by Troy Vander Molen, PT, DPT
With the challenges that face the modern health care system, evidence-based (now often referred to as evidence-informed) practice is becoming increasingly important. Scientific evidence comes in a variety of forms and strength. The weakest type of scientific evidence is anecdotal and expert opinion, which essentially is “evidence” offered by experts in the medical field based upon their own personal experience. Other lower forms of evidence include various experimental and observational study designs ranging from case reports, which are observational studies based upon one subject, to cohort studies, which involves a group of people with a certain characteristic that are observed over time and compared to another group of people without that characteristic.
The best form of evidence to support a practice pattern uses the experimental design of randomized controlled trials (RCTs). In this type of design, a large group of subjects are randomly assigned to a test group, and their outcomes are compared to another “control group” who received a different type of treatment. In fact, systematic reviews that support or deny the value of a medical treatment use multiple RCTs to draw conclusions, also taking into account the quality of the studies included. These reviews help to mitigate the biases that are common with individual studies and give us a more complete picture of treatment effectiveness.
With the popularity of elastic therapeutic tape (ETT) continuing to rise, it might seem safe to assume that these claims are supported by strong scientific evidence, systematic review of randomized controlled trials. However, you might also be surprised.
A 2015 meta analysis found that elastic taping provided significantly more pain relief than no treatment at all, but it was not better than other treatment approaches.1 This same study found no significant changes in disability as a result of elastic taping. The authors also concluded that using elastic taping to facilitate muscular contraction has “no or only negligible effects on muscle strength.”
A 2014 meta analysis indicated that the reported beneficial effects of elastic taping are more likely to be found in studies that have a lower quality.2
A 2012 meta analysis found that pain relief benefits achieved via elastic taping were trivial due to the fact that no studies found clinically important results.3 The researchers concluded that elastic taping (specifically KT) may have a “small beneficial role in improving strength, range of motion in certain injured cohorts… compared to other elastic tapes, but further studies are needed to confirm these findings.” Furthermore, they stated that “KT had some substantial effects on muscle activity, but it was unclear whether these changes were beneficial or harmful.”
Another 2012 scientific research article found that elastic taping might have some effect on lymph drainage (i.e. swelling).4 Other studies support this finding with regard to use in patients following surgery for breast cancer.
Some research published in 2014 tracked 49 subjects with patellofemoral pain syndrome (PFPS), a specific type of knee pain.5 This nonrandomized controlled trial required each subject to complete four functional tasks and a single-leg triple jump test (STJT) while using elastic tape and also while using a sham tape application. The STJT distance increased with the use of elastic tape, but the degree of change did not surpass the minimally detectable change value and could not be supported as effective. It did, however, show statistically significant improvements in pain and was supported to provide a short-term method to control pain.
The most recent study I could find was published in the January 2016 edition of the Clinical Journal of Sport Medicine.6 This study aimed to compare the short-term effectiveness of elastic taping to nonsteroidal anti-inflammatory drugs (NSAIDs), both combined with exercise therapy, in improving pain and function in patients with shoulder impingement. One hundred subjects were included, and the results indicated that neither NSAIDs or elastic taping were any more beneficial at reducing pain than using rehabilitation exercise alone.
Many experts and researchers indicate that the pain relief attained by subjects using elastic tape may be due to the placebo effect.