Effect of Knee Orthosis and Kinesio Taping on Clinical and Neuromuscular Outcomes in Patients with Knee Osteoarthritis: A Randomized Clinical Trial

Document Type : RESEARCH PAPER

Authors

1 Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

2 Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran

3 Rehabilitation Research Center, Department of Physical therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

4 Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

Abstract

Objectives: Impaired proprioception and muscle weakness may not only be a consequence of knee 
osteoarthritis (OA) but also part of its pathogenesis. Thus, the enhancement of quadriceps strength 
and proprioceptive accuracy can play a pivotal role in the management of knee OA. This study aimed 
to investigate the effects of Kinesio tape and flexible knee orthosis in terms of clinical and 
neuromuscular outcomes in patients with knee OA.
Methods: This clinical trial was conducted on 56 patients with knee OA, randomly allocated to two groups: knee 
orthosis or Kinesio tape. The knee orthosis group wore a neoprene knee support for 4 weeks. For participants in the 
Kinesio tape group, tape was applied once a week, for 4 weeks. The primary outcomes were pain intensity and 
physical function evaluated through the visual analog scale and the Western Ontario and McMaster OA index. The 
secondary outcomes were concentric and isometric quadriceps strength, Joint Position Sense (JPS), Threshold to 
Detect Passive Motion (TTDPM), and force sense (FS), all measured by isokinetic dynamometry.
Results: All outcome measures were significantly improved in the orthosis group. The Kinesio tape group also 
demonstrated significant changes in all outcome measures except three proprioception components namely JPS 
(70° target), FS, and TTDPM. At the end of the fourth week, there were no significant between-group differences for 
measured parameters.
Conclusion: Wearing a flexible knee orthosis and/or Kinesio tape for 4 weeks significantly improved knee pain, 
physical function, and quadriceps strength. Although knee orthosis showed significant beneficial effects on various 
components of proprioception, there were no significant differences between the two groups at the end of the 4-
week intervention.
 Level of evidence: II

Keywords

Main Subjects

References

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5.                Alkan BM, Fidan F, Tosun A, Ardıçoğlu Ö. Quality of life and 

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  21. Cho HY, Kim EH, Kim J, Yoon YW. Kinesio taping improves pain, range of motion, and proprioception in older patients with knee osteoarthritis: a randomized controlled trial. Am J Phys Med Rehabil. 2015; 94(3):192-200. doi: 10.1016/j.ijsu.2018.09.015.
  22. Bryk FF, Jesus JF, Fukuda TY, Moreira EG, Marcondes FB, Santos MG. Immediate effect of the elastic knee sleeve use on individuals with osteoarthritis. Rev Bras Reumatol Engl Ed. 2011; 51(5):440-6.
  23. Callaghan MJ, Parkes MJ, Felson DT. The effect of knee braces on quadriceps strength and inhibition in subjects with patellofemoral osteoarthritis. J Orthop Sports Phys Ther. 2016; 46(1):19-25. doi: 10.2519/jospt.2016.5093.
  24. Rahlf AL, Braumann KM, Zech A. Kinesio taping improves perceptions of pain and function of patients with knee osteoarthritis: a randomized, controlled trial. J Sport Rehabil. 2019; 28(5):481-487. doi:10.1123/jsr.2017-0306.
  25. Ghai S, Driller M, Ghai I. Effects of joint stabilizers on proprioception and stability: a systematic review and meta-analysis. Phys Ther Sport. 2017; 25:65-75. doi: 10.1016/j.ptsp.2016.05.006.
  26. Kase K. Clinical therapeutic applications of the Kinesio (! R) taping method Albuquerque. 2003.
  27. Anandkumar S, Sudarshan S, Nagpal P. Efficacy of kinesio taping on isokinetic quadriceps torque in knee osteoarthritis: a double blinded randomized controlled study. Physiother Theory Pract. 2014; 30(6):375-83. doi:10.3109/09593985.2014.896963.

