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Phys. Ther. Korea 2022; 29(3): 171-179

Published online August 20, 2022

https://doi.org/10.12674/ptk.2022.29.3.171

© Korean Research Society of Physical Therapy

Effects of Kinesio Taping on Edema Control in Patients With Musculoskeletal Injuries: A Literature Review

Joon-hyoung Yong1,2 , PT, PhD, Jin-seok Lim2 , PT, MSc, Il-young Moon2 , PT, MSc, Chung-hwi Yi3 , PT, PhD

1Department of Physical Therapy, Hallym Polytechnic University, Chuncheon, 2Department of Physical Therapy, The Graduate School, Yonsei University, 3Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea

Correspondence to: Chung-hwi Yi
E-mail: pteagle@yonsei.ac.kr
https://orcid.org/0000-0003-2554-8083

Received: July 18, 2022; Revised: August 10, 2022; Accepted: August 11, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: The application of Kinesio tape (KT) has become an alternative treatment for the reduction of edema owing to its distinct characteristics that mimic skin behavior. Although many studies have found that KT application has a positive effect on edema related to breast cancer and rehabilitation following mandibular third molar surgery, there is little evidence to support the use of KT for musculoskeletal injuries. Objects: The purpose of this study was to review the literature related to KT application for reducing edema caused by musculoskeletal disorders.
Methods: A literature search (July 2022) was performed on PubMed for articles published between January 2012 and June 2022. The following keywords were used: “Kinesio taping,” “Kinesio tape,” “swelling,” and “edema,” with different combinations and derivations. Only articles available in English were included in this study.
Results: Among 68 identified studies, seven met our search strategy and criteria and were included in the literature review. Five of these studies investigated musculoskeletal disorders of the knee joint; two of them reported that KT application had a positive effect on edema measured using perimetry following total knee replacement and anterior cruciate ligament reconstruction. However, the KT application did not improve swelling in patients with acute lateral ankle sprains. Pediatric patients with acute proximal phalangeal joint sprain experienced a more significant improvement in the reduction of swelling than the group using a splint.
Conclusion: This literature review found discrepant evidence to support using KT for edema control in musculoskeletal disorders. Further research is needed to determine the effectiveness of KT for controlling edema following musculoskeletal injuries.

Keywords: Athletic tape, Edema, Musculoskeletal diseases, Swelling

Kinesio tape (KT) is an elastic therapeutic taping technique for the rehabilitation of sports injuries and various other diseases [1,2]. As a Japanese chiropractor, Dr. Kenso Kase developed KT techniques in the 1970s; the use of KT has become popular, especially among athletes and practitioners [3]. Kase et al. [3] proposed that the unique design of KT mimics the thickness and weight of the skin and that it has various benefits such as protecting and supporting the joint or muscle, improving proprioception, decreasing pain and inflammation, and reducing edema [4-6].

One of the distinct roles of KT compared with traditional tapes is to increase blood and lymphatic flow [4]. The conventional lymphatic treatment recommended by the International Society of Lymphology is complete decongestive therapy, including elastic compression and lymphatic drainage, to increase lymphatic flow by eliminating excessive lymphatic fluid, resulting in sustaining a reduced circumference of the region [7,8]. KT causes the target skin to lift and wrinkle, meaning that lifting increases the space between the skin and muscles [4,9]. As a result, taping improves microcirculation and reduces swelling [4]. Furthermore, KT creates in a constant low pressure on the target skin so that lymphatic flow is increased. When KT stimulates cutaneous mechanoreceptors, it facilitates sensory and mechanical stimulation. This reduces the congestion of lymphatic fluid and decreases the circumference of the target area by its active elastic performance [7,10,11].

As the application of KT in clinical conditions has increased, numerous clinical studies have examined its effects on lymphedema. In 2018, Kasawara et al. [7] performed a meta-analysis of clinical trials that reported the effects of KT on breast cancer-related lymphedema. They concluded that KT application positively affected lymphedema in patients after mastectomy. Moreover, Firoozi et al. [12] revealed in their recent systematic review and meta-analysis that KT application resulted in a significant decrease in swelling scores after mandibular third molar surgery.

Once we looked up the review articles on KT published over the past 5 years through the Medical Literature Analysis and Retrieval System Online (MEDLINE) (accessed via PubMed), a total of 52 studies were identified. Most of 52 studies are on cerebral palsy [13-15], low back pain [16-23], ankle functional performance [24-26], knee osteoarthritis (OA) [27-33], shoulder pain and disability [34-38], breast lymphedema [7,39], rehabilitation after stroke [40-42] and so on; however, there are only four studies related to edema [43-46]. Therefore, the purpose of this study was to review the literature on KT for reducing edema caused by musculoskeletal disorders and investigate whether the use of KT have any effects on controlling edema.

1. Search Strategy and Eligibility Criteria

A search of scientific articles was performed using the MEDLINE from 2012 to June 2022. The studies were included in the first and second quartiles of the Journal Citation Report and selected for the present review. The search strategies for screening the literature published in the scientific database are shown in Table 1.

Table 1 . Search terms for screening studies in PubMed.

#1“Swelling” OR “Edema” AND “Kinesio Taping”
#2“Swelling” OR “Edema” AND “Kinesio Tape”
#3“Swelling” AND “Kinesio Taping”
#4“Swelling” AND “Kinesio Tape”
#5“Edema” AND “Kinesio Taping”
#6“Edema” AND “Kinesio Tape”


Of the 68 identified articles, we selected seven studies for the literature review using the following inclusion/exclusion criteria: (1) clinical studies on patients with edema following musculoskeletal complaints except for any cancer-related disorders and teeth surgery; (2) the article reported data on edema (e.g., volumetry, perimetry); (3) the study presented a comparison group (e.g., placebo taping, no taping, KT applied without tension); and (4) the full text was written in English.

2. Study Selection and Data Extraction

First, two authors independently searched the literature in the databases and reviewed the titles and abstracts of the articles identified after performing the searches. Articles were then identified according to their titles and abstracts to determine whether they provided sufficient data for the purpose of this study. Next, the same authors independently confirmed that the full texts of the articles adhered to the inclusion and exclusion criteria.

The same two reviewers independently performed the searches and selected the evaluated studies. Finally, all authors agreed on the studies that were included in the analysis, with seven studies meeting all established eligibility criteria. All authors performed the analysis. The flowchart of study selection is shown in Figure 1.

Figure 1. Flowchart of the study selection process for this literature review.

Seven clinical studies were analyzed. Of the seven studies, five were related to knee disorders, including total knee arthroplasty (TKA), OA, and anterior cruciate ligament reconstruction (ACLR). One study investigated acute ankle sprain, and another focused on proximal interphalangeal (PIP) joint sprain.

The seven clinical studies included in this literature review are summarized in Table 2. The total number of participants included in the analysis was 517, with 73.9 subjects per study on average. The largest study analyzed 111 patients [47], whereas the smallest number of participants was 36 [48].

Table 2 . Descriptions of studies included in this literature review.

