Effects of Applied Direction of Kinesio Taping in Sensation and Postural Control between Pre- and Post- Muscle Fatigue for Healthy Athletes

DOI: https://doi.org/10.21203/rs.3.rs-1565977/v1

Abstract

Purpose: This study aimed to use two different taping directions on the gastrocnemius muscle, the most important muscle for stance stability, to further investigate the effect of different taping directions on overall balance and sensation systems before versus after muscle fatigue.

Methods: The participants were 45 healthy athletes who random control method was divided into 3 groups: Placebo taping group (PTG), Facilitation KT group (FKTG), and Inhabitation KT group (IKTG). The neuromuscular balance ability and sensory function test were before versus after muscle fatigue.

Results: The two-point discrimination sensitivity of the facilitation taping group was significantly higher than that of the placebo taping group. The eyes open swaying distance of the inhibition taping group was significantly greater than that of the placebo taping group before taping, after taping, and after fatigue from exercise. The swaying speed was also significantly higher in the inhibition taping group than in the placebo and facilitation taping groups. When the participants stood barefoot on one foot with the eyes closed, no significant differences were noted among groups. When standing on a soft cushion on one foot with the eyes open, significant differences were noted between the inhibition taping group and both the placebo and facilitation taping groups before taping, after taping, and after fatigue from exercise . When standing on a soft cushion on one foot with the eyes closed, there were significant differences in the duration of standing among the three groups before taping and after fatigue from exercise.

Conclusion: The results of the present study show that muscle taping effectively improves athletes’ proprioception. Therefore, muscle taping during exercise can help to increase the balance of, improve the performance of, and prevent ankle sprains in athletes.

Introduction

Most sports injuries occur in the middle and late stages of competition or practice and are correlated with some extent of fatigue [1, 2]. Fatigue reduces an athlete’s neuromuscular control [3], in turn decreasing balance.

Balance is an essential ability for athletes. Techniques in sports such as gymnastics, ball games, and track and field are particularly demanding with respect to balance quality, making it essential for athletic performance [4]. Most people rely on dynamic or static balance while standing, walking, or running. Static balance can maintain a stable posture, whereas dynamic balance enhances movement quality [5]. Balance is controlled by two systems in the human body and four factors: vision, the vestibular system, proprioception in the nervous system, and the influence of muscle strength in the musculoskeletal system [6]. Balance is achieved by adjusting the relative position of the center of gravity and base of support to achieve stability. The body must continuously correct and adjust the angles of the ankle and hip joints to maintain static balance while standing. The ankle joint muscles are used primarily in the forward and backward directions, whereas the hip joint muscles are mainly responsible for left–right adjustments. The information sources for these adjustments rely on the continuous input of proprioceptive signals [7].

With respect to static balance, standing is the most functional for postural assessment. The ability to control the ankle joint while standing is an essential factor affecting standing balance [8]. The standing static balance test can be used to determine the test subject’s sensory and muscle coordination [9]. The gastrocnemius is the most important stabilizing muscle for standing. Previous studies suggested that subjects with poor proprioception have poor standing quality, thereby increasing their risk of falls or reducing their activities of daily living [10]. In the clinical setting, constant stimulation is used to compensate for and enhance the sources of proprioception. Stimulation can re-train the nervous system to re-establish neuronal connections, and proprioceptive inputs can be increased by enhancing external signals, such as through sensory stimulation [11], braces [12], and tapes [13].

Kinesio tape (KT) is a widely available auxiliary device with proven ability to enhance proprioceptive input in many studies [14]. KT was experimentally shown to stimulate tactile input when applied to the skin, affect mechanoreceptors, enhance proprioception in the joints, muscles, and tendons [14, 15], improve myoelectric activity and recruitment [1619], and improve ankle joint position sense in healthy individuals and individuals with sports injuries [20].

