Physical and well-being effect of scapular kinesio taping combined with conventional physiotherapy in shoulder impingement syndrome: A randomized controlled study

Abstract

BACKGROUND:

Kinesio taping (KT) is one of the treatment methods used on patients with shoulder impingement syndrome (SIS). There are different results regarding its effectiveness in the literature.

OBJECTIVE:

To investigate the effects of scapular KT combined with a conventional physiotherapy program on scapular dyskinesia, shoulder pain, upper extremity function, and well-being in patients with SIS.

METHODS:

The study was conducted with 60 outpatients diagnosed with SIS, aged 40–65 years. The patients were divided into two groups: KT [conventional physiotherapy program $+$ scapular KT (targets scapular retraction and is applied along the inferior-medial edge of the scapula, starting from the processus coracoids), $n=$ 30] and control [conventional physiotherapy program, $n=$ 30]. In before- and after-treatment evaluations, the Lateral Scapular Slide Test (LSST) for scapular dyskinesia, a Visual Analogue Scale (VAS) for shoulder pain, and the Disabilities of the Arm, Shoulder, and Hand (DASH) for upper extremity function were used. In addition, at the end of treatment, a Kinesio taping Satisfaction Survey, created by the researchers, was filled out by the KT group for the assessment of well-being.

RESULTS:

The interaction effect of Group*Time was not statistically significant in all outcome measures ( $p>$ 0.05). However, the main effect of both group and time was statistically significant in the DASH-Function/Symptom, VAS-Rest, VAS-Activity, and VAS-Night ( $p<$ 0.05). Moreover, only the main effect of time was statistically significant in LSST-1 and LSST-3 ( $p<$ 0.05). In the KT group, the satisfaction level was 8.50 $\pm$ 1.69 and the recommendation level was 8.72 $\pm$ 1.81.

CONCLUSION:

Both conventional physiotherapy programs and additional scapular KT improved scapular dyskinesia, reduced pain, and increased the upper extremity function. Adding scapular KT to treatment did not change the results, but it had positive psychological effects and yielded a high satisfaction rate.

Keywords

Kinesio taping pain scapula shoulder impingement syndrome upper extremity

1. Introduction

Shoulder impingement syndrome (SIS) is one of the most common causes of musculoskeletal shoulder pain [1]. SIS has been associated with altered scapular movement and muscle activity. The scapula plays an important role in almost every aspect of normal shoulder function. Scapular dyskinesia – altered scapular position and movement – is found with most shoulder injuries [2]. Changing scapular motion or position reduces linear measurements of the subacromial space, decreases rotator cuff strength, increases tension in anterior ligaments, and increases the risk of internal impingement [3]. Identification of kinematic and muscle activity disorders related to scapular dyskinesia in a patient with SIS may provide important information for treatment [4]. Therefore, the evaluation of the scapula is thought to be necessary for the detection of SIS symptoms.

Combined treatment methods with exercise are recommended in patients with SIS. One of these recommended treatment methods is Kinesio taping (KT) [5]. Elastic, water-resistant, and chemical-free KT presents various positive results such as reducing pain and edema, increasing blood circulation, increasing joint position sense and kinesthetic awareness, improving scar tissue, increasing joint range of motion and flexibility, and repositioning the muscles, fascias, and joints [6, 7]. In the literature, while it has been shown that KT does not affect shoulder strength, shoulder proprioception, shoulder function, and scapular kinematics [8, 9], it has been reported to improve acromiohumeral distance, shoulder rotator strength, and joint range of motion [10, 11]. Although KT and physical therapy cause similar effects in SIS patients, KT application provides significant benefits in treatment [12]. According to a randomized controlled study by Letafatkar et al. [10], adding KT to therapeutic exercise provides more advantages to reducing pain and disability and improving shoulder kinematics in patients with SIS and adding KT to therapeutic exercise could clinically reduce pain and disability resulting in shoulder kinematics improvement. Also, according to the systematic review clinical taping in addition to physiotherapy interventions (e.g. exercise, electrotherapy, and manual therapy) might be an optional modality for managing patients with SIS, especially for the initial stage of the treatment [13].

