Elsevier

Journal of Biomechanics

Volume 67, 23 January 2018, Pages 150-156
Journal of Biomechanics

Kinesio taping influences the mechanical behaviour of the skin of the low back: A possible pathway for functionally relevant effects

https://doi.org/10.1016/j.jbiomech.2017.12.005Get rights and content

Abstract

Despite claims of functional benefits of kinesio tape application, little mechanistic evidence exists to support physiological pathways to achieve these benefits. As kinesio tape is adhered directly to the skin, it can be supposed that any pathway needs to first achieve effects at this level. To address this, two layers of the skin, the combined epidermis and dermis, as well as the hypodermis were studied. Specifically, -kinematic measures of skin surface stretch and retraction, as well as ultrasound measures of skin thickness, were made along all edges of kinesio tape applied over the low back. Results demonstrated that the more superficial skin layer (combined epidermis and dermis), but not the deeper hypodermis, was significantly stretched (p = .0001) and thinner (p = .0016) at either end of the tape, and significantly retracted (p < .0001) and thicker (p = .0001) along the lateral edges of the tape. These results were partly dependent upon spine posture; skin retraction along the tape edges was only apparent in neutral and flexed (but not extended) spine postures, while skin thinning at the tape ends was only apparent in neutral and extended (but not flexed) spine postures. Hypodermal thickness was not affected by kinesio tape application at any location or in any posture. In summary, measured deformations at the skin surface and within the epidermal and dermal regions provide plausible pathways through which kinesio tape could achieve its claimed benefits.

Introduction

A wide variety of beneficial claims are made with respect to kinesio tape application, including improved proprioception, increased lymphatic drainage, assistance in joint and fascial positioning, and reduction in pain and fatigue (Kase et al., 2003). However, experimental studies that examine these claims are far from universal in their support (Kalron and Bar-Sela, 2013). Kinesio tape is applied directly to the skin and as such can achieve its benefits by either directly influencing skin deformation and subsequently the receptors imbedded in the skin, or by a transfer of force generated by the tape through the skin and subcutaneous tissue to deeper fascial, muscle, and joint tissues and their receptors. While a large number of studies have been conducted to examine functional outcomes of kinesio tape application, little work has addressed mechanistic pathways through which kinesio tape could potentially achieve benefits. Pamuk and Yucesoy (2015) used MRI to determine if kinesio tape applied to the skin over the tibialis anterior muscle could cause measureable deformations of this muscle and its neighbouring muscles. They reported deformations in muscles deep and remote to the site of tape application, thereby providing a clear mechanistic pathway for potential functional responses to the tape.

The skin is a complex tissue that can be separated into three general layers, the epidermis, the dermis and the hypodermis (Geerligs, 2006). The most superficial layer is the epidermis, which is principally cellular in nature (Wilkes et al., 1973). Next is the dermis which is comprised mostly of a dense matrix of fibrous proteins including collagen and elastin (Wilkes et al., 1973) and microvasculature (Braverman, 1989). Finally, the hypodermis is composed mainly of fatty tissue which makes it the most compliant of the three (Geerligs, 2006). In order for kinesio tape to cause its proposed proprioceptive benefits, the force exerted by the tape on the skin surface must be large enough to cause deformations that result in heightened activation of mechanoreceptors that reside in the skin. This could in theory increase proprioceptive ability and potentially alleviate low back pain by providing feedback to avoid painful postures. Furthermore, if the force exerted by the kinesio tape caused a thickening of the affected skin and subcutaneous area, increased drainage could play a role in decreasing pain by alleviating swelling. Many experimental studies have attributed benefits achieved by kinesio taping to a direct influence on these neuromuscular pathways (Paoloni et al., 2011, Álvarez-Álvarez et al., 2014, Konishi, 2013, Yoshida and Kahanov, 2007); however, there is currently no evidence that demonstrates deformations in the skin, caused by kinesio tape application, that could influence the aforementioned pathways.

Therefore, the purpose of this study was to quantify the mechanical effects of kinesio tape application on the skin of the low back. Specifically, stretch/retraction of the skin surface as well as changes in thickness of the superficial (epidermal/dermal) and deep (hypodermal) skin layers were measured when kinesio tape was applied. The main objective of this work was to identify how kinesio tape affected skin deformation and whether or not this was posture dependent. Posture dependence was considered important because it would directly impact the stretch of the kinesio tape, as well as the stretch and thickness of the underlying skin (Beaudette et al., 2017b). These results will provide valuable fundamental knowledge regarding a possible pathway, via skin deformation, through which kinesio tape may achieve its proposed benefits such as increased proprioception and lymph drainage. This will help to establish a future body of work that will determine the relevance of kinesio tape as a training or rehabilitative tool.

Section snippets

Participants

Thirteen young healthy adults (6 males; mean age 23.9 years; mean mass 76 kg; mean height 1.73 m) voluntarily participated from the University of Guelph undergraduate and graduate populations. Exclusion criteria included any recent or history of chronic pain associated with the lumbosacral region or the lower limb, particularly in the knee or ankle. Pain in the lower leg was exclusionary as the postures required to be adopted by the participants necessitated full knee flexion and ankle plantar

Superficial skin (Epidermis plus Dermis) thickness

Kinesio tape significantly affected skin thickness at each of the four measured locations (p = .0001–.0016; Fig. 4). Specifically, the skin was thinner immediately superior and inferior to the kinesio tape when present, while the skin was thicker immediately medial and lateral to the kinesio tape when present. This finding significantly interacted with posture for the superior (p = .0138) and inferior (p = .03) locations, such that the differences between the tape and no tape conditions were

Discussion

The results of this study demonstrate that, in a young healthy population, kinesio taping influences both skin thickness and skin surface stretch in a statistically significant manner, and that this influence is dependent upon spine posture. In terms of superficial skin thickness, the locations superior and inferior to the tape decreased in thickness after kinesio tape was applied in the neutral and extended spine postures. At the medial and lateral locations there was an increase in

Acknowledgements

This work was funded by the Natural Sciences and Engineering Research Council (NSERC) of Canada.

Conflict of interest statement

The authors have no conflicts of interest to declare.

References (24)

  • D.F. Collins et al.

    Cutaneous receptors contribute to kinesthesia at the index finger, elbow, and knee

    J. Neurophysiol.

    (2005)
  • B.B. Edin

    Quantitative analysis of static strain sensitivity in human mechanoreceptors from hairy skin

    J. Neurophysiol.

    (1992)
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