Lower body injuries, including ankle trauma, are common in sports such as lacrosse, baseball, and soccer and are often the result of quick, unplanned changes of direction or landing tasks.1–3 Treatment of these injuries can require significant periods of time away from competition and can result in negative implications for the success of a team.4,5 Therefore, coaches, athletes, and athletic trainers consistently look for prevention strategies such as proprioceptive balance training6 or prophylactic taping of major joints.7 Some believe that the tape serves to enhance proprioception and motor function.7 It has also been proposed that the proprioceptive and motor function improvements may reduce the incidence of injuries.7
Designed to mimic the qualities of human skin, kinesiology tape has become increasingly popular.8,9 Research, although limited, has supported the efficacy of kinesiology tape for addressing acute injury inflammation, promoting a faster return to activity, enhancing proprioceptive training, reducing pain, promoting neurological function after injury, reducing muscle imbalances, and improving postural control.8,10
Postural control is defined as the act of maintaining, achieving, or restoring a state of balance during any posture or activity, whereas dynamic balance is control while in motion or when switching between positions.11 Therefore, evaluations of postural control and dynamic balance are commonly used in sports medicine to evaluate the risk of injury and recovery during a rehabilitation protocol.12 A dynamic assessment that has gained popularity in clinical settings is the Star Excursion Balance Test (SEBT).12 The SEBT is a reliable measure and a valid dynamic test to predict the risk of lower extremity injury.12,13 It is also a valid tool for identifying dynamic balance deficiency in individuals with lower extremity conditions.12,13 The SEBT can be used to evaluate responsiveness to training programs following injury, identify lower extremity injury risk, and examine acute and chronic ankle instability.12–14
The application of kinesiology tape may improve proprioception (the ability to orientate oneself in space) by increasing stimulation of cutaneous mechanoreceptors within the skin.15 The increased pressure on underlying muscles affects joint proprioception and increasing balance.15 Ankle joint proprioception has a special clinical interest because it is linked to ankle sprains.16 Proprioception of the ankle joint is also critical to the functional success of surgical and rehabilitation treatments.16 If there is any deficit or damage to proprioception, a change in joint stability and control of the joint motion occurs.17 Neuromuscular control encompasses both reflexes and voluntary muscle responses to control muscle length changes, which are important for specialized tasks such as regaining balance after an impact.18 When there is damage to musculoskeletal tissues, excessive inflammation often occurs.19 This inflammation can place great pressure on the mechanoreceptors, which alters a person's proprioception.17,19
Individual perceptions and beliefs can affect an athlete's ability to perform.20 When an athlete believes that an intervention is effective, the intervention will often result in a beneficial outcome, regardless of its merit.20 Perception can be defined as our recognition and interpretation of sensory information, as well as how we respond to the information. How one performs in the gym or on the field can be strongly influenced by one's expectations and beliefs.21 When athletes believe they have received a beneficial treatment, increases in performance can be experienced even though an intervention may have no physiological or biomechanical effect.21–23 This perceptual effect may be strong with the use of kinesiology tape because there is a wealth of anecdotal evidence supporting its effectiveness.24
With its bright colors and interesting appearance, kinesiology tape has received a great deal of media attention24 despite a relative lack of supporting scientific literature.25,26 The supposed benefits include improvement of local circulation, pain reduction, muscle facilitation or relaxation, and increasing joint function and stability,16 despite the controversy over the scientific evidence for kinesiology tape and its effectiveness regardless of population. Therefore, the purpose of this study was to determine whether an application of kinesiology tape to the ankle is an effective measure in aiding in dynamic balance by comparing the effect of kinesiology tape, placebo tape, and no tape while using the SEBT. A structured open-ended questionnaire was administered to determine participant perception regarding each intervention. It was hypothesized that the kinesiology tape would not be effective in improving dynamic stability, nor would it be perceived as any more effective than generic athletic tape due to the participants being blinded.
The purpose of this study was to investigate whether the application of kinesiology tape to healthy National Collegiate Athletic Association (NCAA) Division II athletes' ankles would aid in dynamic balance using the SEBT. This research investigated the measurements of each reach distance from the SEBT while participants participated in three different, randomly administered conditions: no tape, kinesiology tape (Mueller kinesiology tape; Mueller Sports Medicine, Inc., Praire du Sac, WI), and placebo tape (MTAPE; Mueller Sports Medicine, Inc.). A questionnaire was used to examine the perceptions of the athletes related to kinesiology tape's effectiveness compared to the placebo tape and no tape conditions. This investigation used quantitative and qualitative methods to investigate these research questions. The study was a randomized, cross-over, single-blind repeated measures design.
