that met our inclusion crite- Questionnaire.21,22,24,25 Five investigations used
ria were carefully identified. Articles which did not the Oswestry Disability Index,19,23,26–28 and one
use pain or disability as outcome measure10–12 or study used both.20
were not randomized controlled trials13–16 were
removed. Follow-up study17 (further study of
Parreira in 2014) or study with non-comparable
Effect on pain relief
baseline parameters were excluded.18 Finally, 10 Figures 2 and 3 demonstrated standardized mean
randomized controlled trials were included in this differences between treatment and control groups
meta-analysis19–28 (Figure 1). regarding the effects of kinesiotape on pain. Figure 2
revealed the treatment effect of kinesiotape alone. It
was suggested that there was a non-significant
Characteristics of included
standard mean difference on pain (P = 0.07), with
patients high heterogeneity (I2 = 82%). When exploring the
Characteristics of 10 included studies were shown effects of kinesiotape in conjunction with physical
in Table 1. A total of 627 participants were therapy, it also revealed a non-significant standard
involved, with 317 in the experimental group and mean difference on pain (P = 0.08), with high heter-
310 in the control group. Among these trials, five ogeneity (I2 = 83%; Figure 3).
randomized controlled trials compared kinesio-
tape to sham taping,20–24 another five randomized
controlled trials compared traditional physical
Effect on disability
therapy or exercise with kinesiotape to interven- Figures 4–6 demonstrated the effects of kinesiotape
tions without kinesiotape.19,25–28 Particularly, two on disability. It was suggested that kinesiotape alone
studies had three-intervention arms.22,26 Three tri- could significantly improve disability, with no heter-
als explored the effects of kinesiotape in individu- ogeneity. This was both true for Oswestry Disability
als with low back pain caused by lumbar disc Index (P < 0.00001, I2 = 0%) and Roland Morris
herniation.19,24,26 The characteristics of the Disability Questionnaire (P = 0.01, I2 = 0%).
included studies were summarized in Table 1. Nevertheless, when physical therapy was added, the
Supplemental Table 1 provided details about study effect of kinesiotape was becoming non-significant
design and methodological quality. (P = 0.05), with a high heterogeneity (I2 = 82%).
4 Clinical Rehabilitation 00(0)

Figure 1.  Flow diagram of the evaluation process for the inclusion or exclusion of studies.

Publication bias low back pain patients when compared with sham/
placebo control. This is in contrary to our initial
Egger’s linear regression test showed no evidence hypothesis. Interestingly, however, those same
of publication bias for the included studies on each patients experience significantly less disability
parameter (Table 2). after kinesiotape application. Meanwhile, our
results suggest that physical therapy/exercise is
efficient in pain reduction, and disability improve-
Discussion ment for chronic low back pain individuals, the
Based on this meta-analysis, kinesiotape could not addition of kinesiotape does not lead to extra effect
provide significantly more pain relief to chronic on these outcomes.
 Li et al.

Table 1.  Characteristics of studies using kinesiology to treat chronic low back pain.