Study (year)Study designSubject characteristicTreatment protocolMeasurementResult
Donec and Kriščiūnas [49], 2014RCT in inpatient rehabilitation facility94 patients who underwent primary TKA surgery divided intotwo groups
KT group (n = 44)
No-taping group (n = 50)
All groups: early mobilization and physical therapy twice a day, occupational therapy once a day, intermittent pneumatic compression, massage, TENS, laser therapy, paraffin therapy.Perimetry measured before surgery and afterwards at four levels (cm): 10 cm above the superior pole of the patella; at the middle line of the knee articular space; in the calf (25 cm above the lateral malleolus inferior pole); and 2 cm above the medial malleolus.Postoperative edema was less severeand regressed quicker in thigh, knee, and calf (p < 0.05, β ≤ 0.2).
Windisch et al [50], 2017Clinical study, prospective study with a historical control group84 subjects with a cemented TKA due to primary OA
KT group (n = 42)
Control group (n = 42)
Control group were fitted with an A-V Impulse SystemTM on both lower limbs immediately p.o in the recovery system. KT group was treated immediately p.o with kinesiotaping.Leg circumference measured at eightpoints daily during 7 p.o. day: on the thigh (20 and 10 cm above the inner knee joint gap), knee (joint gap midline), lower leg (15 cm below the inner knee joint gap), smallest circumference of lower leg and foot (ankle, dorsum of the foot and ball of the foot) of both lower limbs.No significant difference between both groups at any point in time.
Yuksel et al [47], 2022Prospective, RCT with concealed allocation111 patients with total knee arthroplasty
Control group (n = 38)
KT group (n = 37)
Cold-therapygroup (n = 36)
All groups received the same standard postoperative rehabilitation including passive, active-assistive, and active range of motion exercises, strengthening exercises and gait training for two times/day. Weight-bearing, as tolerated, was allowed for all patients on the fist postoperative day.Volumetry was calculated by Volume Frustum formula and circumferential measurements at fourpoints: the midpoint of the patella, 10 cm above the patella, 15 cm above the patella, 10 cm below the patella, and 15 cm below the patella.Cold therapy was effiient in reducing p.o. swelling but KT had no signifiant effects on swelling control.
Wageck et al [51], 2016RCT with concealed allocation, intention-to-treat analysis, and blinded assessment74 older people with knee OA divided in two groups
KT group (n = 38)
Sham-taping group (n = 38)
All groups kept the taping on for 4 days to treat pain, strength, and swelling.Volumetry by water displacement and perimetry measured at threepoints: the fold at the popliteal fossa, 5 cm above that fold, and 5 cm below.At day 4 and the follow-up assessment (day 10), there were no signifiant between-group differences for volumetry (MD: 0.05 ml, 95% CI: –0.01 to 0.11) andperimetry at any measured point.
Baltaci et al [52], 2021Clinical study, prospective analysis, RCT with concealed allocation76 patients with anterior cruciate ligament reconstruction, with discharge 24 hours after surgery
KT group (n = 28)
Control group (n = 28)
All groups received standard postoperative care including compression bandages, ice packing, elevation, and continuous passive motion.Circumferential measurements at five levels: incision level, upper part of incision (5 cm above and 10 cm above) and lower part of incision (5 cm below and 10 cm below). Moreover, the non- operated side was also assessed at the 3-day assessment.There was a significant difference in edema between the groups for incision level and upper part measurements for all 3 days (all p < 0.05), but no difference was found for lower part measurements (all p > 0.05).
Nunes et al [48], 2015RCT with concealed allocation, intention-to-treat analysis, and blinded assessment36 athletes who participated regularly in one of sevendifferent sports and suffered an acute ankle sprain
KT group (n = 18)
Quasi-KT group (n = 18)
Both groups removed the tape before the assessment on day 3. Along with the taping application, both groups received instructions on how to apply ice and elevate the lower limb.Volumetry by water displacement and perimetry measured in a figure-eight fashion.There were no differences between groups for swelling in volumetry (MD: –2 ml, 95% CI: –28 to 32), perimetry (MD: 0.2 cm, 95% CI: –0.6 to 1.0), and relative volumetry (MD: 0.0 cm, 95% CI: –0.1 to 0.1). At day 15 of follow-up, there were no signifiant between-group differences in outcomes.
Serbest et al [53], 2020Retrospective cohort study42 pediatric patients with PIP joint sprain
KT group (n = 21)
Splint group (n = 21)
Each group wastreated with the application for 10 days.Circumference of the PIP joint was measured before and after treatment.Both groups had significantly improvedswelling after treatment (p < 0.001). The KT group displayed a better outcome compared with the splint group (p = 0.021).


Regarding treatments for knee complaints, Donec and Kriščiūnas [49] investigated the effectiveness of KT in decreasing postoperative edema after TKA compared with no taping. Windisch et al. [50] compared KT and A-V impulse systems, which are the conventional devices for lymphatic therapy. In 2022, one study compared no taping with cold therapy in patients with TKA [47]. Wageck et al. [51] evaluated whether KT could be beneficial in patients with knee OA compared with sham taping. Baltaci et al. [52] assessed the effect of KT on the perimetry of the knee within 3 days after ACLR. Two of the seven studies investigated joints other than the knee. Nunes et al. [48] investigated whether KT reduces swelling in athletes with acute lateral ankle sprains. Serbest et al. [53] compared KT with classic finger splint treatment in pediatric patients with PIP joint sprains.

Three of the seven studies reported positive outcomes when using perimetry to assess the swelling [49,52,53]. Donec and Kriščiūnas [49] revealed that the application of KT led to a more rapid decrease in edema in the thigh, knee, and calf (p < 0.05; β ≤ 0.2) during rehabilitation compared with no taping. Baltaci et al. [52] found that incision level and upper knee measurements of KT group were significantly different with no taping group on all 3 days following ACLR (p < 0.05). Serbest et al. [53] reported a better outcome regarding the circumference of the PIP joint with KT application than with splint treatment (p < 0.021). However, KT did not significantly improve swelling in four studies compared with other interventions or no intervention [47,48,50,51].

In this literature review, we investigated the effectiveness of KT for reducing edema caused by various musculoskeletal disorders. We finally analyzed seven studies, related with knee, ankle, and hand joints.

The proposed mechanism of KT for relieving edema is through constant tension on the skin, resulting in folds under the taped region. These folds could enhance the interstitial space between the skin and the underlying connective tissue, resulting in increased lymphatic flow [12]. Another theory is that the application of KT provides a suitable environment for lymphatic fluids in the tissue area to move from a higher to lower pressure, leading to reduced congestion of lymphatic fluid and swelling [3,7].

In this literature review, the outcomes of studies differed according to the location of KT application or the purpose of the treatments. Of the three studies on TKA, only the study by Donec and Kriščiūnas [49] reported significant results using knee perimetry. This study revealed that the use of KT had a positive effect on reducing lymphatic fluid compared with no taping and could decrease the risk of edema from the second postoperative week [49]. Windisch et al. [50] reported that there were no significant differences between the KT group and the group using the A-V impulse system, concluding that KT appeared to be just as effective as the A-V impulse system for reducing soft tissue swelling. However, this study had some limitations and lacked control conditions, meaning that it could not determine a significant improvement in swelling when using KT as lymphatic therapy [50]. A recent study investigated the effectiveness of KT in patients with TKA compared with a standard rehabilitation program (control) and cold therapy, which are traditional treatments for controlling swelling [47]. Although KT application resulted in a significant improvement in pain compared with the control group, it did not significantly control swelling; furthermore, cold therapy was statistically superior to both the control treatment and KT regarding alleviating lymphatic fluids [47].

One study investigating the effects of KT on knee OA revealed that KT intervention did not show any improvement compared with sham taping [51]. However, when KT was used in people who had undergone ACLR, KT resulted in a significant improvement in swelling 72 hours after KT application [52]. Considering previous studies, all subjects developed acute tissue swelling or lymphedema after surgery, but not subjects with OA because their symptoms had been present for at least 6 months [51]. In addition, participants in the sham taping study used taping alone without any physical therapy [51]. Therefore, KT may assist in reducing edema that occurs after surgery, rather than swelling associated with chronic knee joint disorders. Additionally, KT with standard postoperative rehabilitation appears to be more effective than the application of KT alone.

We reviewed only two studies related to joints other than the knee. Nunes et al. [48] evaluated the effects of KT application in athletes with acute lateral ankle sprains. Their study reported no significant improvement in acute swelling with KT [48]. Some studies reported that KT reduces the extracellular liquid resulting from hydrostatic pressure changes and having a low level of protein or transudate such as chronic venous insufficiency [54,55]. They asserted that considering the structural differences of the swelling, KT did not influence the active inflammatory phase because high levels of protein or transudate were exuded during the healing process of acute inflammation [48]. Regarding the effectiveness of KT in pediatric patients with acute PIP joint sprains, both the KT and splint groups had some positive effects on the circumference compared with before treatment [53]. Although splinting is a conventional treatment for acute sprain, the use of KT significantly reduced the congestion of lymphatic fluids compared with splinting [53]. Furthermore, KT also had positive effects on range of motion [53]. We speculate that KT restricts the joint structures less than splinting and, along with muscle activation during the healing process of inflammation, the use of KT could facilitate the movement of lymphatic fluid, consequently improving lymphatic flow. Conversely, a decrease in swelling could improve joint mobility [51].

