Study selection
Two hundred and ninety studies were found during the search (number of records through database search, n=288; n=2 through other sources). There were 41 duplicate records removed leaving 249 studies which were screened at the title and abstract screening phase. After excluding 224 records, 25 full texts were screened leaving nine studies for final inclusion in the systematic review. Data from three studies were pooled together for a meta-analysis. The study selection process is presented in Figure 1.
Characteristics of the included studies
The included nine RCTs enrolled a total of 577 subjects. A total of 250 subjects were enrolled in the experimental group and received therapeutic taping. Control groups included other therapies (n=146), sham taping (n=93) or no intervention (n=88) (Table 1).
Quality evaluation
Methodological quality was assessed using PEDro scale (Table 2). The PEDro score of the included studies ranged from 4 to 7. All the studies satisfied the baseline comparability and between group comparison criteria. However, no study met the criteria for subject blinding and therapist blinding (Figure 2).
Evidence summary
Favorable evidence was found for the effect of Kinesio taping on quality of life outcomes with the evidence being of high quality (Table 3). Favorable evidence was found on the effect of Kinesio taping on pain intensity and anxiety with the evidence being of moderate quality (Table 3). Favorable evidence was found on the effect of spiral taping and balance taping on pain intensity (Table 3).
Study
|
Country
|
Population
(sample, age, setting)
|
Sample size
|
Intervention
|
Duration of treatment
|
Outcome Indicators
(tool)
|
Results
|
Experimental
(sample size)
|
Comparison
(sample size)
|
Experimental
|
Comparison
|
Pazare 2019
|
India
|
Females with PD
18-25 years
PCMC area,
Pune
|
40
|
KT (20)
|
Isometric Exercises (20)
|
3 weeks
(six times twice a week starting
from 14 days before menstruation until its end)
|
8 weeks (since the third day of their menstrual cycle
5 days a week, two sessions a day, and 10 times per
Session)
|
Pain intensity (VAS)
|
KT significantly improves pain compared to isometric exercises
|
Dogan 2020
|
Turkey
|
Nulliparous females diagnosed with PD
Over 18 years
NR
|
60
|
KT + Lifestyle changes (30)
|
Lifestyle changes (30)
|
1 month (first day of the second menstrual cycle to the first day of the third menstrual cycle)
|
1 month (first day of the second menstrual cycle to the first day of the third menstrual cycle)
|
Pain intensity (VAS)
Number of analgesics
The Quality of life
(Turkish version of the SF-36) scale
|
KT combined with lifestyle changes significantly improves pain reduction, quality of life and body awareness compared to lifestyle changes alone
|
Kaur 2017
|
India
|
Female students with complains of
PD,
Between 18-25 years
MVP’s
college of Physiotherapy, Nashik;
|
40
|
KT (20)
|
Connective Tissue Mobilisation (20)
|
3 days ((starts one
day before menstruation)
|
3 days (starts one
day before menstruation. The intervention
consisted of 20 minutes session)
|
Pain intensity (NRS)_
|
Both KT and connective tissue mobilization are equally effective in improving pain
|
Boguszewski 2020
|
Poland
|
Females with complaints of
pain during menstruation
NR
NR
|
44
|
Elastic K-Active® KT (16)
|
Placebo application by using an inelastic
tape (14)
No intervention (14)
|
5 days
|
5 days
5 days
|
Pain intensity (VAS)
Pain severity (modified
version of the Laitinen questionnaire)
Anxiety (Spielberger statetrait
anxiety inventory (STAI-X1)
|
Both KT and placebo application may improve menstrual pain. However, no statistically significant differences between interventions
Anxiety - significantly improved with KT compared to other groups
|
Abdelaziz
2020
|
Egypt
|
Females
with complaints of pain and cramping during menstruation
Between 14 to 20 years
Gynecological and obstetric outpatient clinic of Eltebeen central hospital
|
60
|
KT (30)
|
Pilate exercises (30)
|
Three consecutive menstruation – begins one
day before menstruation and would be remain adhered for around four to five days.
