1 - Introduction

Musculoskeletal conditions include over 150 diagnoses that affect the musculoskeletal system - that is, muscles, bones, joints, and associated tissues such as tendons and ligaments.

Numerous treatments are available for musculoskeletal disorders, the goals of which are to relieve pain, delay complications, and prevent the progression of the pathology (Ernstzen et al. 2017).

In this context, therapeutic elastic taping, also known as Kinesio taping® or KT, has emerged as an interesting and relatively new method for treating musculoskeletal disorders (Kamper et al. 2013). This method, developed in the late 1970s, involves applying elastic tape to the patient's skin under tension, thus placing the target muscle in a stretched position.

According to Dr. Kenzo Kase, creator of the KT method (Kase et al. 2013), the mechanism can be inhibitory or excitatory, depending on the direction in which the tape is applied.

Some authors have suggested an improvement in proprioception through increased stimulation of cutaneous mechanoreceptors as another mechanism of action of KT (Halseth et al. 2004). Various therapeutic benefits have been proposed for KT, including facilitating motor skills, increasing muscle strength, reducing muscle fatigue, inhibiting pain, improving healing, such as reducing lymphedema associated with breast cancer, and improving lymphatic drainage and blood flow, among others (Morris et al. 2013).

Despite its popularity, especially among athletes, and its increasing use in clinical practice, the effectiveness of KT remains uncertain due to insufficient and inconsistent evidence (Vanti et al. 2015).

2 - What indications?

We looked at systematic reviews, meta-analyses, and high-quality studies in order to get a clearer idea of the value of this KT in our patients.

The upper limb

The shoulder

First, what does the literature tell us about the effect of k-tape in shoulder pathologies?

It has been reported that patting the shoulder may contribute to increasing acromiohumeral distance (ADH), especially in individuals with symptoms, where this distance is often reduced. Studies, such as the one conducted by Harput et al. (2017), have shown that applying Kinesio-tape to the scapula can increase acromiohumeral distance, but also increase strength and improve the mobility of the internal and external rotators of the shoulder. This research suggests that scapular taping may be beneficial in the treatment of subacromial impingement syndrome (SIS) (Harput et al. 2017).

Adding taping to a therapeutic exercise program has been shown to be more effective than the exercise program alone in treating subacromial impingement syndrome (Simsek et al. 2013; Letafatkar et al. 2021).

In 2021, Letafatkar and his team conducted a three-arm randomized controlled trial to investigate whether adding KT to therapeutic exercise is an effective treatment for improving clinical outcomes compared to therapeutic exercise alone and no intervention, in patients suffering from subacromial impingement syndrome.

The authors showed that although therapeutic exercises alone had a positive effect on clinical outcomes, adding KT to therapeutic exercises had more significant effects with larger effect sizes. The authors suggest that adding a KT to therapeutic exercises may help clinicians improve clinical outcomes in patients with subacromial impingement syndrome (Letafatkar et al. 2021).

However, the benefits of taping are not universal, as other studies have reported that Kinesio taping does not improve shoulder symptoms, especially in younger patients (Keenan et al. 2017; Thelen et al. 2017; Thelen et al. 2008).

In 2021, the team of de Oliveira et al. carried out a randomized controlled trial to assess the medium and long-term effects of KT, added to a 6-week rehabilitation program, on the symptoms and functional limitations of people with rotator cuff shoulder pain (RCRSP).
The authors found that although symptoms, functional limitations, ROM, and acromiohumeral distance improved in both groups (KT and non-KT), no differences between the groups in the medium and long term were observed. Therefore, the authors suggest that KT did not provide additional effects to a 6-week rehabilitation program for people with RCRSP in order to improve symptoms and functional limitations (de Oliveira et al. 2021).

Regarding the KT technique used in this study. A 5 cm anchor was placed with 0% tension at each end of all bands. First band (1: Y-shape for hypothetical inhibition and muscle relaxation, mild tension [15%-25%], surrounding the 3 portions of the deltoid muscles as a group, from insertion to origin), second band (2: I-shape for functional shoulder correction, recommended for functional shoulder correction, recommended for multi-axial shoulder instability, recommended for multi-axial shoulder instability, severe tension [50%-75%], 7 to 10 cm above the acrojoint) mioclavicular 7 to 10 cm below the tuberosity of the deltoid, passing through the supraspinatus, the trapezius, the glenohumeral joint and the middle deltoid muscle), and third band (3: I-shaped, for mechanical correction of the glenohumeral joint, severe tension [50%-75%], placed with inward pressure, from the coracoid process to the posterior deltoid, just a little below the coracoacromial arch).