The present review has several limitations. Only seven studies met the search criteria, which limited the clinical research that evaluated musculoskeletal complaints. Although these studies aimed to investigate the overall effects of KT by measuring outcomes such as pain, mobility, and strength, the purpose of the present review was to examine and compare edema only. In addition, it was difficult to generalize the effect of KT on swelling owing to the different taping techniques and primary causes of edema among the reviewed studies. Another limitation of this literature review includes a search strategy in which only one database was searched and articles in other languages were excluded. Our literature review did not include an explicit definition of musculoskeletal disorders. A clearer definition of this term is required to generalize the findings to a broad range of musculoskeletal injuries.

Our literature review found insufficient evidence for or against the application of KT in improving lymphatic flow and reducing swelling following various musculoskeletal complaints. Despite the lack of evidence to demonstrate the clinical benefits of KT for edema, this study presents a comprehensive review of the swelling relief effect of KT on different types of musculoskeletal injury. KT can be used as a low-cost complementary intervention for swelling control in postoperative treatment after TKA and ACLR. Furthermore, KT could be a useful modality in rehabilitation following acute PIP joint sprains. Further research is needed to clarify the use of KT in reducing edema in musculoskeletal injuries.

This study was supported by the “Brain Korea 21 FOUR Project” and the Korean Research Foundation for the Department of Physical Therapy at the Graduate School of Yonsei University.

No potential conflict of interest relevant to this article was reported.

Conceptualization: JY, IM, JL. Data curation: JY, IM, JL. Formal analysis: JY, IM, JL. Funding acquisition: JY, CY. Investigation: JY, IM, JL. Methodology: JY, CY, IM, JL. Project administration: CY. Resources: JY, CY. Supervision: CY. Validation: JY, CY. Visualization: JY, IM, JL. Writing - original draft: JY, IM, JL. Writing - review & editing: JY, CY, IM, JL.