Article/country/ Clinic condition Participant characteristics Intervention and duration Outcome Result
number measures
Castro-Sánchez Non-specific low back pain Kinesiotape group Kinesiotape was applied Pain (VAS); The kinesiotape
et al.20/Spain for at least three months. (n = 30): 21 females; mean over the point of maximum Disability (ODI, group had greater
(n = 59) VAS: kinesiotape group: age = 50 ± 15 years; pain in the lumbar area for RMDQ); one week, improvement in ODI
5.6 ± 1.8; Placebo group (n = 29): one week follow-up and RMDQ, and a
Placebo group: 5.4 ± 1.3 19 females; mean four weeks greater decrease in
age = 47 ± 13 years pain
Parreira et al.21/ Chronic low back pain for at Kinesiotape group (n = 74): 56 Kinesiotape was applied Pain (NRS); Kinesiotape did not
Brazil (n = 148) least three months. females; mean age = 51 ± 15 over each erector spinae Disability (RMDQ); have a significant
NRS: kinesiotape group:7 ± 2; years; muscle with 10%–15% of four week, follow- effect on pain or
Placebo group 6.8 ± 2 Placebo group (n = 74): tension in the stretched up 12 week disability
59 females; mean position twice per week
age = 50 ± 15 years for four weeks
Luz et al.22/ Chronic non-specific low Kinesiotape group Kinesiotape was applied Pain (NRS); There was a
Brazil (n = 60) back pain (back pain of (n = 20): 11 females; mean over the erector spinae Disability (RMDQ); significant difference
mechanical origin, apparently age = 44.3 ± 15 years; muscle with 10%–15% of 48 h, follow-up in disability between
without a defined cause, for Placebo group (n = 20): tension in the stretched one week kinesiotape group
at least 12 weeks duration). 13 females; mean position for 48 hours versus the control
NRS: kinesiotape group: age = 50.1 ± 17.5 years; group, but no
6.6 ± 1.2; control group (n = 20): difference when
Placebo group: 6.7 ± 1.6; 17 females; mean compared to the
Control group: 6.1 ± 2.1 age = 48.1 ± 13.4 years placebo group
Al-Shareef Non-specific low back pain Kinesiotape group Kinesiotape was applied Pain (VAS); The kinesiotape
et al.23/Saudi for at least three months. (n = 20): 9 females; mean over the skin in the Disability (Arabic group had greater
Arabia (n = 40) VAS: kinesiotape group: age = 37.55 ± 9.82 years; paravertebral region up ODI); two week, decrease in pain
5.9 ± 1.2; placebo group (n = 20): to the T12 vertebra at follow-up and disability after
Placebo group: 6.45 ± 0.76 11 females; mean 10%–15% stretch twice per four week intervention
age = 35.55 ± 8.04 years week for two weeks (total
of four sessions)
(Continued)
5
 6

Table 1. (Continued)

Article/country/ Clinic condition Participant characteristics Intervention and duration Outcome Result
number measures
Grześkowiak Lumbar or lumbosacral pain Kinesiotape group Kinesiotape was applied Pain (VAS); Kinesiotape and
et al.24/Poland for at least three months (n = 19): 15 females; mean over the lumbosacral Disabiltiy (RMDQ); placebo tape
(n = 38) (with or without referring age = 36.4 ± 10.5 years; junction with 15%–25% one week, no comparably
to leg), confirmed in MRI Placebo group (n = 19): of tapes stringing for follow-up decreased disability
unilateral or central disc 13 females; mean one week level, average pain
herniation at L4/L5 and/or L5/ age = 36.5 ± 8.9 years and the worst pain.
S1 vertebra levels. Kinesiotape was not
NRS: kinesiotape group: superior to placebo
8.5 ± 1.1; in reducing pain and
Placebo group: 7.9 ± 1.8 disability in patients
with LDH
Added et al.25/ Chronic non-specific low PT + kinesiotape group 30–60 minutes, twice a Pain (NRS); Patients who
Brazil (n = 148) back pain for at least (n = 74): 53 females; mean week of manual therapy, Disability (RMDQ); received a physical
three months. age = 44.6 (11.7) years; general exercise, specific five week, follow- therapy programme
NRS: PT + kinesiotape PT group (n = 74): 53 females;
spinal stabilization up three and consisting of exercise
group:7.5 ± 1.72; mean age = 45.6 (11.6) yearsexercises plus kinesiotape. six months and manual therapy
PT group:7.4 ± 1.69 Kinesiotape was applied did not get additional
on the paravertebral benefit from the use
muscles with 10%–15% of kinesiotape
tension twice per week for
five weeks
Köroğlu et al.26/ Mechanical low back pain PT + kinesiotape group Therapeutic ultrasound, a Pain (NRS); A statistically
Turkey (n = 60) caused by a herniated disc (n = 20): 12 females; mean hot pack, transcutaneous Disability (ODI); significant
and mechanical low back pain age = 47.2 ± 14.7 years; electrical nerve stimulation two week; no improvement
for at least three months. PT + placebo group was applied five times follow-up demonstrating the
NRS: PT + kinesiotape group: (n = 20): 12 females; mean a week for two weeks. superiority of the
8.0 ± 2.2; PT + placebo group: age = 50.3 ± 11.5 years; PT Therapeutic exercises was kinesiotape in pain
6.5 ± 3.0; group (n = 20):8 females; mean applied the second week. and disability
PT group: 6.4 ± 2.4 age = 47.9 ± 15.2 years Kinesiotape was applied
over the dimples of the
back for two weeks
Clinical Rehabilitation 00(0)
 Li et al.