Further studies have found that KT can improve proprioception in subjects [2022] and enhance dynamic balance in athletes [13, 23]. Different taping methods can result in different effects, so users have employed different KT shapes, tensions, and directions as needed [24]. Taping methods can be classified based on direction. In the facilitation method, the goal is to support muscle contraction, whereas in the inhibition method, the goal is to relax the muscles and increase flexibility or joint mobility. Some studies suggest that facilitation taping can increase muscle strength, power, and tension [25, 26], but some researchers believe that facilitation and inhibition methods do not affect muscle contraction or coordination [21,27−29]. However, previous studies focused primarily on the coordination of a single muscle and did not test the overall contraction performance and coordination of the muscle group simultaneously. In addition, opinions differ about facilitation and inhibition taping methods [21,25−29].

Although KT has been proven to improve proprioception, such as the joint position sense and force sense [13, 20], the sensation system in the human body can be divided into three categories: superficial, deep, and combined cortical. Superficial sensation is produced from stimulating the skin and subcutaneous tissues, such as light-touch thresholds [11,30−32]; deep sensation is produced from stimulating muscles, tendons, ligaments, joints, and fascia, such as vibratory sense, joint position sense, and force sense; and combined cortical sensation is produced from the combination of superficial and deep sensations [13, 14, 20, 30], such as two-point discrimination. Muscle taping may produce interaction among these three sensation systems, thus influencing proprioception. However, current studies suggest that KT can improve deep sensation (joint position sense and force sense) [13, 20, 33], but many researchers hold the opposite view [29, 34, 35], and the effects of other sensations have not been sufficiently studied. Therefore, this study aimed to use two different taping directions on the gastrocnemius muscle, the most important muscle for stance stability, to further investigate the effect of different taping directions on overall balance and sensation systems before versus after muscle fatigue.

Results

The results of lower limb balance tests (Tables 14) showed that, when standing barefoot on one foot with the eyes open, the swaying distance of the inhibition taping group was significantly greater than that of the placebo taping group before taping, after taping, and after fatigue from exercise (p < .05). The swaying velocity was also significantly higher in the inhibition taping group than in the placebo and facilitation taping groups (p < .05). When the participants stood barefoot on one foot with the eyes closed, no significant differences were noted among groups. When standing on a soft cushion on one foot with the eyes open, significant differences were noted between the inhibition taping group and both the placebo and facilitation taping groups before taping, after taping, and after fatigue from exercise (p < .05). When standing on a soft cushion on one foot with the eyes closed, there were significant differences in the duration of standing among the three groups before taping and after fatigue from exercise (p < .05).

 
 
Table 1

Placebo taping, inhibition taping, facilitation taping three groups' balance data on barefoot with eyes open and eyes closed

 

Placebo taping

Facilitation taping

Inhibition taping

Eyes open

Before

After

Fatigue

Before

After

Fatigue

Before

After

Fatigue

Standing time (sec)

10.0 ± 0.1

10.0 ± 0.0

10.0 ± 0.0

10.0 ± 0.0

10.0 ± 0.1

9.4 ± 2.3

10.0 ± 0.0

10.0 ± 0.1

9.9 ± 0.6

COP area (mm2)

182.99 ± 111.47

200.96 ± 173.48

324.33 ± 411.65

213.21 ± 208.51

308.73 ± 248.54

211.23 ± 106.81

279.51 ± 271.88

278.89 ± 252.48

1070.79 ± 3500.37

COP displacement (mm)

226.12 ± 42.75A

218.87 ± 69.64 A

249.31 ± 74.26 A

250.48 ± 64.59

295.89 ± 66.53

247.32 ± 57.18

311.43 ± 108.92 A

330.49 ± 112.99 A

313.38 ± 166.12 A

COP velocity (mm/sec)

22.89 ± 4.32 A

24.17 ± 3.82 A

25.21 ± 7.31 A

25.39 ± 6.54 B

29.96 ± 6.79 B

25.04 ± 5.82 B

31.67 ± 11.04 AB

33.53 ± 11.39 AB

41.51 ± 36.64 AB

Eyes closed

                 

Standing time (sec)