  1. Thelen MD, Dauber JA, Stoneman PD. The clinical efficacy of kinesio tape for shoulder pain: a randomized, double-blinded, clinical trial. J Orthop Sports Phys Ther 2008;38(7):389-95.
    Pubmed CrossRef
  2. Mostafavifar M, Wertz J, Borchers J. A systematic review of the effectiveness of kinesio taping for musculoskeletal injury. Phys Sportsmed 2012;40(4):33-40.
    Pubmed CrossRef
  3. Kase K, Wallis J, Kase T. Clinical therapeutic applications of the kinesio taping methods. 2nd ed. Tokyo: Kenzo Kase; 2003.
    CrossRef
  4. Jaron A, Konkol B, Gabrysz-Trybek E, Bladowska J, Grzywacz A, Nedjat A, et al. Kinesio taping - a healing and supportive method in various fields of medicine, dentistry, sport and physiotherapy. Balt J Health Phys Act 2021;13(2):11-25.
    CrossRef
  5. Liu K, Qian J, Gao Q, Ruan B. Effects of kinesio taping of the knee on proprioception, balance, and functional performance in patients with anterior cruciate ligament rupture: a retrospective case series. Medicine (Baltimore) 2019;98(48):e17956.
    Pubmed KoreaMed CrossRef
  6. Bischoff L, Babisch C, Babisch J, Layher F, Sander K, Matziolis G, et al. Effects on proprioception by kinesio taping of the knee after anterior cruciate ligament rupture. Eur J Orthop Surg Traumatol 2018;28(6):1157-64.
    Pubmed CrossRef
  7. Kasawara KT, Mapa JMR, Ferreira V, Added MAN, Shiwa SR, Carvas N Jr, et al. Effects of kinesio taping on breast cancer-related lymphedema: a meta-analysis in clinical trials. Physiother Theory Pract 2018;34(5):337-45.
    Pubmed CrossRef
  8. Cormier JN, Rourke L, Crosby M, Chang D, Armer J. The surgical treatment of lymphedema: a systematic review of the contemporary literature (2004-2010). Ann Surg Oncol 2012;19(2):642-51.
    Pubmed CrossRef
  9. Abolhasani M, Halabchi F, Afsharnia E, Moradi V, Ingle L, Shariat A, et al. Effects of kinesiotaping on knee osteoarthritis: a literature review. J Exerc Rehabil 2019;15(4):498-503.
    Pubmed KoreaMed CrossRef
  10. Martins Jde C, Aguiar SS, Fabro EA, Costa RM, Lemos TV, de Sá VG, et al. Safety and tolerability of kinesio taping in patients with arm lymphedema: medical device clinical study. Support Care Cancer 2016;24(3):1119-24.
    Pubmed CrossRef
  11. da Silva RMV, Cavalcanti RL, de França Rêgo LM, Nunes PFL, Meyer PF. Effects of Kinesio Taping® in treatment of cellulite: randomized controlled blind trial. Man Ther Posturology Rehabil J 2014;12:106-11.
    CrossRef
  12. Firoozi P, Souza MRF, de Souza GM, Fernandes IA, Galvão EL, Falci SGM. Does kinesio taping reduce pain, swelling, and trismus after mandibular third molar surgery? a systematic review and meta-analysis. Oral Maxillofac Surg 2022. [Epub]. https://doi.org/10.1007/s10006-021-01025-y.
    Pubmed CrossRef
  13. Ortiz Ramírez J, Pérez de la Cruz S. Therapeutic effects of kinesio taping in children with cerebral palsy: a systematic review. Arch Argent Pediatr 2017;115(6):e356-61.
    Pubmed KoreaMed CrossRef
  14. Inamdar K, Molinini RM, Panibatla ST, Chow JC, Dusing SC. Physical therapy interventions to improve sitting ability in children with or at-risk for cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol 2021;63(4):396-406.
    Pubmed CrossRef
  15. Unger M, Carstens JP, Fernandes N, Pretorius R, Pronk S, Robinson AC, et al. The efficacy of kinesiology taping for improving gross motor function in children with cerebral palsy: a systematic review. S Afr J Physiother 2018;74(1):459.
    Pubmed KoreaMed CrossRef
  16. Sheng Y, Duan Z, Qu Q, Chen W, Yu B. Kinesio taping in treatment of chronic non-specific low back pain: a systematic review and meta-analysis. J Rehabil Med 2019;51(10):734-40.
    Pubmed CrossRef
  17. Xue X, Chen Y, Mao X, Tu H, Yang X, Deng Z, et al. Effect of kinesio taping on low back pain during pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2021;21(1):712.
    Pubmed KoreaMed CrossRef
  18. Sun G, Lou Q. The efficacy of kinesio taping as an adjunct to physical therapy for chronic low back pain for at least two weeks: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2021;100(49):e28170.
    Pubmed KoreaMed CrossRef
  19. da Luz Júnior MA, Nascimento DP, Scola LF, Bastos RM, Costa LO. Commentary on: Kinesio taping in treatment of chronic non-specific low back pain: a systematic review and meta-analysis. J Rehabil Med 2020;52(2):jrm00013.
    Pubmed CrossRef
  20. Luz Júnior MAD, Almeida MO, Santos RS, Civile VT, Costa LOP. Effectiveness of kinesio taping in patients with chronic nonspecific low back pain: a systematic review with meta-analysis. Spine (Phila Pa 1976) 2019;44(1):68-78.
    Pubmed CrossRef
  21. Xue X, Yang X, Deng Z, Chen Y, Mao X, Tu H, et al. Effect of kinesio taping on pregnancy-related low back pain: a protocol for systematic review and meta-analysis. PLoS One 2022;17(1):e0261766.
    Pubmed KoreaMed CrossRef
  22. Chen L, Ferreira ML, Beckenkamp PR, Caputo EL, Feng S, Ferreira PH. Comparative efficacy and safety of conservative care for pregnancy-related low back pain: a systematic review and network meta-analysis. Phys Ther 2021;101(2):pzaa200.
    Pubmed CrossRef
  23. Li Y, Yin Y, Jia G, Chen H, Yu L, Wu D. Effects of kinesiotape on pain and disability in individuals with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2019;33(4):596-606.
    Pubmed CrossRef
  24. Nunes GS, Feldkircher JM, Tessarin BM, Bender PU, da Luz CM, de Noronha M. Kinesio taping does not improve ankle functional or performance in people with or without ankle injuries: systematic review and meta-analysis. Clin Rehabil 2021;35(2):182-99.
    Pubmed CrossRef
  25. Wang Y, Gu Y, Chen J, Luo W, He W, Han Z, et al. Kinesio taping is superior to other taping methods in ankle functional performance improvement: a systematic review and meta-analysis. Clin Rehabil 2018;32(11):1472-81.
    Pubmed CrossRef
  26. Biz C, Nicoletti P, Tomasin M, Bragazzi NL, Di Rubbo G, Ruggieri P. Is kinesio taping effective for sport performance and ankle function of athletes with chronic ankle instability (CAI)? A systematic review and meta-analysis. Medicina (Kaunas) 2022;58(5):620.
    Pubmed KoreaMed CrossRef
  27. Lu Z, Li X, Chen R, Guo C. Kinesio taping improves pain and function in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials. Int J Surg 2018;59:27-35.
    Pubmed CrossRef
  28. Melese H, Alamer A, Hailu Temesgen M, Nigussie F. Effectiveness of kinesio taping on the management of knee osteoarthritis: a systematic review of randomized controlled trials. J Pain Res 2020;13:1267-76.
    Pubmed KoreaMed CrossRef
  29. Mao HY, Hu MT, Yen YY, Lan SJ, Lee SD. Kinesio taping relieves pain and improves isokinetic not isometric muscle strength in patients with knee osteoarthritis - a systematic review and meta-analysis. Int J Environ Res Public Health 2021;18(19):10440.
    Pubmed KoreaMed CrossRef
  30. Ferreira RM, Duarte JA, Gonçalves RS. Non-pharmacological and non-surgical interventions to manage patients with knee osteoarthritis: an umbrella review. Acta Reumatol Port 2018;43(3):182-200.
    Pubmed
  31. Ouyang JH, Chang KH, Hsu WY, Cho YT, Liou TH, Lin YN. Non-elastic taping, but not elastic taping, provides benefits for patients with knee osteoarthritis: systemic review and meta-analysis. Clin Rehabil 2018;32(1):3-17.
    Pubmed CrossRef
  32. Lin CH, Lee M, Lu KY, Chang CH, Huang SS, Chen CM. Comparative effects of combined physical therapy with kinesio taping and physical therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Clin Rehabil 2020;34(8):1014-27.
    Pubmed CrossRef
  33. Pinheiro YT, de Almeida Silva HJ, de Araújo TAB, da Silva RS, de Souza MC, et al.; E Silva RL. Does current evidence support the use of kinesiology taping in people with knee osteoarthritis? Explore (NY) 2021;17(6):574-7.
    Pubmed CrossRef
  34. Ghozy S, Dung NM, Morra ME, Morsy S, Elsayed GG, Tran L, et al. Efficacy of kinesio taping in treatment of shoulder pain and disability: a systematic review and meta-analysis of randomised controlled trials. Physiotherapy 2020;107:176-88.
    Pubmed CrossRef
  35. Deng P, Zhao Z, Zhang S, Xiao T, Li Y. Effect of kinesio taping on hemiplegic shoulder pain: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2021;35(3):317-31.
    Pubmed CrossRef
  36. Ravichandran H, Janakiraman B, Sundaram S, Fisseha B, Gebreyesus T, Yitayeh Gelaw A. Systematic review on effectiveness of shoulder taping in hemiplegia. J Stroke Cerebrovasc Dis 2019;28(6):1463-73.
    Pubmed CrossRef
  37. Saracoglu I, Emuk Y, Taspinar F. Does taping in addition to physiotherapy improve the outcomes in subacromial impingement syndrome? A systematic review. Physiother Theory Pract 2018;34(4):251-63.
    Pubmed CrossRef
  38. Celik D, Karaborklu Argut S, Coban O, Eren I. The clinical efficacy of kinesio taping in shoulder disorders: a systematic review and meta analysis. Clin Rehabil 2020;34(6):723-40.
    Pubmed CrossRef
  39. Abouelazayem M, Elkorety M, Monib S. Breast lymphedema after conservative breast surgery: an up-to-date systematic review. Clin Breast Cancer 2021;21(3):156-61.
    Pubmed CrossRef
  40. Hu Y, Zhong D, Xiao Q, Chen Q, Li J, Jin R. Kinesio taping for balance function after stroke: a systematic review and meta-analysis. Evid Based Complement Alternat Med 2019;2019:8470235.
    Pubmed KoreaMed CrossRef
  41. Wang M, Pei ZW, Xiong BD, Meng XM, Chen XL, Liao WJ. Use of kinesio taping in lower-extremity rehabilitation of post-stroke patients: a systematic review and meta-analysis. Complement Ther Clin Pract 2019;35:22-32.
    Pubmed CrossRef
  42. Wang Y, Li X, Sun C, Xu R. Effectiveness of kinesiology taping on the functions of upper limbs in patients with stroke: a meta-analysis of randomized trial. Neurol Sci 2022;43(7):4145-56.
    Pubmed KoreaMed CrossRef
  43. Wang Y, Zhu X, Guo J, Sun J. Can kinesio taping improve discomfort after mandibular third molar surgery? A systematic review and meta-analysis. Clin Oral Investig 2021;25(9):5139-48.
    Pubmed CrossRef
  44. Marhofer D, Jaksch W, Aigmüller T, Jochberger S, Urlesberger B, Pils K, et al. [Pain management during pregnancy: an expert-based interdisciplinary consensus recommendation]. Schmerz 2021;35(6):382-90. German.
    Pubmed KoreaMed CrossRef
  45. Qi J, Yue H, Liu E, Chen G, Liu Y, Chen J. Effects of kinesio tape on pain and edema following surgical extraction of the third molar: a meta-analysis and systematic review. J Back Musculoskelet Rehabil 2022. [Epub]. https://doi.org/10.3233/BMR-210209.
    Pubmed CrossRef
  46. Yurttutan ME, Sancak KT. The effect of kinesio taping with the web strip technique on pain, edema, and trismus after impacted mandibular third molar surgery. Niger J Clin Pract 2020;23(9):1260-5.
    Pubmed CrossRef
  47. Yuksel E, Unver B, Karatosun V. Comparison of kinesio taping and cold therapy in patients with total knee arthroplasty: a randomized controlled trial. Clin Rehabil 2022;36(3):359-68.
    Pubmed CrossRef
  48. Nunes GS, Vargas VZ, Wageck B, Hauphental DP, da Luz CM, de Noronha M. Kinesio taping does not decrease swelling in acute, lateral ankle sprain of athletes: a randomised trial. J Physiother 2015;61(1):28-33.
    Pubmed CrossRef
  49. Donec V, Kriščiūnas A. The effectiveness of Kinesio Taping® after total knee replacement in early postoperative rehabilitation period. A randomized controlled trial. Eur J Phys Rehabil Med 2014;50(4):363-71.
    Pubmed
  50. Windisch C, Brodt S, Röhner E, Matziolis G. Effects of kinesio taping compared to arterio-venous Impulse System™ on limb swelling and skin temperature after total knee arthroplasty. Int Orthop 2017;41(2):301-7.
    Pubmed CrossRef
  51. Wageck B, Nunes GS, Bohlen NB, Santos GM, de Noronha M. Kinesio taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial. J Physiother 2016;62(3):153-8.
    Pubmed CrossRef
  52. Baltaci G, Ozunlu Pekyavas N, Atay OA. Short-time effect of sterile kinesio tape applied during anterior cruciate ligament reconstruction on edema, pain and range of motion. Res Sports Med 2021. [Epub]. https://doi.org/10.1080/15438627.2021.2010203.
    Pubmed CrossRef
  53. Serbest S, Tiftikci U, Durgut E, Vergili Ö, Yalın Kılınc C. The effect of kinesio taping versus splint techniques on pain and functional scores in children with hand PIP joint sprain. J Invest Surg 2020;33(4):375-80.
    Pubmed CrossRef
  54. Aguilar-Ferrándiz ME, Castro-Sánchez AM, Matarán-Peñarrocha GA, Guisado-Barrilao R, García-Ríos MC, Moreno-Lorenzo C. A randomized controlled trial of a mixed kinesio taping-compression technique on venous symptoms, pain, peripheral venous flow, clinical severity and overall health status in postmenopausal women with chronic venous insufficiency. Clin Rehabil 2014;28(1):69-81.
    Pubmed CrossRef
  55. Labropoulos N, Giannoukas AD, Nicolaides AN, Veller M, Leon M, Volteas N. The role of venous reflux and calf muscle pump function in nonthrombotic chronic venous insufficiency. Correlation with severity of signs and symptoms. Arch Surg 1996;131(4):403-6.
    Pubmed CrossRef

Article

Review Article

Phys. Ther. Korea 2022; 29(3): 171-179

Published online August 20, 2022 https://doi.org/10.12674/ptk.2022.29.3.171

Copyright © Korean Research Society of Physical Therapy.