Also in the shoulder, authors have focused on the contribution of K-tape in improving shoulder proprioception.

In their 2023 systematic review, Ager et al. attempted to synthesize evidence on the effects of KT on proprioception in healthy and pathological shoulders. The authors concluded that there was very low to low certainty evidence that elastic KT improves active and passive shoulder proprioception. The body of evidence is currently so weak that any recommendation on the effectiveness of elastic KT on shoulder proprioception remains speculative (Ager et al. 2023).

Let's now focus on the muscular activation and inhibition associated with the application of K-tape on the shoulder.

Dhein et al. 2020 reported that the application of Kinesio taping resulted in a reduction in EMG activity in the inferior trapezius (LT) muscle in patients diagnosed with subacromial impingement syndrome (SIS), suggesting that caution was needed when using this type of taping in this group of patients, as it may have adverse effects on scapular kinematics and increase symptoms (Dhein and al. 2020).

Reynard et al. 2018 conducted a study to assess the effects of Kinesio taping compared to fictional taping (ST) and no taping six and twelve weeks after rotator cuff surgery. Their results showed that the Kinesio Tape reduced upper trapezius (UT) recruitment, but did not impact deltoid or infraspinatus activity. They also observed that Kinesio taping and ST increased the flexural range of motion at six weeks, although the differences from no taping were not clinically significant. In summary, while shoulder taping has the potential to reduce UT muscle hyperactivity, it has not shown other significant clinical benefits in people who have had rotator cuff surgery (Reynard et al. 2018).

So what about the pain?

Lim et al. 2015 concluded that current evidence did not support the superiority of Kinesio taping over other therapeutic approaches to reduce pain and disability in people with chronic musculoskeletal pain (Lim et al. 2015).

Ghozy et al. 2020 confirmed that Kinesio taping alone was not effective in reducing pain and disability in individuals with shoulder pain compared to placebo, but it was effective when combined with exercise (Ghozy et al. 2020). This study reinforces those of Simsek et al. 2013 and Letafatkar et al. 2021.

In 2021, Gianola and his team conducted a systematic review to determine the pros and cons of KT in adults with rotator cuff pathology.

Based on very low-certainty evidence, their systematic review suggests that KT for rotator cuff disease has uncertain effects in terms of self-reported pain, function, pain upon movement, and active range of motion compared to a sham band or other conservative treatment.

Weak evidence shows that KT may improve quality of life compared to conservative treatment (Gianola et al. 2021).

Even more recently, in 2022, a double-blind randomized controlled trial consisting of 50 subjects suffering from cuff tendinopathy, with 25 subjects assigned to the KT group (to receive a therapeutic application of KT) and 25 subjects to the placebo group (to receive a dummy application of KT). Taping was applied to all participants every 4 days, which equated to a total of three applications during the study period. Participant evaluations were conducted at the start of the study, at the end of the registration period (day 12), as well as one month after registration (day 30). In conclusion, the authors found that the standardized therapeutic KT used for shoulder pain was not superior to a simulated application of KT to improve pain and disability in patients undergoing an RCT (Taik et al. 2022).

In summary, K-tape is really not a reliable ally for treating shoulder pathologies. Eventually, it could be associated with our exercise therapy, especially for patients who are afraid to perform certain movements. It is difficult to identify the part of the placebo in this intervention but it is important not to overlook placebo treatment, which can help some patients feel more comfortable and stronger, especially when external and proprioceptive stimulation is integrated. It should be noted that this intervention may be transitory, offering the patient the opportunity to perform painful exercises and movements with less apprehension.

The elbow

Tennis elbow

Several studies have evaluated the value of kinesiotape in the treatment of lateral epicondylalgia (EL), whether as an intervention alone or in combination with other therapies.

In 2016, Wegener et al. compared the results of performing eccentric exercises alone, with a Ktape application, or with a fictional Ktape application for 12 weeks. Each group also received education on activity modification.
The authors concluded that all groups improved the main results, with no statistically significant differences between groups.
It is therefore possible that exercise alone and/or natural recovery are responsible for the improvements.
However, it should be noted that the use of Ktape was well tolerated by the participants and was not associated with significant side effects or an exacerbation of symptoms (Wegener et al. 2016).

In a 2018 study, the installation of Ktape or fictional Ktape was given three times for one week and the results were evaluated before and after treatment.
The authors concluded that applying Ktape produced a significantly greater improvement compared to a placebo only in pain intensity and upper limb disability in subjects suffering from EL and forearm muscle trigger point (Sakeri et al. 2018).