10.0 ± 0.1

9.72 ± 0.84

9.57 ± 1.74

8.81 ± 2.48

9.56 ± 1.79

9.86 ± 0.73

8.58 ± 2.74

9.01 ± 2.24

8.69 ± 2.65

COP area (mm2)

692.29 ± 584.36

700.53 ± 585.31

650.63 ± 390.58

731.06 ± 566.03

782.78 ± 479.03

809.31 ± 606.70

935.22 ± 1056.88

653.67 ± 545.81

1473.13 ± 2277.59

COP displacement (mm)

592.38 ± 166.55

494.21 ± 186.89

482.78 ± 112.61

498.25 ± 218.34

615.33 ± 193.77

555.00 ± 163.52

459.51 ± 164.90

520.15 ± 221.07

576.90 ± 279.04

COP velocity (mm/sec)

59.96 ± 16.91

51.56 ± 18.37

53.58 ± 19.90

117.51 ± 241.36

63.89 ± 15.99

57.43 ± 17.24

59.11 ± 22.08

100.12 ± 149.69

74.45 ± 46.30

A Significant difference Placebo taping with inhibition taping before, after taping and after fatigue
B Significant difference facilitation taping with inhibition taping before, after taping and after fatigue
 
 
 
Table 2

Statistical results of the balance between the three groups of placebo taping, inhibition taping, facilitation taping on barefoot with eyes open and closed eyes

 

Within-subject (pre-post-post fatigue)

Between-subject (group)

Interaction (group ⅹ time intervention)

Eyes open

F(2,84)

P value

Partial eta squared

F(1,42)

P value

Partial eta squared

F(2,84)

P value

Partial eta squared

Power

Standing time (sec)

1.502

.229

.035

.750

.479

.034

.749

.561

.034

.232

COP area (mm2)

1.073

.347

.025

.750

.479

.034

.823

.514

.038

.253

COP displacement (mm)

.920

.402

.021

5.300

.009

.202

1.364

.254

.061

.408

COP velocity (mm/sec)

1.002

.371

.023

6.687

.003

.242

1.012

.406

.046

.307

Eyes closed

                   

Standing time (sec)

.378

.686

.009

2.046

.142

.089

.825

.513

.038

.253

COP area (mm2)

1.471

.239

.034

.845

.437

.039

1.560

.192

.069

.463

COP displacement (mm)

.273

.762

.006

.390

.680

.018

2.270

.068

.098

.640

COP velocity (mm/sec)

.371

.691

.009

.807

.453

.037

1.110

.357

.050

.335

 

 
Table 3

Placebo taping, inhibition taping, facilitation taping three groups' balance data on balance pad with eyes open and eyes closed

 

Placebo taping

Facilitation taping

Inhibition taping

 

Before

After

Fatigue

Before

After

Fatigue

Before

After

Fatigue

Eyes open

                 

Standing time (sec)

10.02 ± 0.09

10.04 ± 0.08

9.81 ± 0.76

9.49 ± 1.83

9.67 ± 1.32

9.99 ± 0.12

9.88 ± 0.52

10.00 ± 0.03

10.00 ± 0.08

COP area (mm2)

513.33 ± 547.74C

349.65 ± 252.24 C

355.33 ± 349.66 C

663.21 ± 619.43 C

406.19 ± 206.87 C

512.33 ± 354.36 C

674.49 ± 621.13 C

464.25 ± 513.21 C

474.03 ± 492.35 C

COP displacement (mm)

275.29 ± 131.76

271.85 ± 62.81

258.05 ± 71.27

340.15 ± 116.94

299.76 ± 85.34

307.46 ± 53.95

422.75 ± 295.34

305.95 ± 109.26

309.42 ± 116.47

COP velocity (mm/sec)

30.85 ± 8.90

27.45 ± 6.20

26.70 ± 6.92

59.92 ± 89.06

31.91 ± 7.97

31.19 ± 5.43

45.30 ± 38.46

31.05 ± 10.86

31.53 ± 11.88

Eyes closed

                 