Effects of Kinesio Taping on Edema Control in Patients With Musculoskeletal Injuries: A Literature Review

Joon-hyoung Yong1,2 , PT, PhD, Jin-seok Lim2 , PT, MSc, Il-young Moon2 , PT, MSc, Chung-hwi Yi3 , PT, PhD

1Department of Physical Therapy, Hallym Polytechnic University, Chuncheon, 2Department of Physical Therapy, The Graduate School, Yonsei University, 3Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea

Correspondence to:Chung-hwi Yi
E-mail: pteagle@yonsei.ac.kr
https://orcid.org/0000-0003-2554-8083

Received: July 18, 2022; Revised: August 10, 2022; Accepted: August 11, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The application of Kinesio tape (KT) has become an alternative treatment for the reduction of edema owing to its distinct characteristics that mimic skin behavior. Although many studies have found that KT application has a positive effect on edema related to breast cancer and rehabilitation following mandibular third molar surgery, there is little evidence to support the use of KT for musculoskeletal injuries. Objects: The purpose of this study was to review the literature related to KT application for reducing edema caused by musculoskeletal disorders.
Methods: A literature search (July 2022) was performed on PubMed for articles published between January 2012 and June 2022. The following keywords were used: “Kinesio taping,” “Kinesio tape,” “swelling,” and “edema,” with different combinations and derivations. Only articles available in English were included in this study.
Results: Among 68 identified studies, seven met our search strategy and criteria and were included in the literature review. Five of these studies investigated musculoskeletal disorders of the knee joint; two of them reported that KT application had a positive effect on edema measured using perimetry following total knee replacement and anterior cruciate ligament reconstruction. However, the KT application did not improve swelling in patients with acute lateral ankle sprains. Pediatric patients with acute proximal phalangeal joint sprain experienced a more significant improvement in the reduction of swelling than the group using a splint.
Conclusion: This literature review found discrepant evidence to support using KT for edema control in musculoskeletal disorders. Further research is needed to determine the effectiveness of KT for controlling edema following musculoskeletal injuries.

Keywords: Athletic tape, Edema, Musculoskeletal diseases, Swelling

INTRODUCTION

Kinesio tape (KT) is an elastic therapeutic taping technique for the rehabilitation of sports injuries and various other diseases [1,2]. As a Japanese chiropractor, Dr. Kenso Kase developed KT techniques in the 1970s; the use of KT has become popular, especially among athletes and practitioners [3]. Kase et al. [3] proposed that the unique design of KT mimics the thickness and weight of the skin and that it has various benefits such as protecting and supporting the joint or muscle, improving proprioception, decreasing pain and inflammation, and reducing edema [4-6].

One of the distinct roles of KT compared with traditional tapes is to increase blood and lymphatic flow [4]. The conventional lymphatic treatment recommended by the International Society of Lymphology is complete decongestive therapy, including elastic compression and lymphatic drainage, to increase lymphatic flow by eliminating excessive lymphatic fluid, resulting in sustaining a reduced circumference of the region [7,8]. KT causes the target skin to lift and wrinkle, meaning that lifting increases the space between the skin and muscles [4,9]. As a result, taping improves microcirculation and reduces swelling [4]. Furthermore, KT creates in a constant low pressure on the target skin so that lymphatic flow is increased. When KT stimulates cutaneous mechanoreceptors, it facilitates sensory and mechanical stimulation. This reduces the congestion of lymphatic fluid and decreases the circumference of the target area by its active elastic performance [7,10,11].

As the application of KT in clinical conditions has increased, numerous clinical studies have examined its effects on lymphedema. In 2018, Kasawara et al. [7] performed a meta-analysis of clinical trials that reported the effects of KT on breast cancer-related lymphedema. They concluded that KT application positively affected lymphedema in patients after mastectomy. Moreover, Firoozi et al. [12] revealed in their recent systematic review and meta-analysis that KT application resulted in a significant decrease in swelling scores after mandibular third molar surgery.

Once we looked up the review articles on KT published over the past 5 years through the Medical Literature Analysis and Retrieval System Online (MEDLINE) (accessed via PubMed), a total of 52 studies were identified. Most of 52 studies are on cerebral palsy [13-15], low back pain [16-23], ankle functional performance [24-26], knee osteoarthritis (OA) [27-33], shoulder pain and disability [34-38], breast lymphedema [7,39], rehabilitation after stroke [40-42] and so on; however, there are only four studies related to edema [43-46]. Therefore, the purpose of this study was to review the literature on KT for reducing edema caused by musculoskeletal disorders and investigate whether the use of KT have any effects on controlling edema.

MATERIALS AND METHODS

1. Search Strategy and Eligibility Criteria

A search of scientific articles was performed using the MEDLINE from 2012 to June 2022. The studies were included in the first and second quartiles of the Journal Citation Report and selected for the present review. The search strategies for screening the literature published in the scientific database are shown in Table 1.

Table 1 . Search terms for screening studies in PubMed.

#1“Swelling” OR “Edema” AND “Kinesio Taping”
#2“Swelling” OR “Edema” AND “Kinesio Tape”
#3“Swelling” AND “Kinesio Taping”
#4“Swelling” AND “Kinesio Tape”
#5“Edema” AND “Kinesio Taping”
#6“Edema” AND “Kinesio Tape”


Of the 68 identified articles, we selected seven studies for the literature review using the following inclusion/exclusion criteria: (1) clinical studies on patients with edema following musculoskeletal complaints except for any cancer-related disorders and teeth surgery; (2) the article reported data on edema (e.g., volumetry, perimetry); (3) the study presented a comparison group (e.g., placebo taping, no taping, KT applied without tension); and (4) the full text was written in English.

2. Study Selection and Data Extraction

First, two authors independently searched the literature in the databases and reviewed the titles and abstracts of the articles identified after performing the searches. Articles were then identified according to their titles and abstracts to determine whether they provided sufficient data for the purpose of this study. Next, the same authors independently confirmed that the full texts of the articles adhered to the inclusion and exclusion criteria.

The same two reviewers independently performed the searches and selected the evaluated studies. Finally, all authors agreed on the studies that were included in the analysis, with seven studies meeting all established eligibility criteria. All authors performed the analysis. The flowchart of study selection is shown in Figure 1.

Figure 1. Flowchart of the study selection process for this literature review.

RESULTS

Seven clinical studies were analyzed. Of the seven studies, five were related to knee disorders, including total knee arthroplasty (TKA), OA, and anterior cruciate ligament reconstruction (ACLR). One study investigated acute ankle sprain, and another focused on proximal interphalangeal (PIP) joint sprain.

The seven clinical studies included in this literature review are summarized in Table 2. The total number of participants included in the analysis was 517, with 73.9 subjects per study on average. The largest study analyzed 111 patients [47], whereas the smallest number of participants was 36 [48].

Table 2 . Descriptions of studies included in this literature review.