In the same year, Eraslan and his collaborators conducted a study to compare the short-term effects of kinesiotape compared to shock waves, with physiotherapy, on pain, functionality and grip strength in patients suffering from EL.
Patients in all groups received physiotherapy 5 days a week for 3 weeks (cold pack + TENS) as well as a home exercise program with eccentric reinforcement, stretching, and also education on activity modification.
The first group (n=15) only did physiotherapy, the second group (n=15) also had kinesiotape 5 days a week for 3 weeks and finally the third group had one shockwave session per week for 3 weeks (2000 shocks, low energy, 0.06-0.12 MJ/mm2).
The authors conclude that all three interventions decreased pain associated with lateral epicondylalgia and improved patients' functional scores. In the short term, kinesiotaping combined with physiotherapy gave better results in reducing pain during activity (Eraslan et al. 2018).

In 2019, Giray and colleagues compared the effectiveness of kinesiotaping, sham taping, or exercises alone in treating tennis elbow.

The patients were randomly divided into three groups: kinesiotape plus exercises (n=10), sham taping plus exercises (n=10), and control group (exercises alone) (n=10). All groups received a home exercise program that included strengthening and stretching exercises. In the kinesiotape and sham taping groups, tapings were made and changed every 3-4 days for two weeks.

The authors found that the kinesiotape, in addition to exercises, is more effective than sham taping and exercises alone in improving pain in daily activities and arm disability due to tennis elbow (Giray et al. 2019).

A 2019 single-blind RCT also suggested that KT alone is as effective as injecting steroids alone in treating lateral epicondylalgia for pain, grip strength, painful pressure threshold, pain pressure threshold, functional status, and short-term patient satisfaction. However, the joint administration of steroid injection and KT would be more effective than each treatment alone (Koçak et al. 2019).
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Along the same lines, in a 2021 RCT involving 53 elbows with lateral epicondylagia, Erpala and his team compared the short-term effectiveness of injecting corticosteroids and applying KTape.
They prospectively compared the results of the KT, applied 3 times in a row for 5 days, without removing the band between montages, to those obtained with the injection of corticosteroids (CSI) or those obtained in a group using rest or even paracetamol and NSAIDs if necessary (RMG).
Functional scores (PREE-T, QDASH, Nirschl), pain, and grip strength improved statistically significantly in all groups at the end of the second week.
At the end of the fourth week, the CSI and KT groups were superior to the RMG group, but the CSI group had no advantage over the KT group in any parameter. The authors also indicate that during the fourth week, the effectiveness in the CSI and RMG groups decreased, while the effect persisted in the KT group.

KT would therefore be an alternative treatment option as effective as ICS due to the long-term uncertainties of ICS in the treatment of EL (Erpala et al, 2021).

The results here are quite ambiguous and it is difficult to reach any definite conclusions. Based on our various analyses, we are of the opinion that the application of KT should be evaluated on a case-by-case basis, taking into consideration the clinical evaluation specific to each situation. It would seem, based on these results, that the application of kinesiotape, while it does not necessarily seem to provide an additional effect to another intervention, could serve as a complementary treatment, without risk for the patient. Possibly superior effects may even emerge from combining conventional treatments with KT according to some articles (Aldakhiel, 2023).

The wrist

De Quervain tendinopathy

Regarding De Quervain tendinopathies, there is not enough evidence to recommend the use of therapeutic k-taping in the treatment of these patients (Drapeza Jr et al. 2022).

In their systematic review and meta-analysis, Drapeza et al. (2022) indicated that therapeutic taping was no better than other treatment modalities in alleviating the clinical signs and symptoms of De Quervain tendinopathy (p > 0.05). Therapeutic taping did not affect wrist pain, grip strength, clamp strength, and function in participants with De Quervain tendinopathy (p > 0.05) (Drapeza Jr et al. 2022) (Drapeza Jr et al. 2022).

Carpal Tunnel Syndrome

Now let's discuss the effectiveness of the kinesiotape in treating carpal tunnel syndrome (CCS).

In their study in 2016, Geler et al. compared the effect of the kinesiotape compared to a placebo or an orthosis on pain level, grip strength, and functional status in 65 wrists with SCC. The KT was applied 5 days per week for 4 weeks.
The authors conclude that KT is as useful as placebo and the application of an orthosis in relieving pain and decreasing the severity of symptoms. The KT was nevertheless superior to the orthosis in terms of improving functional status but inferior in improving grip strength. KT could therefore be used as an alternative treatment method for SCC without the disadvantage of restricting the daily activities that orthotics present (Geler et al. 2016).