There are studies in the literature in which KT is applied via different techniques in patients with SIS. It has been observed that KT is frequently applied to the deltoid and supraspinatus muscles [12, 14]. However, considering the importance of improving scapular dyskinesia in patients with SIS [4], it is thought that KT applications that support scapular kinematics will be beneficial. Although there are KT applications to improve scapular dyskinesia in the literature [10, 15], to the best of our knowledge, there is no study in which KT-targeting scapular retraction is applied in addition to conventional physiotherapy. Therefore, our study aimed to evaluate the effects of scapular KT applied in combination with a conventional physiotherapy program on scapular dyskinesia, shoulder pain, upper extremity function, and well-being.

Figure 1.

CONSORT flow diagram of the study.

2. Methods

2.1 Design and sample of the study

The study was conducted as a randomized controlled single-blind design according to the Consolidated Standards of Reporting Trials (CONSORT) at Bandirma Training and Research Hospital between September 2021 and April 2022. 66 patients diagnosed with SIS and approved for outpatient treatment by the specialist physician in the Department of Physical Therapy and Rehabilitation were evaluated, and 60 patients aged 40–65 were included (Fig. 1). In both groups, those who did not accept to participate in the study, who had a surgical operation involving the shoulder or neck region, those with systemic rheumatic disease, those with other shoulder-related pathologies such as frozen shoulder, shoulder dislocation, rotator cuff tear, fracture, those with cervical spine problem(s) (such as cervical disc herniation, thoracic outlet syndrome), and those with neurological problems were excluded. In the KT group, those with open wounds that would prevent KT were allergic to KT, or could not tolerate KT were excluded from the study.

The patients participating in the study were randomly divided into the KT group ( $n=$ 30) and control group ( $n=$ 30) using the closed-envelope method. Allocation was implemented using a numbered series of 60 prefilled envelopes specifying group assignments, which had been previously generated by the statistician using a computer-based program (Fig. 1). Before starting the study, all participants were informed about the content of the study and their verbal and written consent was obtained. Participants filled out the Patient Demographic Information Form before the treatment. Scapular dyskinesia was evaluated with the Lateral Scapular Slide Test (LSST), shoulder pain was evaluated with the Visual Analogue Scale (VAS), and upper extremity function was evaluated by the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire by one of the researchers (G.Y.G). The conventional physiotherapy program consisting of 10 sessions of electrotherapy (20 min infrared, 5 min ultrasound, 20 min TENS) and Codman and posture exercises were applied in both groups by the physiotherapist working in the Physical Therapy Department of the hospital every weekday (5 days) for 2 weeks. While only the conventional physiotherapy program was applied in the control group, scapular KT was applied in the KT group in addition to the conventional physiotherapy program by a researcher (S.K). For scapular KT targeting scapular retraction, the participants’ shoulders were passively retracted and KT was applied along the inferior-medial edge of the scapula, starting from the coracoid process and passing over the acromion [16], with the 75% suggested tension for joint repositioning [17]. Until the end of the conventional physiotherapy program, it was applied 3 times at 4-day intervals for 2 weeks. Since the area where the KT was applied did not overlap the area where the electrotherapy agents were applied, the KT was not removed during the sessions. At the end of the 10th session, when the treatment of the patients ended, the initial evaluations were repeated (G.Y.G).

This study was approved by Banırma Onyedi Eylul University Health Sciences Non-nterventional Research Ethics Committee (Ethics Committee No. 2019-04-01) and conducted according to the principles of the Declaration of Helsinki.

2.2 Outcome measures

2.2.1 Disabilities of the arm shoulder and hand (DASH) questionnaire

The DASH questionnaire developed by the American Academy of Orthopedic Surgeons (AAOS) evaluates function and disability in upper extremity injuries [18, 19] and its Turkish validity and reliability study was performed by Düger et al. [20]. The first part [(DASH-Function/Symptom (DASH-FS)], which includes items related to difficulties in daily living activities, symptoms, work, sleep, and self-confidence, consists of 30 items. The Work Module, which evaluates the disability of the patient in work life, consists of 4 items, and the Sport/Performing Arts Module, which evaluates the disability level of the patients who play sports or a musical instrument, consists of 4 items. A high score from the DASH survey result indicates a high level of disability [20].