Twenty NCAA Division II collegiate male (n = 5) and female (n = 5) soccer, male baseball (n = 5), and female lacrosse (n = 5) players volunteered. The mean age, height, weight, and leg length of participants was 21.0 ± 1.3 years, 162.5 ± 11.4 cm, 72.2 ± 13.2 kg, and 92.4 ± 7.59 cm, respectively. Volunteers who had any lower extremity injuries or concussion symptoms within the past month were excluded from the study. Volunteers with any visual or vestibular problems were also excluded from the study. None of the participants had received any form of ankle tape during the previous month because the athletic training department would not apply tape to an individual who did not have preexisting deficits. The study was approved by the university's institutional review board and human research ethics committee, and informed consent was obtained from all participants.
All participants were instructed to wear a pair of sweatpants to prevent them from seeing the tape applied to their ankle. The sweatpants were required to be long and loose enough to effectively blind the participants to each condition, as confirmed by pilot testing. The sweatpants acted similarly to the lower leg skirts used by Simon and Donahue.27 To normalize the test, and to allow for more accurate comparisons of performance among participants, leg length measurements were taken before testing.28 Leg lengths were measured from the anterior superior iliac spine to the distal tip of the medial malleolus. Any hair around the lower leg was removed with a razor and cleaned with alcohol prep pads before testing. Participants were barefoot for all testing. As recommended by Gribble et al.,12,29 Hertel et al.,30 and Olmsted et al.,31 all participants had six practice trials with no tape in each of the eight directions of the SEBT while standing on the dominant leg to become familiar with the task. Participants were asked to state their dominant leg; this was done by asking participants which foot they would use to kick a ball.32 The kicking foot was considered the dominant foot, which was the leg the tape was applied to and the leg used for balance during the SEBT.32 Before the practice trials, an explanation and demonstration of the SEBT were given to each participant. As recommended by Olmsted et al.,31 all trials were performed in the sequential order in a clockwise direction, starting with the anterior direction to keep consistency throughout the study.
Following the practice trials, participants were allowed 5 minutes to rest before the start of the randomized testing. Following the protocol described by Gribble et al.12 and Hertel et al.,30 the participants who started with the no tape condition went straight into performing the SEBT. Participants were required to maintain a stable single leg stance with the center of the foot of the dominant leg in the middle of the grid,12 and were asked to reach for maximal distance with the non-dominant leg in each of the eight directions (Figure 1). The participants were asked to execute a touchdown between each of the eight reach directions by lightly touching the furthest point on the line with the most distal part of the reaching limb. Using a tape measure, the measurement was taken from the center of the grid to the furthest touchdown point to the nearest 0.5 cm. Once the participant successfully completed reach distances in all eight directions, they performed the next two randomized conditions. Between each reach, participants were allowed 10 seconds to rest. Following standard protocol, trials were discarded and repeated if the participant did one or more of the following: did not touch the line with the reach foot while maintaining weight on the stance leg, lifted the stance foot from the center grid, lost balance at any point in the trial, or did not maintain and return the reach leg to starting position for 1 full second.12 Participants were given 30 seconds of rest between repeated trials. Participants were allotted five attempts to complete three reach distances in each of the eight reach directions. The three reaches in each direction of SEBT were recorded, and the mean was included in the analysis.
Star Excursion Balance Test (SEBT) position. A = anterior; AL = anterior-lateral; AM = anterior-medial; L = lateral; M = medial; P = posterior; PL = posterior-lateral; PM = posterior-medial
The participants starting with one of the two taping conditions were asked to roll up their pants and were blindfolded so they would not be able to see which tape was being applied. Consistent with the kinesiology taping methods (Figure 2), an athletic trainer applied the kinesiology tape or placebo tape.33 The same athletic trainer applied all tape to each athlete for each condition. According to standard protocol, the tape was applied to the ankle consistent with a completed functional correction to assist dorsiflexion and eversion; this correction limits plantar flexion and inversion, which is the most common mechanism of injury for a lateral ankle sprain (Figure 2).33 The taping protocol started by placing the anchor with no tension on the medial aspect of the arch, posterior to the base of the first metatarsal.33 Then the participant's ankle was put into dorsiflexion and eversion, bringing the I-strip over the plantar surface with no tension (Figure 2).33 Next, the tape was applied with 50% tension to the I-strip and the anchor was applied in the mid to proximal one-third lateral aspect of the tibia with no tension.33 According to standard protocol, 50% tension was accomplished by stretching the kinesiology tape as far as it could go and then bringing it back to half the distance.33
Tape placement for both kinesiology tape and placebo tape conditions.