|
12 weeks: 3 days a week,
except the days of menstruation
|
Pain intensity (VAS)
Quality of life enjoyment and satisfaction (Q-LES-Q-SF)
Anxiety levels (Spielberger questionnaire (State-Trait Anxiety Inventory (STAI)
Form Y-1 and Y-2))
|
Both KT and pilate exercises were effective in improvement of pain, quality of life, and anxiety
Pilate exercises was superior to KT in terms of pain reduction, quality of life improvement and anxiety relief
|
Rodríguez 2015
|
Spain
|
Female students who suffer from PD
NR
School of Medicine from the Universidad Miguel
Hernández of Elche
|
129
|
A special elastic and hypoallergenic surgical tape (Cure Tape) (75)
|
Non-extendible meshed bandage patches (Cross
Tape) (54)
|
4-5 days from menstruation (Until pain disappears)
|
4-5 days from menstruation (Until pain disappears)
|
Pain intensity (a 10-point scale (0 = no
pain and 10 = maximum pain))
|
Cure tape application significantly improved pain and medication intake compared to placebo application
|
Celenay (2020)
|
Turkey
|
Females with PD, who were nulliparous
Between 18 to 35 years
NR
|
45
|
KT
(15)
|
Sham tape (15)
Control group (15)
|
1 month (two days a week, from the estimated day of ovulation (cycle length in days minus 14) until the next period begins)
|
1 month (two days a week, from the estimated day of ovulation (cycle length in days minus 14) until the next period begins)
1 month
|
Pain intensity (VAS)
The level of anxiety (STAI)
|
KT significantly improved pain intensity and
anxiety compared to ST application and no application
|
Yum (2017)
|
Republic of Korea
|
Female students
Between 13–15 years
Middle school located in Seoul
|
125
|
Balance taping (33)
|
Medication - 1 dose of Tylenol 500 mg
(46)
Control group (46)
|
Start - on the morning
following when they started their period
Pain intensity was measured right before the taping, as well as 1 hour, 4 hours, 8
hours, and 24 hours after
|
The medication group took only 1 dose of Tylenol 500 mg, but
midterm and final exam periods were made an exception
Pain intensity was measured right before the taping, as well as 1 hour, 4 hours, 8
hours, and 24 hours after
|
Pain intensity (VAS)
|
Balance taping significantly improved pain compared to medications
|
Lim (2013)
|
Korea
|
Unmarried, non- parous females without pathologic
findings in the pelvic cavity, whose menstrual pain
scores were five or higher on a visual analogue scale (VAS)
In their twenties and thirties
NR
|
34
|
KT (11)
|
Spiral taping (10)
Control group (13)
|
Three weeks – total six times (twice a week starting from
14 days before menstruation until its end)
|
Three weeks – total six times (twice a week starting from
14 days before menstruation until its end)
Three weeks
|
Pain intensity (VAS)
|
Both KT and spiral taping significantly improved pain relief. Kinesiotaping was more effective in pain relief
|
Abbreviations: KT, kinesiotaping; PCMC, Pimpri-Chinchwad Municipal Corporation; PD, primary dysmenorrhea; Q-LES-Q-SF, Quality of life enjoyment and satisfaction; NR, not reported, NRS, numerical rating scale; STAI-X1, (Spielberger statetrait anxiety inventory; ST, sham taping; VAS, visual analogue scale
Table 1: Characteristics and summary findings of the included studies
Study
|
PEDro scale item
|
PEDro
|
1*
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
Score
|
Abdelaziz 2020
|
Y
|
Y
|
Y
|
Y
|
N
|
N
|
N
|
Y
|
Y
|
Y
|
Y
|
7
|
Boguszewski 2020
|
N
|
Y
|
N
|
Y
|
N
|
N
|
N
|
N
|
N
|
Y
|
Y
|
4
|
Celenay 2020
|
N
|
Y
|
N
|
Y
|
N
|
N
|
N
|
Y
|
N
|
Y
|
Y
|
5
|
Dogan 2020
|
Y
|
Y
|
Y
|
Y
|
N
|
N
|
Y
|
Y
|
N
|
Y
|
Y
|
7
|
Kaur 2017
|
Y
|
Y
|
N
|
Y
|
N
|
N
|
N
|
Y
|
Y
|
Y
|
N
|
5
|
Pazare 2019
|
Y
|
Y
|
N
|
Y
|
N
|
N
|
N
|
N
|
N
|
Y
|
Y
|
4
|
Rodríguez 2015
|
Y
|
Y
|
N
|
Y
|
N
|
N
|
N
|
N
|
Y
|
Y
|
Y
|
5
|
Lim 2013
|
N
|
Y
|
N
|
Y
|
N
|
N
|
N
|
Y
|
N
|
Y
|
Y
|
5
|
Yum 2017
|
Y
|
N
|
N
|
Y
|
N
|
N
|
N
|
Y
|
N
|
Y
|
Y
|
4
|
Y: yes N:no *: Not considered for total score
1: Eligibility criteria 2: Random allocation 3: Concealed allocation 4: Baseline comparability 5: Blind subjects 6: Blind therapist 7: Blind assessor 8: Adequate follow up 9: Intention to treat analysis 10: Between group comparisons 11: Point estimates and variability
Table 2 Risk of bias evaluation of included studies
Outcome indicator
|