2.2.2 Lateral scapular slide test (LSST)

The LSST is a test that evaluates scapular dyskinesia in the static position [21, 22]. This test is carried out in three positions as described by Kibler: arm free at the side of the trunk (position 1), hands on the hips and shoulder extension approximately 10 ${}^{\circ}$ (position 2), and in the arm elevation position of 90 ${}^{\circ}$ or less with maximum internal rotation at the shoulder joint (position 3). The original criterion used by Kibler for positive LSST was defined as a bilateral difference of “more than 1 cm” in the scapular distance, and then, this threshold was changed by Kibler to a difference of greater than 1.5 cm [23].

2.2.3 Visual analog scale (VAS)

The VAS, which is generally used to evaluate the individual’s pain intensity in the last 24 hours or momentarily, is scored in the range of 0–100 mm, where 0 means no pain and 100 mm means unbearable pain. By asking the individual to mark the severity of their pain on the scale, the distance marked by the individual is calculated with the help of a ruler starting from the starting point of zero [24].

2.2.4 Kinesio taping satisfaction survey

The questionnaire includes three questions created by the researchers: Question 1: “How many points would you give for your satisfaction level with KT?”, Question 2: “How many points would you give if you wanted to recommend KT to patients with the same problem as yours?”, and Question 3: “How do you think KT benefits you?”. For the 1st and 2nd questions, a 10-point Likert-type scale scored between 0 and 10 was used in the evaluation. The higher the score, the higher the satisfaction and recommendation. The third question was an open-ended question and the patient’s comments were recorded.

2.3 Statistical analysis

Based on the results of a previous study on scapular dyskinesia [25], it was determined that 20 patients were required in each of the KT and control groups (a total of 40 patients), taking into account a 10% dropout rate, to detect at least 1.5 cm deviation in scapular dyskinesia asymmetry with 80% power and 95% confidence interval (CI). At the end of the study, in the power analysis made according to the DASH-FS outcome measure, the power of the study was found to be 86% with a CI of 95%. IBM SPSS Statistics 23 (IBM Corp., Armonk, NY, USA) analysis program was used for statistical analysis. For descriptive statistics, numerical variables were evaluated with mean $\pm$ standard deviation (SD) if they met the parametric assumption. If not, it was evaluated with median and minimum (min)-maximum (max) values. Categorical variables are given as frequency ( $n$ ) and percentage (%). The Chi-square test was used to compare categorical variables.

Skewness-Kurtosis values were used to evaluate the assumption of normal distribution of the data and $\pm$ 2 was taken as an extreme value. Independent samples t test was used to compare two independent groups in terms of baseline values of the outcome measures (DASH, LSST, VAS). Since there were repeated measurements (pre- and post-treatment) and two independent groups (KT and control group) in the study, both within and between subjects analyses and Two-Way Mixed Model ANOVA were performed. In the Two-Way Mixed Model ANOVA, F (Two-Way Mixed Model ANOVA value), p (significance level) and $\eta$ 2 (effect size-partial eta squared) values were presented. For the interpretation of $\eta$ 2 values, 0.0099, 0.0588, and 0.1379 were taken as small, medium and large effects, respectively All data were analyzed for the effect of ’intention to treat ITT’. The ITT analysis included all participants, including those who did not fit well and those with missing outcome data. $p<$ 0.05 was considered statistically significant.