Once applied, the athletic trainer vigorously rubbed the tape for 10 seconds to initiate adhesion as per standard protocol, before any further patient movement.33 So the participant could not tell the difference between the two tape conditions, the placebo tape was also vigorously rubbed for 10 seconds.
After the three test trials in one condition, the participant was re-blindfolded and was brought back to the treatment table,34 where the tape and any remaining residue were removed with tape remover, and the skin cleaned with rubbing alcohol. The next tape condition was then applied, and the SEBT protocol repeated exactly as described above. The time between the conditions was 5 minutes to allow time to remove the tape, reapply the new tape condition, and allow the participant to rest.
Once all treatments were completed, participants filled out a structured, open-ended questionnaire about their perceptions of the tape conditions (Table 1). A researcher, who was not aware of the intervention order, assisted each participant in completing the questionnaire. This was done on a laptop while allowing the participants to type their answers and not be influenced by the primary investigator or other participants. The open-ended questions allowed participants to identify their experiences associated with the conditions while permitting the investigator to probe and clarify responses.35 The responses, in the participant's own words, became the raw data for the inductive content analysis.35
Perceived Effectiveness of Tape and No Tape Conditions
Treatment of Data
The independent variables in this study were the tape conditions: kinesiology tape, placebo tape, or no tape. The quantitative dependent variables were averaged normalized SEBT reach distances in all eight directions and the sum of all eight reach distances. The qualitative dependent variables were the answers from the questionnaire (Table 1).
The reach distances for the three trials for each of the eight directions of the SEBT were averaged and analyzed. Leg length dimension from the participants was used to normalize the data (reach distance/leg length × 100).28 All analyses were done using SPSS software (version 23; IBM Corporation, Armonk, NY). The data were first assessed for normality and equality of variance using the Shapiro–Wilk test, and Mauchly's test was used to examine whether the assumption of sphericity had been violated. The SEBT reach distances in all eight directions for each condition and effect of sex were analyzed using a multivariate analysis of variance (MANOVA) and a one-way repeated measures analysis of variance (ANOVA). If statistically significant results were found, Bonferroni post-hoc tests were run to determine which conditions were different. For all analyses, an alpha level of 0.05 was used. Cohen's effect sizes (d) were calculated to measure the magnitude of practical effect, with the following criteria used: 0.1 as trivial, 0.2 as small, 0.5 as medium, and 0.8 as large.36 All data are reported as mean ± standard deviation.
The qualitative aspect of this study used an interpretative phenomenological analysis, and the qualitative analysis was based on the guidelines of Smith.37 Each participant's responses to the questionnaire were independently studied and analyzed, finding overall common themes on the perceived perceptions the participants had on the effectiveness of the different types of tape on their balance.35 Ranking for preference of each intervention was also examined.
There were no significant effects of sex on any of the dependent variables measured (P > .05); therefore, the subsequent analyses included all participants (n = 20). The MANOVA tests indicated no significant differences among the three tape conditions (P > .05) on the SEBT sum of distances. To determine any differences in the eight reach directions, a one-way repeated measures ANOVA was used. Table 2 shows the reach distances as mean ± standard deviation for each direction and sum of the SEBT.
Star Excursion Balance Test Directional Reach Distances
A one-way repeated measures ANOVA found that there were significant differences in the SEBT anterior-lateral reach distances: F(2,38) = 4.804, P = .014. Post-hoc comparisons showed significant differences between kinesiology tape (74.3 ± 9.1 cm) and placebo tape (71.6 ± 8.8 cm) in the anterior-lateral direction, although the effect size was considered small (P = .014, d = 0.30).
A one-way repeated measures ANOVA found that there were significant differences in the SEBT lateral reach distances: F(2,38) = 3.78, P = .032. Post-hoc comparisons showed significant differences between placebo tape (76.5 ± 12.6 cm) and no tape (79.9 ± 11.8 cm) in the lateral direction of the SEBT, although the effect size was small (P = 0.032, d = 0.27). No other significant group differences (P > .05) were found for any other reach distance, as shown in Table 2.
