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Therapeutic knee taping improved pain and disability in osteoarthritis of the knee
  1. David Hunter, MD, PhD,
  2. David Felson, MD, MPH
  1. Boston University School of Medicine
 Boston, Massachusetts, USA

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 Q In patients with osteoarthritis (OA) of the knee, does therapeutic knee taping (TKT) reduce pain and disability?

    Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Rheumatology ★★★★★☆☆

    METHODS

    Embedded ImageDesign:

    randomised controlled trial.

    Embedded ImageAllocation:

    not concealed.*

    Embedded ImageBlinding:

    patients and outcome assessors.*

    Embedded ImageFollow up period:

    3 weeks each of intervention and follow up.

    Embedded ImageSetting:

    metropolitan private practices and a university laboratory in Melbourne, Victoria, Australia.

    Embedded ImagePatients:

    87 patients (mean age 69 y, 66% women) who met the American College of Rheumatology criteria for OA of the knee. Exclusion criteria included allergy to tape, history of joint replacement, body mass index >38 kg/m2, and rheumatoid arthritis.

    Embedded ImageIntervention:

    29 patients each were allocated to TKT, control tape, or no tape. The tape was worn for 3 weeks and reapplied weekly. TKT provided medial glide, medial tilt, and anteroposterior tilt to the patella. Control tape aimed to provide sensory input only. Patients in the no tape group received no intervention.

    Embedded ImageOutcomes:

    change from baseline in pain (0–10 cm visual analogue scale) assessed at 3 and 6 weeks, and patient perceived rating of change (1–5 Likert scale) assessed at 3 weeks. Patients with a Likert scale score of 4 or 5 were classified as improved.

    Embedded ImagePatient follow up:

    follow up was 99%.

    MAIN RESULTS

    Analysis was by intention to treat. The table shows the 3-week results. At 6 weeks, reduction in pain on worst activity was greater in the TKT group than in the no tape or control group (p<0.05 for both), whereas reduction in pain on movement was only greater in the TKT group than in the no tape group (p<0.05).

    CONCLUSION

    In patients with osteoarthritis of the knee, therapeutic knee taping improved pain and disability.

    Commentary

    Because no cure for OA exists, treatments focus on managing symptoms so that individuals can maintain reasonable functional capabilities. The overwhelming preponderance of treatments evaluated for OA are drugs (60% of treatment studies) or surgical procedures (26%), with a remarkable neglect of physical treatment methods.1

    The randomised controlled trial by Hinman et al highlights the importance of the patellofemoral joint as source of symptoms in knee OA. Although the American College of Rheumatology recommended taping osteoarthritic knees for years before this trial, evidence to show that it works in reducing pain has been minimal.

    This study shows that TKT reduces pain and disability in patients with knee OA. The influence of the tape may “unload” the lateral patellofemoral joint where pathology and resultant symptoms predominate. The beneficial effects were maintained 3 weeks after the treatment was stopped. The magnitude of the treatment effect of taping was that of drug therapies and exercise programmes.

    The treatment was well tolerated and safe. 28% of patients in the TKT group compared with 1 patient (3%) in the control tape group reported minor skin irritation. Even so, all participants continued to wear their tape for 3 weeks.

    Some study limitations exist: Firstly, the TKT group had greater pain scores at baseline, raising concerns about imbalanced randomisation of participants. Secondly, because the treating therapist could influence by verbal suggestion the subjective outcome of pain, blinding may not have been optimal. Thirdly, a number of potential concerns with wider generalisability and application of the results exist. It should be noted that the tape was applied by physical therapists trained in assessment and application of this technique, and the Australian population studied was not as obese as many OA patient groups in the US. However, TKT may offer a simple and effective self management strategy for knee OA.

    References

    Therapeutic knee taping (TKT) v control tape (CTP) or no tape (NTP) in osteoarthritis of the knee at 3 weeks*

    
 
 Q In patients with osteoarthritis (OA) of the knee, does therapeutic knee taping (TKT) reduce pain and disability?

    Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Rheumatology ★★★★★☆☆

    View Abstract

    Footnotes

    • * See glossary

    • Abstract and commentary also appear in ACP Journal Club.

    • For correspondence: Dr R S Hinman, University of Melbourne, Melbourne, Victoria, Australia. ranashunimelb.edu.au

    • Sources of funding: National Health and Medical Research Council and Australia New Zealand Charitable Trusts.

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