Tips from Other Journals

Knee Taping Benefits Patients with Knee Osteoarthritis

Am Fam Physician. 2004 Mar 1;69(5):1257-1259.

Although knee taping is widely recommended to relieve symptoms of osteoarthritis of the knee, little scientific evidence has been presented to justify its use. Hinman and colleagues conducted a randomized controlled trial of therapeutic taping in patients with significant pain from osteoarthritis of the knee.

Newspaper advertisements were used to recruit volunteers 50 years or older with knee pain. Participants were required to have evidence of osteophytes but no other cause for knee pain. Other exclusions included obesity (body mass index greater than 38), history of knee injection or surgery, and skin conditions that contraindicated the use of adhesive tape. Twelve physical therapists were trained to tape the knee so that the upper tape provided medial glide, medial tilt, and anteroposterior patellar tilt, whereas the lower tape unloaded the infrapatellar fat pad or pes anserinus. The study involved 87 patients who were randomly assigned to one of three groups: therapeutic taping, control taping that provided only sensory input, or no taping. All participants were asked to continue current pain remedies for osteoarthritis but not to start using any new remedies during the study. Participants recorded daily analgesic use in a diary and rated the severity of pain weekly using visual analog scores. Pain and disability from osteoarthritis also were monitored using standardized scales.

Three Interventions for Treatment of Knee Pain Caused by Osteoarthritis

Patient characteristic No tape, n = 29 (%) Control tape, n = 29 (%) Therapeutic n = 29 (%)

Mean (SD) age (years)

69 (9)

71 (8)

66 (8)

Mean (SD) height (m)

1.64 (0.01)

1.64 (0.09)

1.64 (0.01)

Mean (SD) weight (kg)

81.1 (13.4)

78.8 (16.4)

79.1 (10.8)

Mean (SD) body mass index (kg per m2)

30.1 (4.0)

29.3 (4.9)

29.3 (4.0)

Mean (SD) duration of symptoms (years)

9 (11)

9 (10)

9 (8)

Men

10 (34)

10 (34)

10 (34)

Women

19 (66)

19 (66)

19 (66)

Radiographic severity*

Grade I/II

7 (24)

9 (31)

9 (30)

Grade III/IV

22 (76)

20 (69)

20 (70)

Presence of osteophytes in patellofemoral joint

23 (79)

23 (79)

21 (72)

Narrowing of patellofemoral joint

10 (35)

5 (17)

6 (21)


*—Kellgren and Lawrence grading system: higher grade indicates more severe disease. (See Kellgren J II, Jeffrey MR, Ball J.

The epidemiology of chronic rheumatism: atlas of standard radiographs. Oxford: Blackwell Scientific, 1963.)

Adapted with permission from Hinman RS, Crossley KM, McConnell J, Bennell KL. Efficacy of knee tape in the management of osteoarthritis of the knee: blinded randomised controlled trial. BMJ 2003;327:137.

Three Interventions for Treatment of Knee Pain Caused by Osteoarthritis

View Table

Three Interventions for Treatment of Knee Pain Caused by Osteoarthritis

Patient characteristic No tape, n = 29 (%) Control tape, n = 29 (%) Therapeutic n = 29 (%)

Mean (SD) age (years)

69 (9)

71 (8)

66 (8)

Mean (SD) height (m)

1.64 (0.01)

1.64 (0.09)

1.64 (0.01)

Mean (SD) weight (kg)

81.1 (13.4)

78.8 (16.4)

79.1 (10.8)

Mean (SD) body mass index (kg per m2)

30.1 (4.0)

29.3 (4.9)

29.3 (4.0)

Mean (SD) duration of symptoms (years)

9 (11)

9 (10)

9 (8)

Men

10 (34)

10 (34)

10 (34)

Women

19 (66)

19 (66)

19 (66)

Radiographic severity*

Grade I/II

7 (24)

9 (31)

9 (30)

Grade III/IV

22 (76)

20 (69)

20 (70)

Presence of osteophytes in patellofemoral joint

23 (79)

23 (79)

21 (72)

Narrowing of patellofemoral joint

10 (35)

5 (17)

6 (21)


*—Kellgren and Lawrence grading system: higher grade indicates more severe disease. (See Kellgren J II, Jeffrey MR, Ball J.

The epidemiology of chronic rheumatism: atlas of standard radiographs. Oxford: Blackwell Scientific, 1963.)

Adapted with permission from Hinman RS, Crossley KM, McConnell J, Bennell KL. Efficacy of knee tape in the management of osteoarthritis of the knee: blinded randomised controlled trial. BMJ 2003;327:137.

The 29 participants assigned to each of the groups were comparable in all relevant variables. Follow-up was complete in all but one participant. The group treated with therapeutic taping showed a significantly greater reduction in pain and disability after three weeks of treatment than the control and no-intervention groups (see accompanying table). This improvement was sustained three weeks after treatment had been discontinued. The therapeutic tape group was seven times more likely than the untreated group to report improved pain. The number needed to treat was two. Therapeutic taping also was associated with significant improvements in disability and other secondary measures. All participants in the taping groups continued to use the tape for the three weeks of the study, although nine participants reported minor skin irritation. Analgesic use did not differ among groups during the taping period.

The authors conclude that therapeutic taping applied weekly for three consecutive weeks was associated with significant reductions in pain and disability in patients with osteoarthritis of the knee. The improvements were sustained for at least three weeks after discontinuing the taping. Although the mechanism of action is unclear, subtle changes in the distribution of patellofemoral joint pressures may reduce strain on vulnerable tissues or improve proprioceptive acuity, quadriceps strength, and neuromotor control of the knee.

Hinman RS, et al. Efficacy of knee tape in the management of osteoarthritis of the knee: blinded randomised controlled trial. BMJ. July 19, 2003;327:135–8.


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