A one-way repeated measures ANOVA did not find significant differences between tape conditions for the SEBT sum: F(1.31, 24.95) = 1.881, P = .182. These results suggest that the overall SEBT scores were not significantly different between the three tape conditions.
Table 3 ranks which tape condition the participants believed was the most effective for aiding balance. These answers were based on the questionnaire given to each participant after the SEBT was complete under each of the three conditions. Results suggest that the majority of participants ranked no tape as the most effective in aiding balance (45%), followed by kinesiology tape (35%), and placebo tape (20%). These results also indicate that participants ranked kinesiology tape as the second most effective in aiding balance (50%), followed closely by no tape at 40%, and placebo tape at 10%. Participants ranked placebo tape as the worst of the three conditions for aiding balance with 70% of the third place votes, followed by kinesiology tape and no tape both equally getting 15% of the votes.
Tape Conditions Ranking
Results suggest that most participants (80%) would use kinesiology tape again in the future for balance. When looking at placebo tape, the results show that the majority of participants (65%) would not use placebo tape in the future for balance.
The purpose of this study was to determine whether an application of kinesiology tape to the ankle could be an effective measure in aiding balance using a dynamic measure of balance. The original hypothesis was that there would not be any statistically significant differences between tape conditions during the SEBT. Overall, the results of the study support the original hypothesis because there were no significant differences in reach distance among all three tape conditions (P > .05).
Two specific directions (anterior-lateral and lateral) showed significant differences in reach, although the overall SEBT scores showed no significant reach differences between any of the three conditions. These findings were contrary to the original hypothesis that kinesiology tape would not be effective in aiding balance in any of the eight directions of the SEBT. In the anterior-lateral direction, significant differences between kinesiology tape (74.3 ± 9.1 cm) and placebo tape (71.6 ± 8.8 cm) were found (P = .014, d = 0.30). Although the kinesiology tape did not differ significantly from the no tape group, the kinesiology tape group had a significantly longer reach distance than the placebo tape group. Significant differences were found between the placebo tape (76.5 ± 12.6 cm) and no tape (79.9 ± 11.8 cm) groups (P = .032, d = 0.27) for the lateral direction. Although the no tape condition did not differ significantly from the kinesiology tape condition, the no tape condition had significantly further reach distances than the placebo tape condition. The kinesiology tape group had significant differences compared to the placebo tape group in the anterior-lateral direction, and the no tape group had significant differences compared to the placebo tape group in the lateral direction. However, it cannot be claimed from these findings that kinesiology tape or no tape are better in aiding balance than the other because all differences were characterized by low effect sizes and significance was only reached in one of eight directions of the SEBT.
It was hypothesized that the athletes would not have a preference between kinesiology tape and placebo tape because the athletes were not able to see which tape was applied. Contradicting the hypothesis, the majority of participants ranked no tape as the most effective in aiding balance (45%), followed by kinesiology tape (35%) and placebo tape (20%). The results also indicate that 50% of the participants ranked kinesiology tape as the second most effective in aiding balance, followed closely by no tape at 40% and placebo tape at 10%. Participants ranked placebo tape as the worst of the three conditions for aiding balance with 70% of the third place votes, followed by kinesiology tape and no tape both equally accruing 15% of the votes. These findings are interesting because kinesiology tape was statistically more effective than placebo tape only in improving SEBT reach distance in the anterior-lateral plane, yet more participants perceived kinesiology tape to be superior despite being blinded as to what tape was applied. These findings may lend credence to kinesiology tape in that a perceived positive outcome was found without a placebo effect.
Kinesiology tape is proposed to cause an increase in proprioception through increased stimulation to cutaneous mechanoreceptors, hence aiding in balance.38 Halseth et al.38 examined the effects of applying kinesiology tape to the anterior and lateral ankle on proprioception compared to an untaped ankle and concluded that kinesiology tape does not appear to enhance proprioception during a reproduction of joint position sense evaluation in healthy participants. When comparing the effects of kinesiology tape on ankle proprioception between healthy participants and participants with chronic ankle instability using an eversion force sense task, Simon et al.10 found that kinesiology tape could improve proprioception in participants with chronic ankle instability to the level that would be similar to those who have never sustained an ankle injury. However, kinesiology tape did not improve their proprioception more than the individuals who never sustained an ankle injury.10 With contradicting research on the effect of kinesiology tape on improving proprioception, the current study demonstrated that kinesiology tape was not effective in aiding balance during the SEBT when compared to the placebo tape and no tape conditions.