Standing time (sec)

4.71 ± 2.15D

5.51 ± 2.63

7.34 ± 5.93 D

5.11 ± 2.17 D

4.99 ± 2.64

6.24 ± 3.43 D

4.58 ± 2.21 D

4.33 ± 2.21

5.72 ± 2.65 D

COP area (mm2)

2114.84 ± 2117.01

2230.77 ± 1922.22

2456.55 ± 3416.70

2275.95 ± 1502.05

1860.61 ± 1467.55

2080.97 ± 1796.78

4254.07 ± 9600.39

1582.62 ± 1536.49

1394.31 ± 661.20

COP displacement (mm)

397.96 ± 186.08

448.93 ± 230.62

468.08 ± 239.81

473.69 ± 221.18

404.33 ± 226.02

486.43 ± 287.81

423.15 ± 183.69

341.48 ± 278.82

456.55 ± 169.74

COP velocity (mm/sec)

86.97 ± 23.14

84.77 ± 27.50

82.34 ± 24.00

93.61 ± 22.56

82.92 ± 21.94

140.17 ± 233.43

98.31 ± 35.59

76.06 ± 24.00

86.85 ± 31.61

C Significant difference Placebo taping and facilitation taping with inhibition taping before, after taping and after fatigue
D Significant difference Placebo taping and facilitation taping with inhibition taping before taping and after fatigue

 

Table 4

Statistical results of the balance between the three groups of placebo taping, inhibition taping, and facilitation taping on balance pad with eyes open and eyes closed

 

Within-subject (pre-post-post fatigue)

Between-subject (group)

Interaction (group ⅹ time intervention)

 

F(2,84)

P value

Partial eta squared

F(1,42)

P value

Partial eta squared

F(2,84)

P value

Partial eta squared

Power

Eyes open

                   

Standing time (sec)

.351

.705

.008

1.351

.270

0.60

.767

.550

.035

.237

COP area (mm2)

7.236

.001

.147

.454

.638

.021

.198

.939

.009

.090

COP displacement (mm)

4.162

.019

.090

2.068

.139

.090

1.460

.222

.065

.435

COP velocity (mm/sec)

3.359

.040

.074

1.533

.228

.068

.724

.578

.033

.225

Eyes closed

                   

Standing time (sec)

4.001

.022

.087

1.031

.366

.047

.317

.866

.015

.118

COP area (mm2)

1.310

.275

.030

.064

.938

.003

1.254

.295

.056

.377

COP displacement (mm)

1.354

.264

.031

.381

.686

.018

.496

.739

.023

.163

COP velocity (mm/sec)

.867

.424

.020

.770

.469

.035

.840

.503

.038

.258

The results of the vibration test (Table 5) are similar to those of the tenderness threshold test. There was no significant difference among the three taping conditions or before/after taping and after fatigue from exercise. The results of two-point discrimination test for combined cortical sensation (Table 6) indicate no significant interaction among the three taping conditions or before/after taping and after strenuous exercise, but there were significant differences among the groups (p < .05). However, the two-point discrimination sensitivity of the facilitation taping group was significantly higher than that of the placebo taping group (p < .05).

 
 
Table 5

Placebo taping, inhibition taping, facilitation taping three groups' Vibratory sense and Two-point sensory data

 

Placebo tapingA

Facilitation tapingA

Inhibition taping

 

Before

After

Fatigue

Before

After

Fatigue

Before

After

Fatigue

Vibratory sense (sec)

                 
 

31.72 ± 6.88

32.80 ± 8.06

31.48 ± 6.92

31.30 ± 5.85

29.47 ± 3.63

28.78 ± 4.8

29.22 ± 8.03

30.27 ± 8.55

32.01 ± 9.07

Two-point sensory (cm)

               
 

7.47 ± 2.16

7.10 ± 1.50

7.30 ± 2.27

5.57 ± 2.22

5.83 ± 2.12

5.57 ± 2.43

7.30 ± 2.27

7.00 ± 1.61

7.00 ± 1.40

A Significant difference Placebo taping and facilitation taping
 
 
 