Table 1
Demographic characteristics of the groups

		KT group ( $n=$ 30)		Control group ( $n=$ 30)
		Mean $\pm$ SD		Mean $\pm$ SD		$p$ ${}^{t}$
Age (year)		56.33 $\pm$ 6.89		61.03 $\pm$ 9.26		0.030 ${}^{*}$
		Median (min-max)		Median (min-max)		$p$ ${}^{\text{Z}}$
BMI (kg/m ${}^{2}$ )		27.99 (19.63–37.33)		28.04 (20.58–51.40)		0.217
		$n$	%	$n$	%	$p$ ${}^{\text{x2}}$
Gender	Female	22	73.3	24	80	0.542
	Male	8	26.7	6	20
	Total	30	100	30	100

${}^{*}p<$ 0.05. SD: Standard deviation, Min: Minimum, Max: Maximum, $n$ : Frequency, $t$ : Independent Sample, $t$ Test, $Z$ : Mann-Whitney U test, x2: Chi-square test, KT: Kinesio taping, BMI: Body Mass Index.

Table 2

Comparison of DASH, VAS, LSST outcome measures between groups in terms of baseline values

	KT group ( $n=$ 30) Mean $\pm$ SD	Control group ( $n=$ 30) Mean $\pm$ SD	$p^{\text{a}}$
DASH-FS	32.87 $\pm$ 25.83	43.08 $\pm$ 19.48	0.089
DASH-Work Model	26.93 $\pm$ 23.01	32.98 $\pm$ 25.83	0.342
LLST-1	1.09 $\pm$ 0.99	1.43 $\pm$ 0.97	0.188
LLST-2	0.91 $\pm$ 0.64	1.00 $\pm$ 0.82	0.658
LLST-3	0.89 $\pm$ 0.79	1.28 $\pm$ 1.13	0.134
VAS-Rest	23.58 $\pm$ 23.36	37.50 $\pm$ 23.72	0.026 ${}^{\#}$
VAS-Activity	45.79 $\pm$ 28.27	61.05 $\pm$ 23.00	0.025 ${}^{\#}$
VAS-Night	46.76 $\pm$ 32.45	57.86 $\pm$ 31.98	0.187

SD: Standard deviation, KT: Kinesio taping, DASH: Disabilities of The Arm Shoulder and Hand Questionnaire, LSST: Lateral Scapular Slide Test, VAS: Visual Analog Scale, $p$ : Significance level, ${}^{{\#}}$ $p<$ 0.05, ${}^{\text{a}}$ Independent samples $t$ test.

3. Results

For the study, 76 patients were examined. Patients who were deemed unsuitable to receive a 10-session conventional physiotherapy program for their treatment ( $n=$ 10), who did not meet the inclusion criteria ( $n=$ 3), and who did not agree to participate in the study ( $n=$ 3) were excluded from the study. A total of 60 patients were included in the study. Five people from the KT group and one person from the control group did not complete the study (Fig. 1). In terms of the demographic characteristics of the participants, the mean age of the KT group was lower than that of the control group ( $p=$ 0.030). There was no statistically significant difference between the groups in terms of Body Mass Index (BMI) and gender ( $p>$ 0.05) (Table 1).

Table 3
Comparison of means of DASH, VAS and LSST outcome measures according to groups and measurement times