Type of therapeutic taping
|
Grading of evidence
|
|
|
Weak
|
Moderate
|
High
|
Pain intensity
|
Kinesio taping
|
|
X
|
|
|
Spiral taping
|
X
|
|
|
|
Balance taping
|
X
|
|
|
Anxiety
|
Kinesio taping
|
|
X
|
|
Quality of life
|
Kinesio taping
|
|
|
X
|
Table 3: Evidence summary
Effect of therapeutic taping vs no intervention
Four studies compared the effectiveness of therapeutic taping to a no-intervention control group 28-31. A total of 173 subjects either received therapeutic taping (n=85) or no intervention (n=88). Three study (n=143) reported an immediate statistically significant pain improvement in therapeutic taping groups compared to no intervention groups 29-31. The remaining study reported that there was no statistically significant difference in pain improvement among the groups within first 24 hours of treatment 28. Two studies (n=60) reported a significant improvement of anxiety with KT application compared to no intervention. The overall PEDro scores of the four studies ranged from 4 to 5.
Effect of therapeutic taping vs sham taping
Three studies (n=189) compared the effectiveness of therapeutic taping to the sham taping 28,29,32. All studies reported superior pain relief with therapeutic tape application. However, only two studies (n=159) found a statistically significant difference of pain relief when comparing therapeutic taping and sham taping 29, 32. Two studies (n= 60) reported a significant improvement of anxiety with KT application compared to sham taping 28, 29. The overall PEDro scores of the three studies ranged from 4 to 5.
Effect of therapeutic taping vs other interventions
Four studies (n=219) compared the effectiveness of therapeutic taping to other interventions (Pilates, isometric exercises, connective tissue mobilization or medication) 30, 33-35. Two studies (n= 119) reported that the therapeutic taping was more effective in pain relief among women with PD compared to other interventions 30, 33. Both studies had a PEDro score of 4. One study (n=40) reported that the kinesiotaping is similarly effective in relieving pain as connective tissue mobilization 34. One study (n=60), with a PEDro score of 7, reported that Pilates exercises provided superior improvements in pain, anxiety and quality of life compared to kinesiotaping 35.
Effect of therapeutic taping as an adjunct
One study (n= 60), with a PEDro score of 7, reported that kinesio taping with lifestyle modification is more effective in pain relief, quality of life and body awareness compared to lifestyle modification alone [36].
Meta-analysis of studies assessing the effect of taping on pain intensity of people with PD
Three studies 29, 31 ,32 provided adequate data for a meta-analysis, therefore pooled together to quantitively assess the effect of taping on pain intensity in women with PD as assessed by a visual analogue scale (VAS) scale. Given that I2 was 95%, a random effect model was used, and mean difference (MD) was chosen because all studies used a VAS to assess the pain intensity. They had investigated different types of taping as comparison (sham tape (multi-colored sports taping), non-extended tape and spiral taping). With pooled studies, 101 females with PD who were treated using taping (K-taping; n=2 and surgical taping; n=1) were compared with 82 who were treated with sham tape, non-extended tape or spiral taping. The pooled mean of those found to have decreased menstrual pain intensity among PD (pooled MD= -3.12 (95% CI -5.64 - -0.60); P=0.02; I2=95 % (Figure 3).
Adverse events
Three studies investigated potential adverse effects of taping 29,30,36. Two studies (n=60) treated with taping reported no adverse events among participants 29,36. One study (n= 33) treated with taping application has reported that two participants have experienced skin allergic reactions and one person has experience dizziness as adverse reactions 30.
Evidence summary
Kinesiotaping is effective in immediate pain relief with low level of evidence. Studies with moderate level of evidence suggests that kinesiotaping is effective in improvement of anxiety associated with PD. Studies with moderate level of evidence suggests that kinesio taping is at least effective as other therapies such as isometric exercises, connective tissue mobilization and medication.