These findings are further supported by Bicici et al.,39 who found that kinesiology tape had no significant effect on performance during the SEBT, nor did it help performing a hopping test, single limb hurdle, and dynamic balance tests in male basketball players with chronic inversion ankle sprains. Fayson et al.40 also found that there was no effect of kinesiology tape on time to stabilization, showing kinesiology tape has no effect on proprioception in the ankle or dynamic balance in females with no history of ankle injury. With the current study's healthy population, kinesiology tape neither increased nor decreased balance during the SEBT when compared to placebo tape and no tape.
For the lateral reach direction, the post-hoc comparisons showed significant differences in reach distances for the placebo tape (76.5 ± 12.6 cm) and no tape (79.9 ± 11.8 cm) conditions. The no tape condition showed a significantly longer reach distance compared to the placebo tape condition; the kinesiology tape condition did not differ significantly from the no tape condition. The current study proposes that no tape would be a superior option for balance in the lateral direction compared to placebo tape, but is not different in balance compared to kinesiology tape. Yoshida and Kahanov41 found that kinesiology tape applied to the back may improve active range of motion in lower trunk flexion, but not for lateral flexion and extension. Similar to the current study, Yoshida and Kahanov's study did not show an overall trunk range of motion increase compared to no tape, although it may cause a slight increase in one direction (flexion).41 Briem et al.15 also found that non-elastic tape (placebo tape) may enhance muscle activity of the fibularis longus, potentially enhancing dynamic support of the ankle. The efficacy of kinesiology tape in preventing ankle sprains via the same mechanism as the placebo tape is unlikely because it did not affect muscle activity of the fibular longus, showing similar results to no tape.15
Although the current study showed kinesiology tape improved balance in the anterior-lateral direction compared to placebo tape, kinesiology tape had no significant effect in any of the other seven reach directions. It should also be noted that although statistical significance was met for the anterior-lateral (P = .014) reach direction, the outcome exhibited a small effect size of d = 0.30. This small effect size leads the authors to believe that, although statistically significant, there may be no practical effect from kinesiology tape for any of the SEBT directions.
The current study found that kinesiology tape was not effective regarding quantitative measures of balance during the SEBT when compared to placebo tape and no tape conditions in healthy athletes. There are a few aspects that can be taken from this study and brought into the sports medicine field. Confidence is an important feeling in athletics that allows an athlete to enhance performance.34 Although kinesiology tape had no quantitative influence on SEBT balance, several participants had an increase in perceived stability, confidence, and reach distances. Kinesiology tape could be used in the future when alternative measures or treatments may not work, but taping with kinesiology tape or any other tape is likely not worthwhile in healthy athletes. Although kinesiology tape does not appear to be a worthwhile preventative measure in healthy athletes, it may be beneficial for improving proprioception and therefore reduce the risk of re-injury in patients with chronic ankle instability.10,24,39
Although the results of the current study do not support the use of kinesiology tape as a prophylactic, there are several limitations that should be recognized for future studies. Participants in the current study were healthy asymptomatic athletes and the taping techniques used in this study are most commonly applied to patients with lower extremity issues.7,24 Therefore, future studies may examine the effectiveness of kinesiology tape on injured populations. Furthermore, although athletes were excluded if they had any injuries in the past month, it is possible that previous injuries such as sprains or even asymptomatic anterior cruciate ligament reconstruction may negatively affect proprioception.42
Although only one limb was tested in the current study, it is possible that the application of kinesiology tape as a preventative measure may have had different effects based on limb dominance. However, recent studies found no significant difference in SEBT scores between limbs in either healthy participants or patients with chronic lower body injuries.43,44 Therefore, it was deemed unnecessary to test both dominant and non-dominant limbs.
Another potential limitation of the current study is that the athletic trainer who applied all tape did not have any formal training with kinesiology tape. However, directions from Kase et al.33 were closely followed and practiced extensively before the commencement of the study.
Although the SEBT is known to be a valid and reliable measure of dynamic balance12,13 and has also been found useful for tracking and predicting lower extremity injuries in competitive athletes,14,31,43 it is still only one test. Future studies could examine the effects of kinesiology tape while using different tests of dynamic balance, including the Balance Error Scoring System (BESS), Romberg test, Four Square Step Test (FSST), Berg Balance Scale (BBS), and time- to- stabilization,45,46 or using direct measures of athletic performance such as agility, sprinting, or jumping. These may lead to more robust findings, and therefore better guide sports medicine professionals.