In their 2018 study, Aktürk et al. also compared the benefit of KT versus splints in a sample of 58 hands with mild or moderate SCC.
The intervention group (n = 28) had KTape twice a week for 5 weeks, for a total of 10 poses. The KT was removed after 48 hours and applied again after 24 hours of rest. The control group (n=30) had to wear a splint at night and as much as possible during the day for 35 days. Both groups also had an exercise protocol to do at home every day for 35 days.
The results of this study show significant improvements in symptoms, function, clinical examination, and nerve conduction when using the kinesiotape compared to using a splint. According to the authors, since the kinesiotape does not interfere with the patient's daily work, unlike a splint, and does not have any side effects, it could be preferred to a splint in cases of mild to moderate SCC (Aktürk et al. 2018).

In 2018, Güner and his collaborators compared the effect of low-power laser therapy (n=21), a combination of KTape and low-power laser (n=22), and a placebo (n=21) on pain, muscle strength, muscle strength, functionality, and electrophysiological parameters of patients with SCC.
The addition of kinesiotaping to the low-power laser does not seem to provide any additional benefits to low-power laser treatment alone, in the short term. It would appear that in the long term, a significant increase in finger grip and pinch strength occurs in the KTape + low-power laser group (Güner et al. 2018).

In the same year, a study analyzed the contribution of kinesiotaping in addition to tendon and nerve sliding exercises in the treatment of carpal tunnel syndrome. The control group (n = 19) had tendon and nerve sliding exercises three times a day, with 15 repetitions per exercise, for 6 weeks while the intervention group (n = 19) also had a Ktape application, with three poses at intervals of 5 days. The authors concluded that kinesiotaping, in addition to an exercise program, made a positive, but limited, contribution in the short-term treatment of mild or moderate SCC (Yildirim et al. 2018).

Once again, it is difficult to reach definitive conclusions, given the diversity of kinesiotaping techniques. Based on our various analyses, we are of the opinion that the application of KT should be evaluated on a case-by-case basis, taking into consideration the clinical evaluation specific to each situation. The absence of a control group without intervention in most of these studies makes it difficult to know the importance of the placebo effect or the simple natural rest on the results. Despite this, some studies still indicate significant benefits of this technique, especially when combined with other methods such as exercises.

The spine

The neck muscles

Before starting this part, let's take a quick look at the paper by Cupler et al. 2020 who summarized and mapped the evidence for taping methods used for various joints and conditions in the musculoskeletal system. These authors indicated with a strong level of evidence that the application of KT for non-specific neck pain was discouraged (Cupler et al. 2020).

Cupler et al. used numerous studies to arrive at this suggestion. When we look more closely at these studies, some still show a certain interest in Ktape in the management of neck pain. However, the methodological weakness of these studies does not make it possible to extrapolate and draw satisfactory conclusions. In contrast, in 2022, Ceylan et al. indicated in their study that the combination of kinesio taping and exercise therapy was found to be effective in reducing non-specific neck pain and neck disability (Ceylan et al. 2022).

In 2017, Shih et al compared Kinesio taping to therapeutic exercise for head-forward posture on static posture, dynamic mobility, and functional outcomes.

Sixty subjects (31 women, 29 men) with head-forward postures participated in this study. They were randomly assigned to one of the following three groups: (1) exercise group (n = 20), (2) taping group (n = 20), and (3) control group (n = 20). The various parameters evaluated were measured before and after a 5-week intervention and a 2-week follow-up.

In summary, the authors found that Kinesio taping and therapeutic exercise both improved forward head posture after the procedure and a 2-week follow-up. The effectiveness of therapeutic exercise is greater than that of taping (Shih et al. 2017).
These findings differ from those of El-Abd et al in 2017 who found that KT was even better than postural exercises in reducing disability due to neck pain. In contrast, both interventions had similar effects in reducing axioscapular muscle fatigue (El-Abd et al. 2017).

In 2020, Areeudomwong and his team found that when healthy young adults texted via smartphone, the KT app on the shoulder reduced neck and shoulder discomfort and delayed the reduction in the activation and fatigue of neck and upper trunk muscles.In the same year, Alahmari and colleagues compared the effects of the Kinesio™ tape compared to a placebo on proprioception in college athletes suffering from mechanical neck pain (Alahmari et al. 2020).
Applying the KT after 3 and 7 days effectively decreased joint position errors and the intensity of neck pain in participants with mechanical neck pain compared to placebo, while there was no difference between the two groups in terms of the neck disability index (NDI) (Alahmari et al. 2020).

In 2021, Celenay and his team sought to compare the effects of KT and classical massage in addition to cervical stabilization exercise in patients with chronic neck pain.
The authors found that KT + cervical stabilization exercises were superior to classical massage + cervical stabilization exercises in terms of improving disability and quality of life, while classical massage + cervical stabilization exercises were superior to KT + cervical stabilization exercises in terms of increasing rotational movements (Celenay et al. 2021).