Study (year)Study designSubject characteristicTreatment protocolMeasurementResult
Donec and Kriščiūnas [49], 2014RCT in inpatient rehabilitation facility94 patients who underwent primary TKA surgery divided intotwo groups
KT group (n = 44)
No-taping group (n = 50)
All groups: early mobilization and physical therapy twice a day, occupational therapy once a day, intermittent pneumatic compression, massage, TENS, laser therapy, paraffin therapy.Perimetry measured before surgery and afterwards at four levels (cm): 10 cm above the superior pole of the patella; at the middle line of the knee articular space; in the calf (25 cm above the lateral malleolus inferior pole); and 2 cm above the medial malleolus.Postoperative edema was less severeand regressed quicker in thigh, knee, and calf (p < 0.05, β ≤ 0.2).
Windisch et al [50], 2017Clinical study, prospective study with a historical control group84 subjects with a cemented TKA due to primary OA
KT group (n = 42)
Control group (n = 42)
Control group were fitted with an A-V Impulse SystemTM on both lower limbs immediately p.o in the recovery system. KT group was treated immediately p.o with kinesiotaping.Leg circumference measured at eightpoints daily during 7 p.o. day: on the thigh (20 and 10 cm above the inner knee joint gap), knee (joint gap midline), lower leg (15 cm below the inner knee joint gap), smallest circumference of lower leg and foot (ankle, dorsum of the foot and ball of the foot) of both lower limbs.No significant difference between both groups at any point in time.
Yuksel et al [47], 2022Prospective, RCT with concealed allocation111 patients with total knee arthroplasty
Control group (n = 38)
KT group (n = 37)
Cold-therapygroup (n = 36)
All groups received the same standard postoperative rehabilitation including passive, active-assistive, and active range of motion exercises, strengthening exercises and gait training for two times/day. Weight-bearing, as tolerated, was allowed for all patients on the fist postoperative day.Volumetry was calculated by Volume Frustum formula and circumferential measurements at fourpoints: the midpoint of the patella, 10 cm above the patella, 15 cm above the patella, 10 cm below the patella, and 15 cm below the patella.Cold therapy was effiient in reducing p.o. swelling but KT had no signifiant effects on swelling control.
Wageck et al [51], 2016RCT with concealed allocation, intention-to-treat analysis, and blinded assessment74 older people with knee OA divided in two groups
KT group (n = 38)
Sham-taping group (n = 38)
All groups kept the taping on for 4 days to treat pain, strength, and swelling.Volumetry by water displacement and perimetry measured at threepoints: the fold at the popliteal fossa, 5 cm above that fold, and 5 cm below.At day 4 and the follow-up assessment (day 10), there were no signifiant between-group differences for volumetry (MD: 0.05 ml, 95% CI: –0.01 to 0.11) andperimetry at any measured point.
Baltaci et al [52], 2021Clinical study, prospective analysis, RCT with concealed allocation76 patients with anterior cruciate ligament reconstruction, with discharge 24 hours after surgery
KT group (n = 28)
Control group (n = 28)
All groups received standard postoperative care including compression bandages, ice packing, elevation, and continuous passive motion.Circumferential measurements at five levels: incision level, upper part of incision (5 cm above and 10 cm above) and lower part of incision (5 cm below and 10 cm below). Moreover, the non- operated side was also assessed at the 3-day assessment.There was a significant difference in edema between the groups for incision level and upper part measurements for all 3 days (all p < 0.05), but no difference was found for lower part measurements (all p > 0.05).
Nunes et al [48], 2015RCT with concealed allocation, intention-to-treat analysis, and blinded assessment36 athletes who participated regularly in one of sevendifferent sports and suffered an acute ankle sprain
KT group (n = 18)
Quasi-KT group (n = 18)
Both groups removed the tape before the assessment on day 3. Along with the taping application, both groups received instructions on how to apply ice and elevate the lower limb.Volumetry by water displacement and perimetry measured in a figure-eight fashion.There were no differences between groups for swelling in volumetry (MD: –2 ml, 95% CI: –28 to 32), perimetry (MD: 0.2 cm, 95% CI: –0.6 to 1.0), and relative volumetry (MD: 0.0 cm, 95% CI: –0.1 to 0.1). At day 15 of follow-up, there were no signifiant between-group differences in outcomes.
Serbest et al [53], 2020Retrospective cohort study42 pediatric patients with PIP joint sprain
KT group (n = 21)
Splint group (n = 21)
Each group wastreated with the application for 10 days.Circumference of the PIP joint was measured before and after treatment.Both groups had significantly improvedswelling after treatment (p < 0.001). The KT group displayed a better outcome compared with the splint group (p = 0.021).


Regarding treatments for knee complaints, Donec and Kriščiūnas [49] investigated the effectiveness of KT in decreasing postoperative edema after TKA compared with no taping. Windisch et al. [50] compared KT and A-V impulse systems, which are the conventional devices for lymphatic therapy. In 2022, one study compared no taping with cold therapy in patients with TKA [47]. Wageck et al. [51] evaluated whether KT could be beneficial in patients with knee OA compared with sham taping. Baltaci et al. [52] assessed the effect of KT on the perimetry of the knee within 3 days after ACLR. Two of the seven studies investigated joints other than the knee. Nunes et al. [48] investigated whether KT reduces swelling in athletes with acute lateral ankle sprains. Serbest et al. [53] compared KT with classic finger splint treatment in pediatric patients with PIP joint sprains.

Three of the seven studies reported positive outcomes when using perimetry to assess the swelling [49,52,53]. Donec and Kriščiūnas [49] revealed that the application of KT led to a more rapid decrease in edema in the thigh, knee, and calf (p < 0.05; β ≤ 0.2) during rehabilitation compared with no taping. Baltaci et al. [52] found that incision level and upper knee measurements of KT group were significantly different with no taping group on all 3 days following ACLR (p < 0.05). Serbest et al. [53] reported a better outcome regarding the circumference of the PIP joint with KT application than with splint treatment (p < 0.021). However, KT did not significantly improve swelling in four studies compared with other interventions or no intervention [47,48,50,51].

DISCUSSION

In this literature review, we investigated the effectiveness of KT for reducing edema caused by various musculoskeletal disorders. We finally analyzed seven studies, related with knee, ankle, and hand joints.

The proposed mechanism of KT for relieving edema is through constant tension on the skin, resulting in folds under the taped region. These folds could enhance the interstitial space between the skin and the underlying connective tissue, resulting in increased lymphatic flow [12]. Another theory is that the application of KT provides a suitable environment for lymphatic fluids in the tissue area to move from a higher to lower pressure, leading to reduced congestion of lymphatic fluid and swelling [3,7].

In this literature review, the outcomes of studies differed according to the location of KT application or the purpose of the treatments. Of the three studies on TKA, only the study by Donec and Kriščiūnas [49] reported significant results using knee perimetry. This study revealed that the use of KT had a positive effect on reducing lymphatic fluid compared with no taping and could decrease the risk of edema from the second postoperative week [49]. Windisch et al. [50] reported that there were no significant differences between the KT group and the group using the A-V impulse system, concluding that KT appeared to be just as effective as the A-V impulse system for reducing soft tissue swelling. However, this study had some limitations and lacked control conditions, meaning that it could not determine a significant improvement in swelling when using KT as lymphatic therapy [50]. A recent study investigated the effectiveness of KT in patients with TKA compared with a standard rehabilitation program (control) and cold therapy, which are traditional treatments for controlling swelling [47]. Although KT application resulted in a significant improvement in pain compared with the control group, it did not significantly control swelling; furthermore, cold therapy was statistically superior to both the control treatment and KT regarding alleviating lymphatic fluids [47].

One study investigating the effects of KT on knee OA revealed that KT intervention did not show any improvement compared with sham taping [51]. However, when KT was used in people who had undergone ACLR, KT resulted in a significant improvement in swelling 72 hours after KT application [52]. Considering previous studies, all subjects developed acute tissue swelling or lymphedema after surgery, but not subjects with OA because their symptoms had been present for at least 6 months [51]. In addition, participants in the sham taping study used taping alone without any physical therapy [51]. Therefore, KT may assist in reducing edema that occurs after surgery, rather than swelling associated with chronic knee joint disorders. Additionally, KT with standard postoperative rehabilitation appears to be more effective than the application of KT alone.

