Abstract
Context: Nonoperative treatment of patellofemoral dysfunction (PFD) is commonly considered the typical standard of care for symptomatic patients. Previous research has shown that patellofemoral taping techniques improve quadriceps function and pain. However, limited evidence exists comparing the effectiveness of different taping techniques.
Objective: To compare dynamic balance, pain and neuromuscular responses in physically active patients diagnosed with acute unilateral PFD after undergoing two different therapeutic taping techniques. We hypothesized that taping conditions would yield improved outcomes compared to no tape.
Design: Retrospective cohort (2b evidence).
Setting: Controlled laboratory.
Patients or Other Participants: Twenty (7 men and 13 women) patients (age = 21.2 ± 2.9 years, height = 1.69 ± 0.2m, mass = 68.11 ± 11.6kg, Tegner = 6.25 ± 1.3, Kujala = 78.9 ± 9.38). Patients with history of traumatic injury to either lower extremity were excluded.
Interventions: Patients underwent one bilateral baseline testing session and two unilateral taping (McConnell medial glide and NUCAP Medical Upper Knee Spider®) sessions. Forty-eight hours separated sessions. Randomization was used to prevent order effects.
Main Outcome Measures: Knee taping condition was the independent variable. Dependent variables included single-leg balance reach distances as well as pain and quadriceps neuromuscular activity during the balance task. Reach distances were normalized to leg-length (% LL). Pain was gauged via a standard visual analog scale measured in centimeters (cm). Quadriceps neuromuscular activity was normalized to maximal volitional isometric contraction (%MVIC). Onetail paired t-tests were calculated to determine bilateral baseline statistically significant differences. Oneway analyses of variance with Tukey’s post hoc test was calculated to determine statistically significant differences among knee conditions (baseline, McConnell and Spider®) for the involved leg. P ≤ 0.05 denoted statistical significance.
Results: Data met assumptions for statistical analyses. Lesser baseline reach distances were recorded for the involved (72.14 ± 6.0 %LL) compared to uninvolved (74.14 ± 6.0 %LL) leg (P =0.014). Patients displayed increased reach distances with the involved leg under McConnell (75.65 ± 7.3 %LL, P =0.002) and Spider® (75.39 ± 6.5 %LL, P = 0.005) conditions compared to baseline (72.14 ± 6.0 %LL). Pain also decreased under McConnell (1.16 ± 1.2cm,P = 0.001) and Spider® (1.04 ± 1.03cm, P = 0.001) conditions compared to baseline (1.95 ± 1.4cm). Vastus medialis activation increased under the McConnell condition (17.63 ± 7.6 %MVIC) compared to baseline (14.68 ± 7.8 %MVIC, P =0.015). Furthermore, there was a difference in vastus medialis activation between McConnell (17.63 ± 7.6 %MVIC) and Spider® (14.36 ± 8.2 %MVIC) condition (P=0.026). Other comparisons were statistically insignificant.
Conclusion: Our findings suggest both McConnell and Spider® taping techniques improve outcome measures in acute PFD patients. However, further research is warranted to investigate the efficacy of such interventions.
Objective: To compare dynamic balance, pain and neuromuscular responses in physically active patients diagnosed with acute unilateral PFD after undergoing two different therapeutic taping techniques. We hypothesized that taping conditions would yield improved outcomes compared to no tape.
Design: Retrospective cohort (2b evidence).
Setting: Controlled laboratory.
Patients or Other Participants: Twenty (7 men and 13 women) patients (age = 21.2 ± 2.9 years, height = 1.69 ± 0.2m, mass = 68.11 ± 11.6kg, Tegner = 6.25 ± 1.3, Kujala = 78.9 ± 9.38). Patients with history of traumatic injury to either lower extremity were excluded.
Interventions: Patients underwent one bilateral baseline testing session and two unilateral taping (McConnell medial glide and NUCAP Medical Upper Knee Spider®) sessions. Forty-eight hours separated sessions. Randomization was used to prevent order effects.
Main Outcome Measures: Knee taping condition was the independent variable. Dependent variables included single-leg balance reach distances as well as pain and quadriceps neuromuscular activity during the balance task. Reach distances were normalized to leg-length (% LL). Pain was gauged via a standard visual analog scale measured in centimeters (cm). Quadriceps neuromuscular activity was normalized to maximal volitional isometric contraction (%MVIC). Onetail paired t-tests were calculated to determine bilateral baseline statistically significant differences. Oneway analyses of variance with Tukey’s post hoc test was calculated to determine statistically significant differences among knee conditions (baseline, McConnell and Spider®) for the involved leg. P ≤ 0.05 denoted statistical significance.
Results: Data met assumptions for statistical analyses. Lesser baseline reach distances were recorded for the involved (72.14 ± 6.0 %LL) compared to uninvolved (74.14 ± 6.0 %LL) leg (P =0.014). Patients displayed increased reach distances with the involved leg under McConnell (75.65 ± 7.3 %LL, P =0.002) and Spider® (75.39 ± 6.5 %LL, P = 0.005) conditions compared to baseline (72.14 ± 6.0 %LL). Pain also decreased under McConnell (1.16 ± 1.2cm,P = 0.001) and Spider® (1.04 ± 1.03cm, P = 0.001) conditions compared to baseline (1.95 ± 1.4cm). Vastus medialis activation increased under the McConnell condition (17.63 ± 7.6 %MVIC) compared to baseline (14.68 ± 7.8 %MVIC, P =0.015). Furthermore, there was a difference in vastus medialis activation between McConnell (17.63 ± 7.6 %MVIC) and Spider® (14.36 ± 8.2 %MVIC) condition (P=0.026). Other comparisons were statistically insignificant.
Conclusion: Our findings suggest both McConnell and Spider® taping techniques improve outcome measures in acute PFD patients. However, further research is warranted to investigate the efficacy of such interventions.
| Original language | English (US) |
|---|---|
| Pages (from-to) | S148 |
| Journal | Journal of Athletic Training |
| Volume | 47 |
| Issue number | 3, Supplement |
| State | Published - Jun 2012 |