In 2022, Özden et al. conducted a systematic review on the effect of KT on patients with neck pain. The authors concluded that KT applications may provide additional benefits in terms of pain, ROM, and short-term function. They add that it has been inferred that KT applications could contribute to proprioception, psychosocial status, and quality of life in the medium term (Özden et al. 2022).
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In 2023, Xiong et al. conducted a study to investigate the effectiveness of KT combined with multi-angle isometric resistance training for cervical spondylosis (Xiong et al. 2023). The authors indicated that KT combined with multi-angle isometric resistance training may further alleviate clinical symptoms and correct abnormal neck posture. But its effects on the range of cervical movements remain uncertain.
Once again, it remains complex to reach definitive conclusions, given the diversity of Kinesiotape (KT) techniques. In light of our various analyses, our conclusion is intended to be more nuanced compared to that of Cupler et al. 2020. We are of the opinion that the application of KT should be evaluated on a case-by-case basis, taking into consideration the clinical evaluation specific to each situation. However, some studies indicate significant benefits of this technique, especially when combined with other methods. Further studies should make it possible to assess the effect of kinesio taping on various parameters such as kinesiophobia, pain catastrophization and fear avoidance.

Low back pain

Acute low back pain

In 2016, Kelle and her team evaluated the effects of ktape on non-specific acute low back pain.

The intervention group received information and comfort, as well as KT, while the control group received only information and comfort. All participants were allowed to use paracetamol doses according to their needs. The Kinesio tape was applied to the most painful area in the lower back for a total of 12 days.

The authors found that Kinesio taping provided significant improvements in pain and disability; thus, it can be used as a complementary method in non-specific acute low back pain (Kelle et al. 2016).

Chronic non-specific low back pain‍

In 2016, Added et al performed a randomized controlled trial to compare the effectiveness of adding KT to a physical therapy program consisting of exercise and manual therapy in patients with chronic non-specific low back pain, compared to patients who only received physical therapy without KT.

After five weeks of treatment, comparisons between groups showed no benefit from using KT in these patients.

Therefore, the literature suggests that using KT in isolation provides no benefit to patients with chronic low back pain (Luz et al. 2015; Parreira et al. 2014). Likewise, its use as an additional method in treatment based on exercise and manual therapy does not change the results (Added M et al. 2016).

Based on the results of the systematic review by Nelson et al. (2016), the effect of KT on the parameters evaluated is small and may be more beneficial as an adjunct therapy for people with chronic low back pain.

The meta-analysis by Ramírez-Vélez et al. 2019 shows that KT does not produce superior effects on pain and disability scores or on the amplitude of trunk flexure, compared to a fictional intervention. Paradoxically, when the two groups were analyzed independently, the KT group and the fictional intervention group (pre-post analysis) showed a significant improvement in several parameters in patients with low back pain. Therefore, it seems that no matter how these bands are placed, there is no difference in terms of the effect on performance or improvement in the condition of the low back pain patient (Ramírez-Vélez et al. 2019).

The meta-analysis by Sheng et al. (2019) demonstrated that KT, alone or in combination with other general therapies, provided greater pain relief and improved ADLs than general physical therapies without KT in patients with common low back pain (Sheng et al. 2019).

In 2021, Mitova and her team evaluated the effect of the Ktape methodology on chronic pain syndrome in the lumbosacral region.

42 participants with chronic low back pain were recruited and randomly divided into two groups - control (n=19) and experimental (n=23). Participants received a specialized physical therapy program combined with a kinesiotape every day for 15 days, for 40 minutes per procedure. They all received a home physiotherapy program.

The authors found that ktape significantly reduced pain and muscle spasms after application and improved lumbar spine function (Mitova et al. 2021).

In 2022, Llamas-Ramos et al. evaluated the effectiveness of KT on low back pain.
It was a randomized, controlled, double-blind clinical trial. Twenty-eight caregivers and cleaners received a manual therapy program and a KT bandage or a fictional KT (FKT). They received two sessions per week for three weeks and a follow-up one month after the last session. Pain, range of motion, and function were measured at baseline, at the end of each session, and one month after the last session.

The authors reported that KT was an effective adjunct to this treatment. Although both treatments provided improvements, the authors recommend KT (Llamas-Ramos et al. 2022).

In 2023, Pan and his team conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the effectiveness of KT for patients with chronic non-specific low back pain (Pan et al. 2023). The authors indicated that KT may have immediate and short-term positive effects in reducing pain intensity, but existing data do not confirm the superiority of KT over other interventions for improving the functions of people with common low back pain (Pan et al. 2023).