We reviewed only two studies related to joints other than the knee. Nunes et al. [48] evaluated the effects of KT application in athletes with acute lateral ankle sprains. Their study reported no significant improvement in acute swelling with KT [48]. Some studies reported that KT reduces the extracellular liquid resulting from hydrostatic pressure changes and having a low level of protein or transudate such as chronic venous insufficiency [54,55]. They asserted that considering the structural differences of the swelling, KT did not influence the active inflammatory phase because high levels of protein or transudate were exuded during the healing process of acute inflammation [48]. Regarding the effectiveness of KT in pediatric patients with acute PIP joint sprains, both the KT and splint groups had some positive effects on the circumference compared with before treatment [53]. Although splinting is a conventional treatment for acute sprain, the use of KT significantly reduced the congestion of lymphatic fluids compared with splinting [53]. Furthermore, KT also had positive effects on range of motion [53]. We speculate that KT restricts the joint structures less than splinting and, along with muscle activation during the healing process of inflammation, the use of KT could facilitate the movement of lymphatic fluid, consequently improving lymphatic flow. Conversely, a decrease in swelling could improve joint mobility [51].

The present review has several limitations. Only seven studies met the search criteria, which limited the clinical research that evaluated musculoskeletal complaints. Although these studies aimed to investigate the overall effects of KT by measuring outcomes such as pain, mobility, and strength, the purpose of the present review was to examine and compare edema only. In addition, it was difficult to generalize the effect of KT on swelling owing to the different taping techniques and primary causes of edema among the reviewed studies. Another limitation of this literature review includes a search strategy in which only one database was searched and articles in other languages were excluded. Our literature review did not include an explicit definition of musculoskeletal disorders. A clearer definition of this term is required to generalize the findings to a broad range of musculoskeletal injuries.

CONCLUSIONS

Our literature review found insufficient evidence for or against the application of KT in improving lymphatic flow and reducing swelling following various musculoskeletal complaints. Despite the lack of evidence to demonstrate the clinical benefits of KT for edema, this study presents a comprehensive review of the swelling relief effect of KT on different types of musculoskeletal injury. KT can be used as a low-cost complementary intervention for swelling control in postoperative treatment after TKA and ACLR. Furthermore, KT could be a useful modality in rehabilitation following acute PIP joint sprains. Further research is needed to clarify the use of KT in reducing edema in musculoskeletal injuries.

ACKNOWLEDGEMENTS

None.

FUNDING

This study was supported by the “Brain Korea 21 FOUR Project” and the Korean Research Foundation for the Department of Physical Therapy at the Graduate School of Yonsei University.

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

AUTHOR CONTRIBUTIONS

Conceptualization: JY, IM, JL. Data curation: JY, IM, JL. Formal analysis: JY, IM, JL. Funding acquisition: JY, CY. Investigation: JY, IM, JL. Methodology: JY, CY, IM, JL. Project administration: CY. Resources: JY, CY. Supervision: CY. Validation: JY, CY. Visualization: JY, IM, JL. Writing - original draft: JY, IM, JL. Writing - review & editing: JY, CY, IM, JL.

Fig 1.

Figure 1.Flowchart of the study selection process for this literature review.
Physical Therapy Korea 2022; 29: 171-179https://doi.org/10.12674/ptk.2022.29.3.171

Table 1 . Search terms for screening studies in PubMed.

#1“Swelling” OR “Edema” AND “Kinesio Taping”
#2“Swelling” OR “Edema” AND “Kinesio Tape”
#3“Swelling” AND “Kinesio Taping”
#4“Swelling” AND “Kinesio Tape”
#5“Edema” AND “Kinesio Taping”
#6“Edema” AND “Kinesio Tape”

Table 2 . Descriptions of studies included in this literature review.

Study (year)Study designSubject characteristicTreatment protocolMeasurementResult
Donec and Kriščiūnas [49], 2014RCT in inpatient rehabilitation facility94 patients who underwent primary TKA surgery divided intotwo groups
KT group (n = 44)
No-taping group (n = 50)
All groups: early mobilization and physical therapy twice a day, occupational therapy once a day, intermittent pneumatic compression, massage, TENS, laser therapy, paraffin therapy.Perimetry measured before surgery and afterwards at four levels (cm): 10 cm above the superior pole of the patella; at the middle line of the knee articular space; in the calf (25 cm above the lateral malleolus inferior pole); and 2 cm above the medial malleolus.Postoperative edema was less severeand regressed quicker in thigh, knee, and calf (p < 0.05, β ≤ 0.2).
Windisch et al [50], 2017Clinical study, prospective study with a historical control group84 subjects with a cemented TKA due to primary OA
KT group (n = 42)
Control group (n = 42)
Control group were fitted with an A-V Impulse SystemTM on both lower limbs immediately p.o in the recovery system. KT group was treated immediately p.o with kinesiotaping.Leg circumference measured at eightpoints daily during 7 p.o. day: on the thigh (20 and 10 cm above the inner knee joint gap), knee (joint gap midline), lower leg (15 cm below the inner knee joint gap), smallest circumference of lower leg and foot (ankle, dorsum of the foot and ball of the foot) of both lower limbs.No significant difference between both groups at any point in time.
Yuksel et al [47], 2022Prospective, RCT with concealed allocation111 patients with total knee arthroplasty
Control group (n = 38)
KT group (n = 37)
Cold-therapygroup (n = 36)
All groups received the same standard postoperative rehabilitation including passive, active-assistive, and active range of motion exercises, strengthening exercises and gait training for two times/day. Weight-bearing, as tolerated, was allowed for all patients on the fist postoperative day.Volumetry was calculated by Volume Frustum formula and circumferential measurements at fourpoints: the midpoint of the patella, 10 cm above the patella, 15 cm above the patella, 10 cm below the patella, and 15 cm below the patella.Cold therapy was effiient in reducing p.o. swelling but KT had no signifiant effects on swelling control.
Wageck et al [51], 2016RCT with concealed allocation, intention-to-treat analysis, and blinded assessment74 older people with knee OA divided in two groups
KT group (n = 38)
Sham-taping group (n = 38)
All groups kept the taping on for 4 days to treat pain, strength, and swelling.Volumetry by water displacement and perimetry measured at threepoints: the fold at the popliteal fossa, 5 cm above that fold, and 5 cm below.At day 4 and the follow-up assessment (day 10), there were no signifiant between-group differences for volumetry (MD: 0.05 ml, 95% CI: –0.01 to 0.11) andperimetry at any measured point.
Baltaci et al [52], 2021Clinical study, prospective analysis, RCT with concealed allocation76 patients with anterior cruciate ligament reconstruction, with discharge 24 hours after surgery
KT group (n = 28)
Control group (n = 28)
All groups received standard postoperative care including compression bandages, ice packing, elevation, and continuous passive motion.Circumferential measurements at five levels: incision level, upper part of incision (5 cm above and 10 cm above) and lower part of incision (5 cm below and 10 cm below). Moreover, the non- operated side was also assessed at the 3-day assessment.There was a significant difference in edema between the groups for incision level and upper part measurements for all 3 days (all p < 0.05), but no difference was found for lower part measurements (all p > 0.05).
Nunes et al [48], 2015RCT with concealed allocation, intention-to-treat analysis, and blinded assessment36 athletes who participated regularly in one of sevendifferent sports and suffered an acute ankle sprain
KT group (n = 18)
Quasi-KT group (n = 18)
Both groups removed the tape before the assessment on day 3. Along with the taping application, both groups received instructions on how to apply ice and elevate the lower limb.Volumetry by water displacement and perimetry measured in a figure-eight fashion.There were no differences between groups for swelling in volumetry (MD: –2 ml, 95% CI: –28 to 32), perimetry (MD: 0.2 cm, 95% CI: –0.6 to 1.0), and relative volumetry (MD: 0.0 cm, 95% CI: –0.1 to 0.1). At day 15 of follow-up, there were no signifiant between-group differences in outcomes.
Serbest et al [53], 2020Retrospective cohort study42 pediatric patients with PIP joint sprain
KT group (n = 21)
Splint group (n = 21)
Each group wastreated with the application for 10 days.Circumference of the PIP joint was measured before and after treatment.Both groups had significantly improvedswelling after treatment (p < 0.001). The KT group displayed a better outcome compared with the splint group (p = 0.021).