 
Table 6

Statistical results of the Vibratory sense and Two-point sensory between the three groups of placebo taping, inhibition taping, and facilitation taping

 

Within-subject (pre-post-post fatigue)

Between-subject (group)

Interaction (group ⅹ time intervention)

 

F(2,84)

P value

Partial eta squared

F(1,42)

P value

Partial eta squared

F(2,84)

P value

Partial eta squared

Power

Vibratory sense

.007

.993

.000

.494

.614

.023

1.586

.186

.070

.470

Two-point sensory

.364

.696

.009

3.992

.026

.160

.355

.840

.017

.127

 

Discussion

Sensation

The results of this study showed that muscle taping had no effect on vibratory sense but had significant benefits for two-point discrimination after taping. Most previous studies focused on deep sensation position and strength before versus after taping [14, 20], but other researchers believe that KT has no effect on position sense or force sense [29, 34, 35]. The present study also found that KT had no effect on vibratory sense, which is classified as a deep sensation, but that it affect two-point discrimination, which is classified as combined cortical sensation. Furthermore, the present study found that facilitation taping improved two-point discrimination and increased the sensitivity of combined cortical sensation. Two-point discrimination with facilitation taping increased from 5.57 cm before taping to 5.83 cm after taping and then back to 5.57 cm after fatigue from exercise. This shows that facilitation taping is consistent with the direction of muscle contraction and can enhance skin sensation, which may improve muscle coordination and reduce the effects of muscle fatigue. In a previous study facilitation and inhibition taping were used on the outer edge of the forearm of 10 healthy individuals, who were asked to perform repeated flexing and bending of the wrist. The results of sensorimotor coordination tests showed that KT improved the subjects’ muscle coordination [22].

Balance

The present study revealed no significant differences among any of the groups when the participants stood barefoot on one foot with the eyes closed. However, when they stood barefoot on one foot with the eyes open, the swaying distance of the inhibition taping group was significantly greater than that of the placebo taping group before taping, after taping, and after fatigue from exercise, and the swaying velocity was significantly higher in the inhibition taping group than in the placebo and facilitation taping groups. When participants stood on a soft cushion on one foot with the eyes open, the swaying surface area of the three groups gradually decreased before taping, after taping, and after fatigue from exercise. When standing on a soft cushion on one foot with the eyes closed, the duration of standing among the three groups improved significantly. During static balance, a lack of visual feedback increases the influence of proprioception on maintaining balance. Although there is no immediate effect after taping, there is significant improvement in balance after fatigue from exercise. This may be because the tests were conducted immediately after taping, when coordination between proprioception and neuromuscular control has not yet been achieved. However, after the intervention of fatigue from exercise, subjects may exhibit improved balance because of improved proprioception.

When standing still, the human body adjusts the center of mass within the base of support to maintain balance [36]. In the present study, the extent and velocity of center of pressure movement were measured to evaluate the stability of the subject’s swaying, proprioception, and posture [3741].

In the present study, the gastrocnemius was taped because forward-backward displacement of the center of pressure when standing still is affected by the ankle strategy for posture control [7], and the contractile state of the gastrocnemius directly affects ankle control ability. Previous studies reported that interventional muscle taping before exercise can improve dynamic balance in healthy athletes [13, 23] but did not involve intervention after fatigue from exercise. The present study included intervention after fatigue from exercise and divided the taping methods into facilitation and inhibition taping to elucidate the effects of the two taping methods. Taping of the gastrocnemius in different directions revealed that the taping direction did not increase vertical jumping ability but changed the electromyographic activation state of the gastrocnemius [17]. Activation of the gastrocnemius directly affects ankle control. The present study found that taping of the gastrocnemius improved the subjects’ ankle control and, thus, balance. Previous studies on different directions of taping showed that facilitation taping of the quadriceps increased torque in the knee joint [26]. This result may also explain the improved balance in subjects in the present study after taping, as the proprioception around the ankle joint and the coordination between muscles is increased after taping, thus generating greater joint torque and functionally maintaining postural stability.