In conclusion, we are not adding much to the conclusion of Pan and colleagues (2023). It may be interesting to use KT in chronic low back pain patients, if only in order to gradually desensitize the patient in order to bring about movement.

Low back pain in pregnant women

The aim of the study by Kaplan et al. in 2016 was to examine the short-term effects of lumbar Kinesio taping on pain intensity and disability in women with pregnancy-related low back pain.

Compared to paracetamol therapy alone, the combination of Kinesio taping and paracetamol therapy seems to be more effective in reducing pain and improving functional capacity in the treatment of pregnancy-related low back pain. The authors therefore conclude that Kinesio taping can be used as a complementary treatment method to effectively control pregnancy-related low back pain (Kaplan et al. 2016).

Mohamed and his team highlighted the interest of Ktape on back pain in post-natal women. The authors suggested that kinesiotape and postural correction exercises may be recommended as effective treatment methods for postnatal back pain in women. The effect of kinesiotape and postural correction exercises is greater than that of exercise alone (Mohamed et al. 2018).

The lower limb

The knee

Knee osteoarthritis

The results of the meta-analysis by Ramírez-Vélez and his team indicate inconclusive and low-quality evidence of a beneficial effect of KT alone compared to the fictional tape in knee osteoarthritis (Ramírez-Vélez et al. 2019).

The systematic review and meta-analysis by Melese et al. 2020 indicates that KT improved pain and physical functioning in subjects suffering from knee osteoarthritis. Although this systematic study showed that KT is effective in improving muscle strength compared to other interventions, psychological benefits and knee joint stability support effects, which were not considered in the study by Melese et al. 2020, may be other benefits of applying KT (Melese et al. 2020).

In the study by Baykal et al. (2023), the authors sought to investigate the acute effect of kinesiotape application on pain, balance, and walking performance in patients with knee osteoarthritis.

They included 164 patients with grade 1 to 3 knee osteoarthritis according to the Kellgren-Lawrence staging system in the study. Patients were assessed using a visual analog scale (EVA), a 10-meter walk test (10mEWT), the TUG test, a single-leg balance test (SLST), and the Functional Reach Test (FRT) before and after applying the KT.

The authors saw significant improvements in both groups. The average levels of improvement in pain and balance scores were better in the KT group than in the pre-tape group (Baykal et al. 2023).

In light of these various studies, our conclusion is similar to that of Cupler et al. 2020, although some levels of evidence lead to caution. We are of the opinion that the application of KT should be evaluated according to the expectations and needs of the patient, taking into consideration the clinical evaluation specific to each situation. However, some studies indicate significant benefits of this technique in the context of knee osteoarthritis.

Patellofemoral syndrome (PFPS)

According to Logan and his team, knee taping, which includes rigid tape but also K-tape, can be an adjunct to traditional exercise therapy as part of PFPS. The evidence does not support the isolated use of knee bandaging for patellofemoral pain (Logan et al. 2017).

In 2020, Kellish and his team demonstrated that participants with PFPS while walking with the KT applied produced a significant reduction in reported pain. The effect measured in reducing pain was only for immediate relief. Although KT causes a significant reduction in PFPS pain, no significant results were observed regarding changes in pace or position time in participants with PFPS, suggesting that deficits in quadriceps recruitment may still be present. This study suggests that KT with a mechanical technique is effective in relieving pain that may not be the result of alterations in a participant's gait (Kellish et al. 2020).

In 2021, the meta-analysis by Al-Muhannadi et al indicates that the kinesio taping method does not appear to be effective in reducing knee pain in patients with patellofemoral pain syndrome (Al-Muhannadi et al. 2021).

In 2023, Lee and his team questioned whether adding KT to exercise therapy had a beneficial effect on the treatment of PFPS.
The authors found that adding KT to exercise therapy did not result in additional benefits in terms of quadriceps muscle strength and acceleration time (measured by isokinetism), or AKPS in patients suffering from SPPF and presenting an anomaly in the patella trajectory at one month. The authors suggest that it is possible for KT to interfere with quadriceps strength gain over a period of one month instead. Lee and colleagues add that physical therapists should be aware of the contradictory and limited scientific evidence regarding taping in the treatment of SPPF (Lee et al. 2023).

On performance (jumps, sprints, agility)

In 2018, Reneker et al conducted a systematic review in an attempt to establish the effectiveness of KT on sports performance abilities compared to other taps or no taps.