Implications for Clinical Practice
When examining the results of the current study, it can be concluded that kinesiology tape is not effective in aiding balance during the SEBT when compared to placebo tape and no tape conditions in a healthy population. Results showed no significant reach differences between all three tape conditions, although many participants perceived kinesiology tape to be effective. However, it appears that kinesiology tape applied to the ankle does not aid in dynamic stability or balance in a young athletic population. Additionally, kinesiology tape often comes at a steep price point compared to the standard athletic tape that is commonly found in athletic training facilities. It is also recommended that those using kinesiology tape have specific training, which may require a significant sacrifice of time and resources. Therefore, the use of kinesiology tape is not recommended as a prophylactic due to the considerable price point and lack of apparent advantage over conventional athletic taping.
- Hinton RY, Lincoln AE, Almquist JL, Douoguih WA, Sharma KM. Epidemiology of lacrosse injuries in high school-aged girls and boys: a 3-year prospective study. Am J Sports Med. 2005;33:1305–1314. doi:10.1177/0363546504274148 [CrossRef]
- Engström B, Johansson C, Tornkvist H. Soccer injuries among elite female players. Am J Sports Med. 1991;19:372–375. doi:10.1177/036354659101900408 [CrossRef]
- Posner M, Cameron KL, Wolf JM, Belmont PJ Jr, Owens BD. Epidemiology of major league baseball injuries. Am J Sports Med. 2011;39:1676–1680. doi:10.1177/0363546511411700 [CrossRef]
- Hägglund M, Waldén M, Magnusson H, Kristenson K, Bengtsson H, Ekstrand J. Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med. 2013;47:738–742. doi:10.1136/bjsports-2013-092215 [CrossRef]
- Eirale C, Tol JL, Farooq A, Smiley F, Chalabi H. Low injury rate strongly correlates with team success in Qatari professional football. Br J Sports Med. 2013;47:807–808. doi:10.1136/bjsports-2012-091040 [CrossRef]
- Söderman K, Werner S, Pietilä T, Engström B, Alfredson H. Balance board training: prevention of traumatic injuries of the lower extremities in female soccer players? A prospective randomized intervention study. Knee Surg Sports Traumatol Arthrosc. 2000;8:356–363. doi:10.1007/s001670000147 [CrossRef]
- Karlsson J, Swärd L, Andréasson GO. The effect of taping on ankle stability: practical implications. Sports Med. 1993;16:210–215. doi:10.2165/00007256-199316030-00005 [CrossRef]
- Aktas G, Baltaci G. Does kinesio taping increase knee muscle strength and functional performance?Isokinetics and Exercise Science. 2011;19:149–155.
- Aytar A, Ozunlu N, Surenkok O, Baltaci G, Oztop P, Karatas M. Initial effects of kinesio taping in patients with patellofemoral pain syndrome: a randomized, double blind study. Isokinetics and Exercise Science. 2011;19:135–142.
- Simon J, Garcia W, Docherty CL. The effect of kinesio tape on force sense in people with function ankle instability. Clin J Sport Med. 2014;24:289–294. doi:10.1097/JSM.0000000000000030 [CrossRef]
- Pollock AS, Durward BR, Rowe PJ, Paul JP. What is balance?Clin Rehabil. 2000;14:402–406. doi:10.1191/0269215500cr342oa [CrossRef]
- Gribble PA, Hertal J, Plisky P. Using the star excursion balance test to assess dynamic postural control deficit and outcomes in lower extremity injury: a literature and systematic review. J Athl Train. 2012;47:339–357. doi:10.4085/1062-6050-47.3.08 [CrossRef]
- Hyong IH, Kim JH. Test of intrarater and interrater reliability for the star excursion balance test. J Phys Ther Sci. 2014;26:1139–1141. doi:10.1589/jpts.26.1139 [CrossRef]
- Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB. Star excursion balance test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther. 2006;36:911–919. doi:10.2519/jospt.2006.2244 [CrossRef]
- Briem K, Eythörsdöttir H, Magnúsdóttir RG, Pálmarsson R, Rúnarsdöttir T, Sveinsson T. Effects of kinesio tape compared with nonelastic sports tape and the untaped ankle during a sudden inversion perturbation in male athletes. J Orthop Sports Phys Ther. 2011;41:328–335. doi:10.2519/jospt.2011.3501 [CrossRef]
- Miralles I, Monterde S, del Rio O, Valero S, Montull S, Salvat I. Has kinesio tape effects on ankle proprioception? a randomized clinical trial. Clinical Kinesiology. 2014;68:9–18.