Prolonged exercise causes muscle fatigue and affects balance control [6], and muscle fatigue causes pain and decreased control [42, 43]. Fatigue of the gastrocnemius reduces ankle joint stability [3]. Preventing fatigue of the plantaris is necessary for accurate control of the ankle joint [44]. Previous studies reported that muscle taping effectively reduces the pain immediately after fatigue from exercise [45], muscle fatigue [46], and the incidence of ankle sprains [46, 47]. The present study further showed that gastrocnemius taping can improve motion control after fatigue from exercise. This is similar to the results of previous studies showing that muscle taping before fatigue intervention can reduce the tendency of balance to decline after fatigue [48]. This result can be applied in preventive taping plans to reduce the probability of lower limb fatigue and sports injuries through muscle taping.

In conclusion, the results of the present study show that muscle taping effectively improves athletes’ proprioception. Therefore, muscle taping during exercise can help to increase the balance of, improve the performance of, and prevent ankle sprains in athletes. Studies reported that the balance of athletes is improved after gastrocnemius taping. The major reason for this may be improved proprioception, but movement and neuromuscular adaptation are required after taping to optimize the results. Therefore, to improve balance using muscle taping, it should be completed before the athlete warms up for best results after adaptation.

Methods

Experimental Approach to the Problem

This study aimed to use two different taping directions on the gastrocnemius muscle, the most important muscle for stance stability, to further investigate the effect of different taping directions on overall balance and sensation systems before versus after muscle fatigue. Forty-five healthy athletes were recruited for this study (Table 7). The admission conditions of healthy athletes: (1) The participants reported no history of surgery on the lower limbs or musculoskeletal disorders in a span of 1 year prior to data collection. (2) The frequency of sports training is more than 3 days per week, and there are at least three years of training experience in this sport. (3) Never had a medical problem that affects balance, such as head injury, concussion, otitis media, Meniere disease, or hearing loss. Approval from the relevant local Institutional Review Board (Cheng Ching Hospital Institutional Review Board [07/05/2017-; IRB No: HP170013]) and individual written informed consent from all participants were obtained beforehand. All experiments were performed in accordance with relevant local guidelines and regulations.

Table 7

Mean ± SD of demographic characteristics of participants

Variable

PTG

FKTG

IKTG

F

P

Number of participants (male: female)

15 (6: 9)

15(12:2)

15(7:8)

--

--

Age (years)

20.5 ± 1.7

19.9 ± 1.4

19.8 ± 1.0

1.186

.316

Height (cm)

165.9 ± 9.3

172.0 ± 7.9

166.7 ± 9.4

2.085

.137

Body mass(kg)

61.1 ± 13.0

64.3 ± 8.6

63.3 ± 14.1

.282

.755

Training frequency (time/week)

3.5 ± 1.5

4.4 ± 1.5

3.4 ± 1.8

1.744

.187

Training time (hour/week)

2.2 ± 1.0

2.8 ± 1.2

2.5 ± 1.0

1.109

.339

Experimental design

The random control method was divided into 3 groups: Placebo taping group (PTG), Facilitation KT group (FKTG), and Inhabitation KT group (IKTG). The tests involved in this study were the balance test, superficial sensory function test, and combined cortical sensation test. the balance, superficial sensory function, and combined cortical sensation data were collected at before the taping, immediately after the taping, and after the continuous heel raising movement to the fatigue and rest for 10 minutes.

Procedures

Applied direction of Kinesio taping

A two-inch (5 cm) kinesio tape (Kinesio Tex Tape, Kinesio Holding Company, Albuquerqe, NM) was used in this study, and the stretch tension of the tape was 100–140%. The taping site was the gastrocnemius muscle, and the taping methods were divided into Placebo taping, Inhibition taping, and Facilitation taping (Fig. 4).