The authors concluded that there is no convincing evidence of the effectiveness of KT on any of the concepts of sports performance abilities that had been included in their systematic review (Reneker et al. 2018).

Athletic performance abilities included: ball skill, leg curls, leg curls, cycling, cycling, dynamic balance, jumps (vertical and horizontal), agility, sprint speed, and distance running (Reneker et al. 2018).

A little more recently, Abellán et al sought to analyze the effect of KT on countermovement jumping (CMJ) and 20-meter sprints (sp) immediately and 24 hours after it was applied to the quadriceps and gluteus maximus (Abellán et al. 2021).

The authors stated that applying KT to the gluteus maximus and quadriceps of young soccer players increased sprint execution time immediately and 24 hours after application, even if the sprint execution time was no more than one-tenth of a second (0.08 s). It also has no effect on CMJ (Abellán et al. 2021).

The systematic review and meta-analysis by the Karabicak et al team is particularly interesting. These authors sought to study the effects of kinesio taping on the kinetics and kinematics of the lower extremities after a musculoskeletal disorder. In summary, KT has uncertain effects, even though it is widely used, due to its practicality, ease of use, and safety despite the additional costs. The authors indicated that there was insufficient evidence to demonstrate the effect of kinesio taping on lower limb kinetics and kinematics in patients with short- and long-term musculoskeletal disorders (Karabicak et al. 2022).

In 2023, it was Maria Elizabeth Cochrane and her team who suggested that applying KT to stabilizing muscles in the lower extremities significantly improved running speed, agility, and plyometrics in amateur soccer players immediately after application (Cochrane et al. 2023).

The ankle

Periostitis

In 2017, Kachanathu et al. carried out a study to compare the functional results of the most commonly used anti-pronation techniques, kinesio taping and standard orthoses.
A total of 40 subjects with symptoms of tibial periostitis participated in this study. These subjects were randomly divided into two groups (N.=20) and underwent anti-pronation kinesio taping and standard orthoses respectively (Kachanathu et al. 2017).

The authors indicated that Kinesio Taping played a critical role in improving functional outcomes compared to orthotics by reducing pain and improving functional activity in patients with periostitis; however, navicular fall correction did not occur with either intervention (Kachanathu et al. 2017).

In 2022, Guo et al. conducted a systematic review to assess the current status of relevant evidence on the effectiveness of KT for periostitis. In conclusion, this study revealed that the effectiveness of KT on tibial periostitis is not clearly established. The evidence for its effectiveness in people with periostitis is currently limited. The authors suggest that further studies of good methodological quality and good design are needed.

Ankle sprain

Now let's focus on ankle sprains. We first looked at the paper by Cupler et al. 2020 who summarized and mapped evidence relating to taping methods used for various joints and conditions in the musculoskeletal system. This paper was therefore based on the study by Nunes et al. 2016 to indicate with a moderate level of evidence that the Ktape for ankle sprain was unfavorable (Cupler et al. 2020).
And indeed, Nunes et al. 2016 indicate that the application of Kinesio Taping, in order to stimulate the lymphatic system, is ineffective in reducing acute swelling after an ankle sprain in athletes (Nunes et al. 2016).

In 2017, Kim et al. carried out a study whose objective was to investigate the immediate effect on the walking function of an ankle balance Ktape applied to amateur soccer players suffering from lateral ankle sprain.
The authors reported that applying ankle balance bands using a Ktape instantly increased the walking ability of amateur soccer players with severe ankle sprains. Therefore, ankle balance taping is a useful alternative to prevent and treat severe ankle sprains in amateur soccer players (Kim et al. 2017).
This study is contrary to the results of Nunes et al. 2016. This variability may in part be due to the severity of the sprains, which was not the same in the two studies, by the different Ktape setups, and by the measures evaluated.

In 2021, Nunes and her team conducted a systematic review and meta-analysis to investigate whether the KT technique, applied to the ankles of healthy people as a preventive intervention and in people with ankle injuries, is superior to fictional or alternative interventions on ankle function. Based on their results, it seems that the current evidence does not support the use of KT to improve ankle function for the purpose of prevention in healthy subjects.

Also, current evidence does not support the use of KT in the ankle area in the elderly, aimed at improving balance and therefore the risk of falling. Finally, there is no evidence supporting the use of KT in people with chronic ankle instability because the authors indicated that there was no positive effect on postural control, function, muscle capacity, and activity (Nunes et al. 2021).