Table 1. (Continued)

Article/country/ Clinic condition Participant characteristics Intervention and duration Outcome Result
number measures
Bae et al.27/ Low back pain for more than PT + kinesiotape group A hot pack, ultrasound and Pain (VAS), After the application
Republic of 12 weeks. (n = 10): 5 females; mean transcutaneous electrical Disability (ODI); of kinesiotape,
Korea (n = 20) VAS: PT + kinesiotape group: age = 53.6 ± 2.1 years; nerve stimulation was 12 week; no VAS and ODI
7.83 ± 0.38; PT + placebo PT + placebo group applied three times a week follow-up scores significantly
group: 7.71 ± 0.61 (n = 10): 6 females; mean for 12 weeks. The tape decreased
age = 51.3 ± 3.7 years was applied on the lumber
area with the maximum
pain three times a week for
12 weeks
Kamali et al.28/ Chronic low back pain for PT + kinesiotape group Lumbar rotational Pain (NRS), Adding kinesiotape
Iran (n = 42) at least three consecutive (n = 21): 11 females; mean manipulation was applied. Disability (ODI) to SM did not appear
months. age = 27.14 ± 6.04 years; Kinesiotape was applied immediately, to have a significant
NRS: PT + kinesiotape group: PT group (n = 21): 10 females; with 25% stretch on the one day, follow-up extra effect on pain
5.17 ± 1.02; mean age = 25.14 ± 3.66 years most painful point of the one week and one and disability
PT group: 4.95 ± 0.88 lumbar region for 24 h month
Keles et al.19/ Chronic low back pain for PT + kinesiotape group Exercise was performed Pain (NRS), Compared with
Turkey (n = 52) at least three months due (n = 29): 19 females; mean once a day. Kinesiotape Disability (ODI), placebo taping, no
to lumbar disc herniation. age = 39.1 ± 6.9 years; was applied to the point baseline, one week, significant differences
NRS: PT + kinesiotape group: PT + placebo group that is most painful once a two week, regarding pain,
6.17 ± 1.85; (n = 23): 15 females; mean week for three months three week, disability and lumbar
PT group: 6.33 ± 2.22 age = 35.7 ± 6.5 years six week, 12 week flexion were detected
between groups

VAS: Visual Analogue Scale; NRS: Numerical rating scale; ODI: Oswestry Disability Index; RMDQ: Roland Morris Disability Questionnaire; PT: physical therapy; MRI: mag-
netic resonance imaging; SM: spinal manipulation: LDH: lactate dehydrogenase.
7
8 Clinical Rehabilitation 00(0)

Figure 2.  Forest plot: effects on pain.

Figure 3.  Forest plot: effects of combined kinesiotape/physical therapy on pain.

Figure 4.  Forest plot: effects on disability (Oswestry Disability Index).

Figure 5.  Forest plot: effects of combined kinesiotape/physical therapy on disability (Oswestry Disability Index).
Li et al. 9

Figure 6.  Forest plot: effects on disability (the Roland Morris Disability Questionnaire).