DASH-FS	KT group ( $n=$ 30) Mean $\pm$ SD	Control group ( $n=$ 30) Mean $\pm$ SD	Between subjects (Group)	Within-subjects (Time)	Group*Time
1st measurement	32.87 $\pm$ 25.83	43.08 $\pm$ 19.48	F: 5.162	F: 41.523	F: 0.387
2nd measurement	17.56 $\pm$ 10.43	24.50 $\pm$ 10.68	$p$ : 0.027 ${}^{\#}$ $\eta^{2}$ : 0.082	$p$ : $<$ 0.001 ${}^{\#}$ $\eta^{2}$ : 0.417	$p$ : 0.536 $\eta^{2}$ : 0.007
DASH-work model
1st measurement	26.93 $\pm$ 23.01	32.98 $\pm$ 25.83	F: 1.818	F: 0.697	F: 0.116
2nd measurement	24.25 $\pm$ 14.39	31.86 $\pm$ 21.17	$p$ : 0.183 $\eta^{2}$ : 0.030	$p$ : 0.407 $\eta^{2}$ : 0.012	$p$ : 0.734 $\eta^{2}$ : 0.002
LLST-1
1st measurement	1.09 $\pm$ 0.99	1.43 $\pm$ 0.97	F: 2.243	F: 32.633	F: 0.406
2nd measurement	0.48 $\pm$ 0.49	0.66 $\pm$ 0.72	$p$ : 0.140 $\eta^{2}$ : 0.037	$p$ : $<$ 0.001 ${}^{\#}$ $\eta^{2}$ : 0.360	$p$ : 0.526 $\eta^{2}$ : 0.007
LSST-2
1st measurement	0.91 $\pm$ 0.64	1.00 $\pm$ 0.82	F: 0.024	F: 1.410	F: 0.177
2nd measurement	0.80 $\pm$ 0.97	0.77 $\pm$ 0.89	$p$ : 0.877 $\eta^{2}$ : 0.000	$p$ : 0.240 $\eta^{2}$ : 0.024	$p$ : 0.675 $\eta^{2}$ : 0.003
LSST-3
1st measurement	0.89 $\pm$ 0.79	1.28 $\pm$ 1.13	F: 1.750	F: 4.157	F: 0.884
2nd measurement	0.74 $\pm$ 0.80	0.86 $\pm$ 0.90	$p$ : 0.191 $\eta^{2}$ : 0.029	$p$ : 0.046 ${}^{\#}$ $\eta^{2}$ : 0.067	$p$ : 0.351 $\eta^{2}$ : 0.015
VAS-Rest
1st measurement	23.58 $\pm$ 23.36	37.50 $\pm$ 23.72	F: 4.863	F: 14.354	F: 1.457
2nd measurement	16.39 $\pm$ 19.32	23.61 $\pm$ 18.99	$p$ : 0.031 ${}^{\#}$ $\eta^{2}$ : 0.077	$p$ : $<$ 0.001 ${}^{\#}$ $\eta^{2}$ : 0.198	$p$ : 0.232 $\eta^{2}$ : 0.024
VAS-activity
1st measurement	45.79 $\pm$ 28.27	61.05 $\pm$ 23.00	F: 9.922	F: 25.469	F: 0.013
2nd measurement	28.44 $\pm$ 18.35	42.91 $\pm$ 20.34	$p$ : 0.003 ${}^{\#}$ $\eta^{2}$ : 0.146	$p$ : $<$ 0.001 ${}^{\#}$ $\eta^{2}$ : 0.305	$p$ : 0.910 $\eta^{2}$ : 0.000
VAS-night
1st measurement	46.76 $\pm$ 32.45	57.86 $\pm$ 31.98	F: 4.046	F: 31.781	F: 0.304
2nd measurement	25.50 $\pm$ 19.88	40.39 $\pm$ 27.27	$p$ : 0.049 ${}^{\#}$ $\eta^{2}$ : 0.065	$p$ : $<$ 0.001 ${}^{\#}$ $\eta^{2}$ : 0.354	$p$ : 0.584 $\eta^{2}$ : 0.005

SD: Standard deviation, KT: Kinesio taping, DASH: Disabilities of The Arm Shoulder and Hand Questionnaire, LSST: Lateral Scapular Slide Test, VAS: Visual Analog Scale, F: Two-Way Mixed Model ANOVA value, $p$ : Significance level, ${}^{\#}p<$ 0.05, $\eta$ 2: Partial effect size.

The comparison of DASH, LSST, VAS outcome measures between the groups in terms of baseline values is shown in Table 2. There was no statistically significant difference ( $p>$ 0.05) except for VAS-Rest and VAS-Activity (0.026, 0.025, respectively).

According to Two-Way Mixed Model ANOVA results, it was found that the interaction effect of Group*Time was not statistically significant in all outcome measures ( $p>$ 0.05). However, the main effect of both group and time was statistically significant in the DASH-FS, VAS-Rest, VAS-Activity, and VAS-Night ( $p<$ 0.05). Moreover, only the main effect of time was statistically significant in LSST-1 and LSST-3 ( $p<$ 0.05). The main effect of time for DASH-FS, LSST-1, VAS-Rest and VAS-Night ( $\eta$ 2 $=$ 0.417, 0.360, 0.198, 0.354, respectively) and the main effect of both group and time for VAS-Activity ( $\eta$ 2 $=$ 0.146, 0.305, respectively) had large effect size. In addition, the main effect of group for DASH-FS, VAS-Rest, VAS-Night $\eta$ 2 $=$ 0.082, 0.077, 0.065, respectively) and the main effect of time for LSST-3 ( $\eta$ 2 $=$ 0.067) had medium-large effect sizes (Table 3).