The systematic review and meta-analysis by Biz et al. 2022 shows that KT, used on athletes with CAI (playing soccer, basketball, volleyball, baseball, and badminton), is only effective on some of the ankle performances and functions analyzed. It was not possible to define the precise moment of application of KT to the ankle joint of the athletes included in order to see the benefit of it in sports practice. However, meta-analysis showed a significant improvement in particular in the following elements: gait functions (step speed, step and stride length and reduction of the support base in dynamics); reduction of joint ROM in reversion-eversion; decrease in reversion-eversion joint ROM; decrease in peroneal muscle activation; decrease in postural balance during movement in the mediolateral direction.

In contrast, other aspects such as dynamic balance, lateral landing from a monopodal jump, and agility testing did not improve significantly by applying KT to the ankle joint.

Finally, as the improvement obtained by some of the parameters analyzed reflects an increased stabilization of the ankle joint of these athletes during sports performance, it is possible to conclude that KT has a moderate stabilizing effect on the ankles of athletes with CAI.

Mollet

In 2022, Malhotra and his team conducted a study to determine the effects of applying KT on acute muscle pain and calf muscle extensibility in endurance athletes. The authors found that KT was more effective in reducing pain intensity and delaying the time to induce fatigue caused by acute muscle pain in the calf muscle than sham taping (placebo) immediately after the treadmill running for endurance athletes.

In addition, KT and sham taping were equally effective in improving calf muscle flexibility (for both right and left legs) in endurance athletes after immediate application. However, KT and sham taping failed to limit the decrease in ankle dorsiflection and to reduce pain intensity 10 min after running on the treadmill (Malhotra et al. 2022).

The foot

Plantar fasciapathy

Tezel et al. 2020 studied the effectiveness of Ktape compared to ESWT in treating plantar fasciopathy. The results after six weeks showed a significant improvement in pain for both treatments. However, only the Ktape group showed a significant reduction in pain, disability, and activity restrictions according to the Foot Function Index subscales.

A randomized controlled trial by Castro-Méndez et al. 2022 compared an elastic band (Dynamic Tape®) to a rigid tape during a 1-week follow-up in 57 subjects (28 women and 29 men) with an average age of 41.7 SD ± 8.9 years. Dynamic Tape® significantly decreased pain scores on EVA compared to applying a rigid tape. However, the rigid tape was able to significantly reduce pronation on the Foot Posture Index-6 (FPI-6) compared to Dynamic Tape®.

The study by Ordahan et al. 2017 compared a group receiving ESWT to a group with ktape during a 5-week follow-up. Both groups showed significant improvement, with no significant difference between ESWT and KTAPE in terms of pain reduction and the FAOS index.

Tulasi Ratna et al. 2015 compared a group receiving conventional therapy (ultrasound, stretching of the plantar fascia and Achilles tendon, strengthening the intrinsic muscles of the foot) to a group receiving this conventional therapy combined with Ktape. The results at three weeks showed a significantly greater improvement for patients who received Ktape in addition to conventional therapy, both in pain levels and in the reduction of disability.

Three low-quality randomized clinical trials showed positive effects of Ktape at a follow-up of two weeks. Kirthika et al. 2018 looked at the effectiveness of applying Ktape compared to stretching exercises for the plantar fascia and calf muscles, with significantly better results in terms of balance and functional performance for the Ktape group.

Rahane et al. 2020 also found better results with Ktape combined with therapy compared to therapy alone, in terms of reducing pain and foot function index. The therapy included ultrasound, contrast baths, strengthening the intrinsic and calf muscles, and stretching the plantar fascia and Achilles tendon.

Karishma et al. 2022 compared Ktape and stretching to ultrasound and stretching in 30 subjects, finding that the group with Ktape had lower pain and foot function scores at two weeks of follow-up.

Conclusion

To conclude, kinesiotaping is a fairly new modality that can be used by the physiotherapist with many different techniques and for various purposes.

Although the physiology of the KT effect is practical and seems to be well tolerated by patients, it should be applied in a professional and thoughtful manner so that patients can receive the benefits they are looking for.

In this paper, different levels of evidence and different levels of interest in the use of Ktape have been shown depending on the pathology.

While it is rarely useful alone, it has sometimes shown promising results when combined with various conventional therapies such as exercise.

It is therefore complex to reach definitive conclusions, given the diversity of Kinesiotape (KT) techniques present in the studies. Based on our various analyses, we are of the opinion that the application of KT should be evaluated on a case-by-case basis, taking into consideration the expectations and clinical evaluations specific to each patient.

Finally, it may be interesting to also rely on the patient's beliefs and adjust the KT voltage if necessary. Indeed, although it is not in a position to promote muscular activity and improve muscular endurance performance, regardless of your personal belief in KT, people with a positive belief in KT perceive better performance with higher band tension than those with a negative belief (Lam et al. 2023).

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