- Riemann BL, Lephart SM. The sensorimotor system, part II: the role of proprioception in motor control and functional joint stability. J Athl Train. 2002;37:80–84.
- Hung YJ. Neuromuscular control and rehabilitation of the unstable ankle. World J Orthop. 2015;6:434–438. doi:10.5312/wjo.v6.i5.434 [CrossRef]
- Yamashita T, Minaki Y, Takebayashi T, Sakamoto N, Ishii S. Neural response of mechanoreceptors to acute inflammation in the rotator cuff of the shoulder joint in rabbits. Acta Orthop Scand. 1999;70:137–140. doi:10.3109/17453679909011251 [CrossRef]
- Beedie CJ. Placebo effects in competitive sport: qualitative data. J Sports Sci Med. 2007;6:21–28.
- Duncan MJ, Lyons M, Hankey J. Placebo effects of caffeine on short term resistance exercise to failure. Int J Sports Physiol Perform. 2009;4:244–253. doi:10.1123/ijspp.4.2.244 [CrossRef]
- Jamshidian F, Hubbard AE, Jewell NP. Accounting for perception, placebo and unmasking effects in estimating treatment effects in randomized clinical trials. Statistical Methods in Medical Research. 2014;23:293–307. doi:10.1177/0962280211413449 [CrossRef]
- McClung M, Collins D. “Because I know it will:” placebo effects of an ergogenic aid on athletic performance. J Sport Exerc Psychol. 2007;29:382–394. doi:10.1123/jsep.29.3.382 [CrossRef]
- Williams S, Whatman C, Hume PA, Sheerin K. Kinesio taping in treatment and prevention of sports injuries: a meta-analysis of the evidence for its effectiveness. Sports Med. 2012;42:153–164. doi:10.2165/11594960-000000000-00000 [CrossRef]
- Cortesi M, Cattaneo D, Jonsdottir J. Effect of kinesio taping on standing balance in subjects with multiple sclerosis: a pilot study. NeuroRehabilitation. 2011;28:365–372.
- Ujino A, Eberman LE, Kahanov L, Renner C, Demchak T. The effects of kinesio tape and stretching on shoulder ROM. International Journal of Athletic Therapy and Training. 2013;18:24–28. doi:10.1123/ijatt.18.2.24 [CrossRef]
- Simon J, Donahue M. Effect of ankle taping or bracing on creating an increased sense of confidence, stability, and reassurance when performing a dynamic-balance task. J Sport Rehabil. 2013;22:229–233. doi:10.1123/jsr.22.3.229 [CrossRef]
- Gribble PA, Hertel J. Considerations for normalizing measures of the star excursion balance test. Measurement in Physical Education and Exercise Science. 2003;7:89–100. doi:10.1207/S15327841MPEE0702_3 [CrossRef]
- Gribble PA, Kelly SE, Refshauge KM, Hiller CE. Interrater reliability of the star excursion balance test. J Athl Train. 2013;48:621–626. doi:10.4085/1062-6050-48.3.03 [CrossRef]
- Hertel J, Braham RA, Hale SA, Olmsted-Kramer LC. Simplifying the star excursion balance test: analyses of subjects with and without chronic ankle instability. J Orthop Sports Phys Ther. 2006;36:131–137. doi:10.2519/jospt.2006.36.3.131 [CrossRef]
- Olmsted LC, Carcia CR, Hertel J, Shultz SJ. Efficacy of the star excursion balance tests in detecting reach deficits in subjects with chronic ankle instability. J Athl Train. 2002;37:501–506.
- Wilkins JC, Valovich McLeod TC, Perrin DH, Gansneder BM. Performance on the balance error scoring system decreases after fatigue. J Athl Train. 2004;39:156–161.
- Kase K, Wallis J, Kase T. Clinical Therapeutic Applications of the Kinesio Taping Method, 3rd ed. Albuquerque: Kinesio USA; 2013.