Table 2.  The results of Egger’s linear regression test. confirmed that kinesiotape could counter quadri-
ceps femoris weakness due to attenuated la afferent
Parameters t value P-value
activity. Other studies have reported that kinesio-
VAS 2.13 0.066 tape is effective in increasing muscular strength.34,35
ODI 0.42 0.696 Thus, kinesiotape could be useful for increasing
RMDQ 0.44 0.693 muscle strength in individuals with low back pain,
which leads to the function improvement.
VAS: Visual Analogue Scale; ODI: Oswestry Disability Index;
RMDQ: Roland Morris Disability Questionnair. Meanwhile, combined kinesiotape/physical therapy
does not seem to be more effective for disability
than physical therapy alone. Previous study found
Various mechanisms have been suggested for the that manipulation for patients with chronic neck
pain relief effect of kinesiotape. According to Kase pain was helpful for the improvement of proprio-
et al.,29 kinesiotape accelerates the blood circulation ception,36 which could probably increase muscle
and stimulates the neurological system, thus leading strength and improve disability.37 Therefore, it is
to reduced pain and improved function. However, possible that addition of kinesiotape could only pro-
some other researchers have questioned the therapeu- duce limited extra effects through tactile stimula-
tic effect of elastic tape application, indicating that tion and proprioception improvement.
wrinkling the skin does not increase local blood Some limitations of this meta-analysis should
flow.30,31 Nevertheless, it is still somewhat surprising be addressed. First of all, due to the paucity of eli-
that our meta-analysis reveals the kinesiotape is not gible randomized controlled trials, the quality of
superior to placebo taping regarding pain reduction. some included studies is low, thus one should use
One possible explanation is the use of non-elastic tape caution when interpreting the results. Second, the
as placebo in some of the included studies.20,21,23 intervention protocols varied a lot among the
Since non-elastic tape could also help to realign sur- included studies, making the comparison impossi-
rounding structures and modulate muscle activities, it ble or inaccurate.
is possible that placebo taping already provides
enough neurological stimuli and pain relief.32 As a Clinical Messages
result, the finding of our meta-analysis could be
biased by the improper selection of placebo taping •• Although no significant difference in
and future researchers should be aware of this. pain relief has been found between kine-
Based on our results, it seems that the disability- siotape and placebo taping, individuals
improving effects of kinesiotape may not be attrib- with chronic low back pain experienced
utable to pain relief. The application of elastic tape statistically significant improvements in
has been postulated to enhance proprioception by disability through the sole application of
stimulating cutaneous mechanoreceptors. Konishi33 kinesiotape.
10 Clinical Rehabilitation 00(0)

Acknowledgements 8. Vargas Batista C, Ruaro JA, Boeing Ruaro M, et al.

Kinesio taping on low back pain: systematic review.
Y.L. initiated the study, searched the literature and Conscient Saúd 2014; 13: 147–152.
screened the article. Y.Y. and H.C. performed the data 9. Furlan AD, Malmivaara A, Chou R, et al. 2015 updated
analysis. G.J. searched the literature and screened the method guideline for systematic reviews in the Cochrane
article. D.W. designed the study and wrote the paper. Back and Neck Group. Spine 2015; 40: 1660–1673.
L.Y. monitored the progress. 10. Velasco-Roldan O, Riquelme I, Ferragut-Garcias A, et al.
Immediate and short-term effects of kinesio taping tight-
ness in mechanical low back pain: a randomized con-
Declaration of Conflicting Interests
trolled trial. PM R 2018; 10(1): 28–35.
The author(s) declared no potential conflicts of interest 11. Hagen L, Hebert JJ, Dekanich J, et al. The effect of elas-
with respect to the research, authorship and/or publica- tic therapeutic taping on back extensor muscle endurance
tion of this article. in patients with low back pain: a randomized, controlled,
crossover trial. J Orthop Sports Phys Ther 2015; 45(3):
215–219.
Funding 12. Fong SS, Tam YT, Macfarlane DJ, et al. Core muscle
The author(s) received no financial support for the activity during TRX suspension exercises with and with-
research, authorship and/or publication of this article. out kinesiology taping in adults with chronic low back
pain: implications for rehabilitation. Evid-Based Compl
Alt 2015; 2015: 910168.
Supplemental material 13. Abbasi S, Rojhani-Shirazi Z, Shokri E, et al. The effect
Supplemental material for this article is available online. of kinesio taping on postural control in subjects with non-
specific chronic low back pain. J Bodyw Mov Ther 2018;
22: 487–492.
ORCID iD 14. Chang NJ, Chou W, Hsiao PC, et al. Acute effects of
Dandong Wu https://orcid.org/0000-0001-8128-0611 kinesio taping on pain, disability and back extensor
muscle endurance in patients with low back pain caused
by magnetic resonance imaging-confirmed lumbar disc
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