Design
This pre post treatment trial was reported according to the recommendations of the Consolidated Standards of Reporting Trials (CONSORT) statement. [9]
Seventy patients participated in our study. Participants were randomly assigned equally to one of two groups: researched group and control group.
Qualification was based on the simple randomization (coin toss) performed by main Author. Patients assigned to the researched group underwent rehabilitation protocol including KT. The control group underwent the same protocol excluding KT.
Inclusion criteria:
- between 20 and 60 years of age
- subacromial bursitis
- tendinopathy of at least one of the rotator cuff muscle
- edema of the area of the attachment or tendon or muscle belly of at least one of the rotator cuff muscles
- signs of subacromial impingement.
Exclusion criteria:
- severe arthrosis
- complete rupture of one of the tendons of rotator cuff muscles
- injury to other muscles surrounding the shoulder (except rotator cuff)
- shoulder ligaments lesions
- surgery of the shoulder
- previous injuries to the glenohumeral joint
- injuries of the muscles surrounding shoulder joint
- neuromuscular abnormalities
- skin diseases
- drugs affecting musculoskeletal system, i.e.
Patients Written consent was obtained, and the rights of subjects were protected.
Measurements were carried out between 2017 and 2018 at the University of Physical Education in Faculty of Motor Rehabilitation, in collaboration with outpatient rehabilitation clinic.
Intervention
Rehabilitation protocol:
Rehabilitation protocol lasted 6 weeks with three 55 minutes sessions per week and was identical for both groups. Each session was conducted individually with the same physiotherapist. Each session consisted 3 parts:
Early phase (approx. 5 min.) consisted of warm up exercises, included free active exercises (with low intensity) of the upper extremities and corpus in closed kinematic chains.
Main phase (approx. 35 min.) consisted exercises in lying, sitting and standing position, includedisometrics, active exercises without external force applied, active with the external exercises, sensomotoric exercises, and Proprioceptive Neuromuscular Facilitation (PNF) exercises.
The last phase (approx. 5 min.) consisted stretching and relaxing exercises.
Methodology of Kinesio Taping method application
Patients from the researched group underwent standard rehabilitation protocol with conjunction of KT. The tapes were applied to relief tendons that had lesions. All of these patients had tapes applied to deltoid muscle. The tapes were changed every 4 days for the period of six weeks. The first application of tapes was done right after examination of the patient with Biodex System 4 dynamometer.
The technique of applying a V-shaped tape over the deltoid muscle, infraspinatus muscle and subscapularis muscle was used. The technique of applying an “I” tape to the supraspinatus muscle and teres minor muscle was used. [10]
Outcome measures
In all participants (researched and control group) the measurement of muscle force was checked twice using with Biodex System 4 dynamometer, and the clinical examination according to Cyriax protocol was also performed twice, before and at the end of rehabilitation protocol. [11]
Primary outcome: during Biodex System 4 dynamometer examination the measurements were taken in external and internal rotation, abduction and adduction in the setting of isokinetic contraction. We applied concentric – concentric protocol with the following angular velocities: 120, 180, and 240 degrees per second. During every tryout Peak Torque (PT) and ROM were measured.
During functional Cyriax examination the estimation of the degree of pain was divided into three parts and was measured using Visual Analog Scale (VAS). [12] In the first part we estimated all anatomical parts of the shoulder (three global tests). In the second part passive examination of the scapula glenoid joint was performed (three passive tests). In the last phase we performed six active test with resistance to check all the muscles of the shoulder girdle. Additionally, the measurement of three dimensional range of motion (ROM) of the shoulder joint was performed using goniometer. [13]
Statistical Analysis
Statistical analysis of the gathered data was analyzed using Statistica 10.0 (StatSoft). The total sample size was estimated through an a-priori power analysis. Following parameters were used: mean average, median, minimal and maximal values and standard deviation in relation to body mass, body weight and age of the patients. Normal values were verified with Shapiro-Wilk test. For statistical analysis we used t – Student test and U Mann – Whitney test. In all of the test the level of significance was set as p<0.05.