סקירה מחקרית של טייפינג

 

Effectiveness of Taping for Injury Prevention, Part 1

Taping is described in the literature in the treatment and prevention of several musculoskeletal conditions such as ankle sprains

(Thacker et al, 1999), patellofemoral pain (Gigante et al, 2001), wrist sprains (Rettig et al, 1997) and shoulder injuries (Kneeshaw, 2002).

Research methods include randomised controlled trials, retrospective and prospective cohort studies, biomechanical lab base studies,

correlational epidemiological studies. The scientific evidence for the effectiveness of taping for these problems is mixed, but the clinical use

of taping techniques is widespread (Macdonald, 1994).

Miller and Hergenroeder (1990) examined the effectiveness of tape versus laced ankle stabilisers and found that support provided was

equal. Each method had practical advantages and disadvantages, namely that the stabiliser could be applied by the athlete and re-tightened 

during competition; whereas the tape could be modified to the athletes preference and was better in sports which used low cut footwear

such as a soccer boot. Hopper et al (1999) undertook a similar study, examining the difference in muscle activity and joint forces during landing

when wearing an ankle brace or ankle tape. The study involved 15 elite female netball players whose landing technique was analysed using

video, force plate (to measure ground reaction force) and EMG electrodes (to measure muscle activity). The authors concluded that the

mechanics of landing were the same for both methods, but that the ankle brace altered muscular activity, though this was deemed

not to affect function.

The ankle is the most commonly taped joint in soccer (Junge et al, 2002). There are several studies which examine the effectiveness of taping

as a preventative measure. Garrick and Requa (1973) undertook a randomised controlled trial of the effects of taping on the incidence of

ankle sprain in college basketball players. Those subjects who were taped every day suffered 14.7 sprains per 1000 participant games,

compared with 32.8 sprains per 1000 participant games. A retrospective study by Rovere et al (1988) showed the injury incidence in students

with taped ankles was 4.9 ankle sprains per 1000 participant games, compared with 2.6 ankle sprains per 1000 participant games in

students wearing ankle braces. However this was another basketball study and the findings are not truly relevant to soccer as ankle braces

are generally not conducive to soccer play.

 

 

Effectiveness of Taping for Injury Prevention, Part 2

The method of action of ankle taping as a prophylactic measure is unknown. Garrick and Requa (1973) demonstrated that tape becomes looser

after only ten minutes and provides very little mechanical restraint after half an hour of competition. Garn and Newton (1998) and Karlsson

and Andreasson (1992) have hypothesised that the benefit of taping comes from enhanced proprioceptive awareness which allows the

Peroneal muscles to contract faster in a reflex response to a twisted ankle.

The type of taping technique and the choice of material used is largely based on the athletes preference, with this decision largely based on

custom, superstition and comfort (both physical and mental). A couple of common preventative ankle taping techniques are demonstrated later

within this guide.

Ankle tape is also appropriate following acute ankle sprain. As well as immobilisation, a compression bandage can help to limit swelling. Capasso

et al (1989) compared the effect of adhesive and non-adhesive tape on ankle compression using a pressure cuff. They concluded that

non-adhesive tape has to be renewed after three days, but that adhesive tape lasted 10 days. This would indicate that adhesive tape provides

more compression, but it should be remembered that too much compression compromises venous blood flow, which can be counter

productive in limiting swelling. There is an example of a compression support for an acute ankle sprain later within this guide.

In the mid eighties Australian physiotherapists advocated taping as a major component of the management of anterior knee pain.

The reasoning behind this approach was that it improved patellofemoral mechanics and altered muscle imbalances around the knee.

The evidence for this was largely anecdotal (the original research by McConnell (1986) did not contain a control group and there was no

objective measure of improvement), but the technique has enjoyed widespread use. More recently more rigorous studies (Kowall et al 1996)

have found no evidence to support the use of patellofemoral taping, as their randomised controlled trial found that taping did not enhance a

standard physiotherapy treatment program without taping. Further research by Gigante et al (2001) using a CT scan to assess

patellofemoral mechanics showed that patella taping didn't affect patella orientation and concluded that this approach doesn't improve anterior

knee pain by changing patella position. Recently more theories from 'down under' advocate the use of tape to offload injured muscles - but

we find that rest is the best method to offload damaged muscles.

Another taping technique that is commonly used by athletes, including elite level footballers is a 'clasp' over the patella tendon. This can be

seen in several high profile soccer players, although it is unclear whether they are over their symptoms and simply wear the tape as a

superstitious pre-match ritual. The reasoning behind this tape job is to compress the patella tendon thus restricting the force that can be

exerted through it. Although the theory has very good face validity it is very difficult to provide objective evidence to support this technique,

either clinically or in biomechanical studies.