33.              Cudejko T, van der Esch M, van der Leeden M, et al. Effect of soft braces on pain and physical function in patients with 

  1. Ma VY, Chan L, Carruthers KJ. Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain. Arch Phys Med Rehabil. 2014; 95(5):986-995.e1. doi: 10.1016/j.apmr.2013.10.032.
  2. Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheumatol. 1987; 30(8):914-8. doi: 10.1002/art.1780300811.
  3. Felson DT, Gross KD, Nevitt MC, et al. The effects of impaired joint position sense on the development and progression of pain and structural damage in knee osteoarthritis. Arthritis Rheum.2009; 61(8):1070-6. doi: 10.1002/art.24606.
  4. Jordan J, Luta G, Renner J, Dragomir A, Hochberg M, Fryer J. Knee pain and knee osteoarthritis severity in self-reported task specific disability: the Johnston County Osteoarthritis Project. J. Rheumatol. 1997; 24(7):1344-9.
  5. Alkan BM, Fidan F, Tosun A, Ardıçoğlu Ö. Quality of life and self-reported disability in patients with knee osteoarthritis. Mod Rheumatol. 2014; 24(1):166-71; 24(1):166-71. doi: 10.3109/14397595.2013.854046.
  6. Hassan BS, Mockett S, Doherty M. Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects. Ann Rheum Dis. 2001; 60(6):612-8. doi: 10.1136/ard.60.6.612.
  7. Hurley MV, Scott DL, Rees J, Newham DJ. Sensorimotor changes and functional performance in patients with knee osteoarthritis Ann Rheum Dis. 1997;56(11):641-8. doi: 10.1136/ard.56.11.641.
  8. Lund H, Juul-Kristensen B, Hansen K, et al. Movement detection impaired in patients with knee osteoarthritis compared to healthy controls: a cross-sectional case-control study. J Musculoskelet Neuronal Interact. 2008;8(4):391-400.
  9. Baert IA, Mahmoudian A, Nieuwenhuys A, et al. Proprioceptive accuracy in women with early and established knee osteoarthritis and its relation to functional ability, postural control, and muscle strength. J Clin Rheumatol. 2013; 32(9):1365-74. doi: 10.1007/s10067-013-2285-4.
  10. Knoop J, Steultjens MP, Van der Leeden M, et al. Proprioception in knee osteoarthritis: a narrative review. Osteoarthritis Cartilage. 2011; 19(4):381-8. doi: 10.1016/j.joca.2011.01.003.
  11. Konishi Y. Sport, Tactile stimulation with Kinesiology tape alleviates muscle weakness attributable to attenuation of Ia afferents. J Sci Med Sport.2013; 16(1):45-8. doi: 10.1016/j.jsams.2012.04.007.
  12. Shakoor N, Foucher KC, Wimmer MA, et al. Asymmetries and relationships between dynamic loading, muscle strength, and proprioceptive acuity at the knees in symptomatic unilateral hip osteoarthritis. Arthritis Res Ther. 2014;16(6):455. doi:10.1186/s13075-014-0455-7.
  13. Segal NA, Glass NA, Felson DT, et al. The effect of quadriceps strength and proprioception on risk for knee osteoarthritis. Med Sci Sports Exerc. 2010; 42(11):2081-8. doi:10.1249/MSS.0b013e3181dd902e.
  14. McAlindon TE, Cooper C, Kirwan JR, Dieppe PA. Determinants of disability in osteoarthritis of the knee. Ann Rheum Dis. 11993; 52(4):258-62. doi: 10.1136/ard.52.4.258.
  15. Ramirez DS, van der Leeden M, Knol DL, et al. Association of postural control with muscle strength, proprioception, self-reported knee instability and activity limitations in patients with knee osteoarthritis. J Rehabil Med. 2013; 45(2):192-7. doi: 10.1007/s10067-012-2025-1.
  16. Hunt MA, McManus FJ, Hinman RS, Bennell KL. Predictors of single‐leg standing balance in individuals with medial knee osteoarthritis. Arthritis Care Res. 2010; 62(4):496-500. doi: 10.1002/acr.20046.
  17. Schmitt LC, Fitzgerald GK, Reisman AS, Rudolph KS. Instability, laxity, and physical function in patients with medial knee osteoarthritis. Phys Ther. 2008; 88(12):1506-16. doi: 10.2522/ptj.20060223.
  18. SSharma L, Pai YC, Holtkamp K, Rymer WZ. Is knee joint proprioception worse in the arthritic knee versus the unaffected knee in unilateral knee osteoarthritis? Arthritis Rheumatol. 1997 Aug; 40(8):1518-25. doi:10.1002/art.1780400821.