- Sawkins K, Refshauge K, Kilbreath S, Raymond J. The placebo effect of ankle taping in ankle instability. Med Sci Sports Exerc. 2007;39:781–787. doi:10.1249/MSS.0b013e3180337371 [CrossRef]
- Hunt E, Short S. Collegiate athletes' perceptions of adhesive ankle taping: a qualitative analysis. Journal of Sport Rehabilitation. 2006;15:280–298. doi:10.1123/jsr.15.4.280 [CrossRef]
- Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
- Smith JA. Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qualitative Research in Psychology. 2004;1:39–54.
- Halseth T, McChesney JW, DeBeliso M, Vaughn R, Lien J. The effects of kinesio taping on proprioception at the ankle. Journal of Sports Science and Medicine. 2004;3:1–7.
- Bicici S, Karatas N, Baltaci G. Effect of athletic taping and kinesiotaping on measurements of functional performance in basketball players with chronic inversion ankle sprains. Int J Sports Phys Ther. 2012;7:154–166.
- Fayson SD, Needle AR, Kaminsky TW. The effects of ankle kinesio taping on ankle stiffness and dynamic balance. Res Sports Med. 2013;21:204–216. doi:10.1080/15438627.2013.792083 [CrossRef]
- Yoshida A, Kahanov L. The effect of kinesio taping on lower trunk range of motions. Res Sports Med. 2007;15:103–112. doi:10.1080/15438620701405206 [CrossRef]
- Hoffman M, Schrader J, Koceja D. An investigation of postural control in postoperative anterior cruciate ligament reconstruction patients. J Athl Train. 1999;34:130–136.
- Munro AG, Herrington LC. Between-session reliability of the star excursion balance test. Phys Ther Sport. 2010;11:128–132. doi:10.1016/j.ptsp.2010.07.002 [CrossRef]
- Herrington L, Hatcher J, Hatcher A, McNicholas M. A comparison of star excursion balance test reach distances between ACL deficient patients and asymptomatic controls. Knee. 2009;16:149–152. doi:10.1016/j.knee.2008.10.004 [CrossRef]
- Ross SE, Guskiewicz KM. Time to stabilization: a method for analyzing dynamic postural stability. Athletic Therapy Today. 2003;8:37–39. doi:10.1123/att.8.3.37 [CrossRef]
- Ross SE, Guskiewicz KM, Yu B. Single-leg jump-landing stabilization times in subjects with functionally unstable ankles. J Athl Train. 2005;40:298–304.
Perceived Effectiveness of Tape and No Tape Conditions
|Date of Test _________________________________|
|What was your experience using tape #1? Please explain in detail. ___________________________|
|Would you use tape #1 in the future? Yes or No? _________|
|Why or why not? _____________________________|
|What was your experience using tape #2? Please explain in detail. _____________________________________|
|Would you use tape #2 in the future? Yes or No? _________|
|Why or why not? _____________________________|
|What was your experience with no tape? Please explain in|
|Rank the condition that you believe was the most effective, #1, #2, or the no tape condition?|
|Explain why? ________________________________|
Star Excursion Balance Test Directional Reach Distances
|Direction||Kinesiology Tape (cm)||Placebo Tape (cm)||No Tape (cm)||P|
|Anterior||83.4 ± 7.7||81.6 ± 7.3||83.8 ± 7.9||.121|
|Anterior-lateral||74.3 ± 9.1||71.6 ± 8.8||73.9 ± 10.5||.014a|
|Lateral||77.8 ± 10.7||76.5 ± 12.6||79.9 ± 11.8||.032b|
|Posterior-lateral||93.8 ± 11.2||92.7 ± 12.7||94.4 ± 9.9||.475|
|Posterior||100.4 ± 10.7||100.3 ± 11.5||100.9 ± 10.2||.853|
|Posterior-medial||101.6 ± 9.7||101.4 ± 9.6||102.4 ± 9.0||.646|
|Medial||98.2 ± 7.7||97.7 ± 8.8||98.5 ± 7.9||.685|
|Anterior-medial||90.1 ± 6.5||89.8 ± 7.8||90.1 ± 8.0||.911|
|Sum||719.5 ± 56.8||711.8 ± 66.1||723.9 ± 59.8||.182|
Tape Conditions Ranking
|Rank||Kinesiology Tape||Placebo Tape||No Tape|
|1||7 (35%)||4 (20%)||9 (45%)|
|2||10 (50%)||2 (10%)||8 (40%)|
|3||3 (15%)||14 (70%)||3 (15%)|