According to the KT satisfaction and recommendation results of the patients who underwent KT, the satisfaction level was 8.50 $\pm$ 1.69 and the recommendation level was 8.72 $\pm$ 1.81. In general, the patients stated that KT reduced their pain, improved their posture, relaxed their muscles, gave a sense of security, and supported their bodies.

4. Discussion

In this randomized controlled single-blind study, the effects of scapular KT applied in addition to a 10-session conventional physiotherapy program on scapular dyskinesia, shoulder pain, and upper extremity function were investigated in patients with SIS. Based on the results, an improvement in scapular dyskinesia, a decrease in shoulder pain, and an increase in upper extremity function was found in both groups after the treatment. KT applied in addition to the conventional physiotherapy program in patients with SIS did not make a significant difference in the results.

When the literature is examined, it is noteworthy that there are different results regarding the effectiveness of KT in patients with SIS. While it was stated that scapular KT has moderate evidence in the short term in reducing pain and improving function and may be beneficial in addition to physiotherapy interventions [26], it was also found that its application with other treatments or its application alone did not have a remarkable effect [27]. Another important result is that KT can be used effectively and optionally in addition to physiotherapy approaches or alone, especially in the first week of treatment [28] and the effect of any taping method is short-term [13]. On the other hand, it was stated that the acute effect of KT in the first week may be important in increasing the performance of patients during exercise [28] and taping can be chosen depending on short-term goals during the rehabilitation process [13]. If we had evaluated our patients not only at the end of the treatment (at the end of the second week) but also at the end of the first week in our study, we could have discussed the difference between the first week and the second week. In the future, studies in which evaluations of short-term rehabilitation goals and exercise performance are started in the first week can be designed.

In studies on the biomechanical properties of tendons in rats [29, 30], it has been shown that scapular motor control causes changes in tendon mechanical properties following tendon pathology in the rotator cuff muscles. Therefore, it is assumed that scapular dyskinesia may be a factor to be considered together with SIS. Therefore, the treatment of scapular components in the treatment of SIS is a matter of debate [31, 32, 33]. It is thought that interventions including scapular components should be added to physical therapy approaches to improve shoulder pain, upper extremity function, and range of motion in people with SIS. Detailed studies are needed to determine the duration, dose, and type of scapula-focused approaches to alleviate symptom relief [33]. In the results of our study, although there was a difference in the LSST-position 1 only in the groups before and after treatment, a difference of more than 1.5 cm, which is Kibler’s criterion for scapular dyskinesia, was not observed in the pre-treatment values. However, pre-treatment values were higher in LSST-position 1 than in other LSST positions, and Kibler’s original criterion [23], a difference of more than 1 cm was present in pre-treatment values, while post-treatment values were less than 1 cm, suggesting improvement in scapular dyskinesia.

In the studies, it is seen that KT is generally in the form of muscle technique for the deltoid, supraspinatus, and teres minor muscles, and mechanical correction technique. The applications are implemented 2–4 times every other 3–5 days [34]. It was stated that there is no consensus about taping sessions, and different results may occur depending on the techniques due to the variety of KT techniques [13]. In our study, we applied KT 3 times every other 4 days, similar to the application times specified in the literature. As a KT technique, we applied scapular KT aimed at scapular retraction, as applied by Yildiz et al. [16]. In this way, we think that we have introduced an alternative to the literature about the effectiveness of a different KT technique in patients with SIS. On the other hand, it is known that the effectiveness degree of KT differs according to age categories (young, middle-aged, elderly) [35]. Although the mean age of the KT group in our study was lower than that of the control group, both groups were in the middle-age category. Therefore, we do not think that the age factor affects the results.