  19. Shakoor N, Furmanov S, Nelson DE, Li Y, Block JA. Pain and its relationship with muscle strength and proprioception in knee OA: results of an 8-week home exercise pilot study. J Musculoskelet Neuronal Interact. 2008; 8(1):35-42.
  20. Tsauo JY, Cheng PF, Yang RS. The effects of sensorimotor training on knee proprioception and function for patients with knee osteoarthritis: a preliminary report. Clin Rehabil. 2008; 22(5):448-57. doi: 10.1177/0269215507084597.
  21. Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: the chronic osteoarthritis management initiative of the US bone and joint initiative. Semin Arthritis Rheum. 2014; 43(6):701-12. doi: 10.1016/j.semarthrit.2013.11.012.
  22. Morris D, Jones D, Ryan H, Ryan CG. The clinical effects of Kinesio® Tex taping: A systematic review. Physiother Theory Pract. 2013; 29(4):259-70. doi: 10.3109/09593985.2012.731675.
  23. Lu Z, Li X, Chen R, Guo C. Kinesio taping improves pain and function in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials. Int J Surg.  2018; 59:27-35. doi: 10.1016/j.ijsu.2018.09.015.
  24. Sharif NA, Goh SL, Usman J, Safwani WK. Biomechanical and functional efficacy of knee sleeves: a literature review. Phys Ther Sport. 2017; 28:44-52. doi: 10.1016/j.ptsp.2017.05.001.
  25. Beaudreuil J, Bendaya S, Faucher M, et al. Clinical practice guidelines for rest orthosis, knee sleeves, and unloading knee braces in knee osteoarthritis. Joint Bone Spine. 2009; 76(6):629-36. doi: 10.1016/j.jbspin.2009.02.002.
  26. Cho HY, Kim EH, Kim J, Yoon YW. Kinesio taping improves pain, range of motion, and proprioception in older patients with knee osteoarthritis: a randomized controlled trial. Am J Phys Med Rehabil. 2015; 94(3):192-200. doi: 10.1016/j.ijsu.2018.09.015.
  27. Bryk FF, Jesus JF, Fukuda TY, Moreira EG, Marcondes FB, Santos MG. Immediate effect of the elastic knee sleeve use on individuals with osteoarthritis. Rev Bras Reumatol Engl Ed. 2011; 51(5):440-6.
  28. Callaghan MJ, Parkes MJ, Felson DT. The effect of knee braces on quadriceps strength and inhibition in subjects with patellofemoral osteoarthritis. J Orthop Sports Phys Ther. 2016; 46(1):19-25. doi: 10.2519/jospt.2016.5093.
  29. Rahlf AL, Braumann KM, Zech A. Kinesio taping improves perceptions of pain and function of patients with knee osteoarthritis: a randomized, controlled trial. J Sport Rehabil. 2019; 28(5):481-487. doi:10.1123/jsr.2017-0306.
  30. Ghai S, Driller M, Ghai I. Effects of joint stabilizers on proprioception and stability: a systematic review and meta-analysis. Phys Ther Sport. 2017; 25:65-75. doi: 10.1016/j.ptsp.2016.05.006.
  31. Kase K. Clinical therapeutic applications of the Kinesio (! R) taping method Albuquerque. 2003.
  32. Anandkumar S, Sudarshan S, Nagpal P. Efficacy of kinesio taping on isokinetic quadriceps torque in knee osteoarthritis: a double blinded randomized controlled study. Physiother Theory Pract. 2014; 30(6):375-83. doi:10.3109/09593985.2014.896963.
  33. Cudejko T, van der Esch M, van der Leeden M, et al. Effect of soft braces on pain and physical function in patients with knee osteoarthritis: systematic review with meta-analyses. Arch Phys Med Rehabil. 2018; 99(1):153-163. doi: 10.1016/j.apmr.2017.04.029.
  34. Cudejko T, van der Esch M, van der Leeden M, et al. The immediate effect of a soft knee brace on pain, activity limitations, self-reported knee instability, and self-reported knee confidence in patients with knee osteoarthritis.

Arthritis Res Ther. 2017; 19(1):260. doi: 10.1186/s13075-017-1456-0.

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46.              Hortobágyi T, Garry J, Holbert D, Devita P. Aberrations in the control of quadriceps muscle force in patients with knee osteoarthritis. Arthritis Care Res. 2004; 51(4):562-9. doi: 10.1002/art.20545.

The Archives of Bone and Joint Surgery
Volume 11, Issue 10
October 2023
Pages 625-634

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History

  • Receive Date: 15 May 2023
  • Revise Date: 01 July 2023
  • Accept Date: 20 July 2023

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