Inhibition taping

Tape was applied from the end (at the bottom of the heel) to the beginning of the muscle (at the back of the knee). The knee was bent and the foot was pushed down into a dorsiflexed position. A 10-cm piece of tape was applied from the sole of the foot, a Y-shaped strip was applied along the outer edge of the calf, and another strip of tape was applied along the inner edge of the calf. In addition, the knee was passively straightened, and the tension of the tape to 100% (Fig. 4a).

Facilitation taping

Tape was applied from the beginning (at the back of the knee) to the end of the muscle (at the bottom of the heel). The tape was placed in an I-shape, the subject's knee joint was extension and the ankle was in a plantar flexion position. The patch was applied from the back of the knee to the heel, and the tension of the tape to 100% (Fig. 4b).

Placebo taping

On the midsection of the gastrocnemius, an I-shaped horizontal strip is attached, and the tension of the tape to 100% (Fig. 4c).

Fatigue exercise:

The definition of gastrocnemius fatigue is continuous heel raising movement the height of the heel is less than half of the starting point for three consecutive times [49].

Testing procedures

The Zebris force plate (Zebris FDM-S, Zebris Medical GmbH, Germany) was used in this study. The capture frequency of the Zebris force platform was set at 100 Hz. and the center of pressure (COP) mobile change was used to evaluate the neuromuscular balance ability of the lower extremities. This study was conducted in a single-leg standing manner, and the standing leg was chosen to be performed with the dominant leg. The dominant leg defines the foot that steps up the stairs first when going up stairs, and the leg that kicks the ball as the dominant leg. There are four situations in this study (1) Open-eye, bare feet, single-leg standing; (2) Close-eye, bare feet, single-leg standing; (3) Open-eye, feet on soft-mat, single-leg standing; and (4) close-eye, feet on soft-mat, single-leg standing, measurement variables It includes the time of standing on one leg, area of body sway, path length of body sway, and velocity of body sway (Fig. 1).

Superficial sensory function test:

Use Vibrating tuning fork (Fig. 2a) and two-point recognition tool (Two-Point Aesthesiometer, Lafayette Instrument, Lafayette, IN) to conduct superficial sensory test (Fig. 2a), measure three times during the test, and take the average of three times as the final value; Vibratory sense is to use a 128 Hz vibrating tuning fork. During the test, subjects are required to close eyes and wear headphones, place the tuning fork on the lateral ankle bone after vibrating, and let the subjects feel the vibration of the tuning fork and start timing. When the tester no longer feels the vibration of the tuning fork, the timing stops, and the value on the tuning fork and the stop time were recorded (Fig. 2b).

Combined cortical sensation test:

Adjust the distance between the two ends of the two-point sensory tool (Fig. 3a) from 10 cm width down. Subject lie on the bed to test every time you adjust it by 1 the centimeter-wide distance was measured once until the subject could not distinguish the two endpoints. That is, the length of the previous distance was recorded (Fig. 3b).

Data statistical analyses

The detection time points are before the taping, immediately after the taping, and after the continuous heel raising movement to the fatigue and rest for 10 minutes. To examine the differences among comparisons, Two-way ANOVA, mixed design with LSD adjustment was conducted in the IBM SPSS Package Software 22.0. The parameters in two situations, before taping and after taping, whereas the taping method were placebo taping group, PTG; facilitation KT group, FKTG and inhabitation KT group, IKTG. The significance level was set to a = .05.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Declarations

ACKNOWLEDGMENTS

This research was supported by the National Science Council in Taiwan (MOST 106-2410-H-040-013-). This study None of the authors declare competing financial interests. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

AUTHOR CONTRIBUTIONS

MHH, HYC and SYC conceived and designed research. YCC and CWC conducted experiments. MHH and SYC analyzed data. MHH, HYC, YCC, SYC, and CWC wrote the manuscript. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors.

SYC is the Hsiao-Yun Chang5*

HYC is the Hui-Ya Chen2

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