In our study, the satisfaction of the KT group from KT was quite high, and the level of recommendation to other patients was just as high. Also, the KT group stated that KT had positive psychological effects such as reducing pain, correcting posture, giving a feeling of confidence in addition to relaxing the muscles, and feeling that they support their body. It is known that taping has a psychological reminder function, creates awareness, and therefore, has a positive psychological effect [36]. If the scales that evaluate the psychological well-being of patients and devices that make more objective and sensitive measurements were used in our study, it would be possible to reveal more clearly whether these results reported by the patients were psychological or physiological. Although the effectiveness of KT did not make a difference compared to the conventional physiotherapy program in terms of the parameters we evaluated, its positive effects on improving the well-being of the patients should not be ignored.

Our study has some limitations. The first limitation, upper extremity function was not evaluated objectively, but it was evaluated with a valid and reliable questionnaire for the upper extremity. Since the evaluation of scapular dyskinesia was achieved with the LSST, the scapula was measured in a static position. If we could evaluate the scapular kinematics using a motion capture system, more reliable results could have been obtained with more precise measurements. The second limitation is that we did not have data on the effects of the treatments applied on the results in the first week, and scales evaluating the psychological well-being of the patients were not used. The third limitation, the mean age of the KT group was lower than that of the control group. However, both groups were in the middle-age category. The last limitation is that although the study was conducted prospectively, the study was not registered on ClinicalTrials.gov. Therefore, we do not think that the age factor affects the results. Despite these limitations, the strengths of the study are that a) it is the first study to evaluate the effects of scapular KT applied in addition to the conventional physiotherapy program on scapular dyskinesia, shoulder pain, upper extremity function, and well-being in patients with SIS, b) it is a randomized controlled single-blind study, c) it has high statistical power, and d) it has a high number of participants compared to other studies. Future studies are needed to evaluate the effectiveness of different KT techniques on scapular dyskinesia, pain, function, and well-being in patients with SIS with more sensitive objective measurements.

5. Conclusion

Both the conventional physiotherapy program and combined with the scapular KT in patients with SIS increase the upper extremity function of the patients, reduce their pain, and provide improvement in scapular dyskinesia. On the other hand, scapular KT combined with the conventional physiotherapy program did not affect the results of the treatment. However, the psychological positive effects of KT on patients should not be ignored. Studies can be designed to objectively evaluate the effectiveness of KT for the scapula in patients with SIS with different techniques and durations.

Funding

This project was supported by Bandırma Onyedi Eylül University Scientific Research Projects Coordination Unit (BAP-19-1003-008).

Ethics statement

This study was approved by Bandırma Onyedi Eylul University Health Sciences Non-Interventional Research Ethics Committee (Ethics Committee N. 2019-04-01) and conducted according to the principles of the Declaration of Helsinki. All participants provided verbal and written consent.

Footnotes

Acknowledgments

The authors would like to thank the Bandırma Training and Research Hospital Physical Therapy and Rehabilitation Department team, who supported the data collection and conducted the treatment program of the patients.

Conflict of interest

The authors declare that they have no conflict of interest.

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Physical and well-being effect of scapular kinesio taping combined with conventional physiotherapy in shoulder impingement syndrome: A randomized controlled study

Abstract

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Keywords

1. Introduction

2.1 Design and sample of the study

2.2 Outcome measures

2.2.1 Disabilities of the arm shoulder and hand (DASH) questionnaire

2.2.2 Lateral scapular slide test (LSST)

2.2.3 Visual analog scale (VAS)

2.2.4 Kinesio taping satisfaction survey

2.3 Statistical analysis

Table 1 Demographic characteristics of the groups

Table 3 Comparison of means of DASH, VAS and LSST outcome measures according to groups and measurement times

5. Conclusion

Funding

Ethics statement

Footnotes

Acknowledgments

Conflict of interest

References

Table 1
Demographic characteristics of the groups

Table 3
Comparison of means of DASH, VAS and LSST outcome measures according to groups and measurement times