References

  1. Thelen MD, Dauber JA, Stoneman PD. The clinical efficacy of kinesio tape for shoulder pain: a randomized, double-blinded, clinical trial. J Orthop Sports Phys Ther 2008;38(7):389-95.
    Pubmed CrossRef
  2. Mostafavifar M, Wertz J, Borchers J. A systematic review of the effectiveness of kinesio taping for musculoskeletal injury. Phys Sportsmed 2012;40(4):33-40.
    Pubmed CrossRef
  3. Kase K, Wallis J, Kase T. Clinical therapeutic applications of the kinesio taping methods. 2nd ed. Tokyo: Kenzo Kase; 2003.
    CrossRef
  4. Jaron A, Konkol B, Gabrysz-Trybek E, Bladowska J, Grzywacz A, Nedjat A, et al. Kinesio taping - a healing and supportive method in various fields of medicine, dentistry, sport and physiotherapy. Balt J Health Phys Act 2021;13(2):11-25.
    CrossRef
  5. Liu K, Qian J, Gao Q, Ruan B. Effects of kinesio taping of the knee on proprioception, balance, and functional performance in patients with anterior cruciate ligament rupture: a retrospective case series. Medicine (Baltimore) 2019;98(48):e17956.
    Pubmed KoreaMed CrossRef
  6. Bischoff L, Babisch C, Babisch J, Layher F, Sander K, Matziolis G, et al. Effects on proprioception by kinesio taping of the knee after anterior cruciate ligament rupture. Eur J Orthop Surg Traumatol 2018;28(6):1157-64.
    Pubmed CrossRef
  7. Kasawara KT, Mapa JMR, Ferreira V, Added MAN, Shiwa SR, Carvas N Jr, et al. Effects of kinesio taping on breast cancer-related lymphedema: a meta-analysis in clinical trials. Physiother Theory Pract 2018;34(5):337-45.
    Pubmed CrossRef
  8. Cormier JN, Rourke L, Crosby M, Chang D, Armer J. The surgical treatment of lymphedema: a systematic review of the contemporary literature (2004-2010). Ann Surg Oncol 2012;19(2):642-51.
    Pubmed CrossRef
  9. Abolhasani M, Halabchi F, Afsharnia E, Moradi V, Ingle L, Shariat A, et al. Effects of kinesiotaping on knee osteoarthritis: a literature review. J Exerc Rehabil 2019;15(4):498-503.
    Pubmed KoreaMed CrossRef
  10. Martins Jde C, Aguiar SS, Fabro EA, Costa RM, Lemos TV, de Sá VG, et al. Safety and tolerability of kinesio taping in patients with arm lymphedema: medical device clinical study. Support Care Cancer 2016;24(3):1119-24.
    Pubmed CrossRef
  11. da Silva RMV, Cavalcanti RL, de França Rêgo LM, Nunes PFL, Meyer PF. Effects of Kinesio Taping® in treatment of cellulite: randomized controlled blind trial. Man Ther Posturology Rehabil J 2014;12:106-11.
    CrossRef
  12. Firoozi P, Souza MRF, de Souza GM, Fernandes IA, Galvão EL, Falci SGM. Does kinesio taping reduce pain, swelling, and trismus after mandibular third molar surgery? a systematic review and meta-analysis. Oral Maxillofac Surg 2022. [Epub]. https://doi.org/10.1007/s10006-021-01025-y.
    Pubmed CrossRef
  13. Ortiz Ramírez J, Pérez de la Cruz S. Therapeutic effects of kinesio taping in children with cerebral palsy: a systematic review. Arch Argent Pediatr 2017;115(6):e356-61.
    Pubmed KoreaMed CrossRef
  14. Inamdar K, Molinini RM, Panibatla ST, Chow JC, Dusing SC. Physical therapy interventions to improve sitting ability in children with or at-risk for cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol 2021;63(4):396-406.
    Pubmed CrossRef
  15. Unger M, Carstens JP, Fernandes N, Pretorius R, Pronk S, Robinson AC, et al. The efficacy of kinesiology taping for improving gross motor function in children with cerebral palsy: a systematic review. S Afr J Physiother 2018;74(1):459.
    Pubmed KoreaMed CrossRef
  16. Sheng Y, Duan Z, Qu Q, Chen W, Yu B. Kinesio taping in treatment of chronic non-specific low back pain: a systematic review and meta-analysis. J Rehabil Med 2019;51(10):734-40.
    Pubmed CrossRef
  17. Xue X, Chen Y, Mao X, Tu H, Yang X, Deng Z, et al. Effect of kinesio taping on low back pain during pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2021;21(1):712.
    Pubmed KoreaMed CrossRef
  18. Sun G, Lou Q. The efficacy of kinesio taping as an adjunct to physical therapy for chronic low back pain for at least two weeks: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2021;100(49):e28170.
    Pubmed KoreaMed CrossRef
  19. da Luz Júnior MA, Nascimento DP, Scola LF, Bastos RM, Costa LO. Commentary on: Kinesio taping in treatment of chronic non-specific low back pain: a systematic review and meta-analysis. J Rehabil Med 2020;52(2):jrm00013.
    Pubmed CrossRef
  20. Luz Júnior MAD, Almeida MO, Santos RS, Civile VT, Costa LOP. Effectiveness of kinesio taping in patients with chronic nonspecific low back pain: a systematic review with meta-analysis. Spine (Phila Pa 1976) 2019;44(1):68-78.
    Pubmed CrossRef
  21. Xue X, Yang X, Deng Z, Chen Y, Mao X, Tu H, et al. Effect of kinesio taping on pregnancy-related low back pain: a protocol for systematic review and meta-analysis. PLoS One 2022;17(1):e0261766.
    Pubmed KoreaMed CrossRef
  22. Chen L, Ferreira ML, Beckenkamp PR, Caputo EL, Feng S, Ferreira PH. Comparative efficacy and safety of conservative care for pregnancy-related low back pain: a systematic review and network meta-analysis. Phys Ther 2021;101(2):pzaa200.
    Pubmed CrossRef
  23. Li Y, Yin Y, Jia G, Chen H, Yu L, Wu D. Effects of kinesiotape on pain and disability in individuals with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2019;33(4):596-606.
    Pubmed CrossRef
  24. Nunes GS, Feldkircher JM, Tessarin BM, Bender PU, da Luz CM, de Noronha M. Kinesio taping does not improve ankle functional or performance in people with or without ankle injuries: systematic review and meta-analysis. Clin Rehabil 2021;35(2):182-99.
    Pubmed CrossRef
  25. Wang Y, Gu Y, Chen J, Luo W, He W, Han Z, et al. Kinesio taping is superior to other taping methods in ankle functional performance improvement: a systematic review and meta-analysis. Clin Rehabil 2018;32(11):1472-81.
    Pubmed CrossRef
  26. Biz C, Nicoletti P, Tomasin M, Bragazzi NL, Di Rubbo G, Ruggieri P. Is kinesio taping effective for sport performance and ankle function of athletes with chronic ankle instability (CAI)? A systematic review and meta-analysis. Medicina (Kaunas) 2022;58(5):620.
    Pubmed KoreaMed CrossRef
  27. Lu Z, Li X, Chen R, Guo C. Kinesio taping improves pain and function in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials. Int J Surg 2018;59:27-35.
    Pubmed CrossRef
  28. Melese H, Alamer A, Hailu Temesgen M, Nigussie F. Effectiveness of kinesio taping on the management of knee osteoarthritis: a systematic review of randomized controlled trials. J Pain Res 2020;13:1267-76.
    Pubmed KoreaMed CrossRef
  29. Mao HY, Hu MT, Yen YY, Lan SJ, Lee SD. Kinesio taping relieves pain and improves isokinetic not isometric muscle strength in patients with knee osteoarthritis - a systematic review and meta-analysis. Int J Environ Res Public Health 2021;18(19):10440.
    Pubmed KoreaMed CrossRef
  30. Ferreira RM, Duarte JA, Gonçalves RS. Non-pharmacological and non-surgical interventions to manage patients with knee osteoarthritis: an umbrella review. Acta Reumatol Port 2018;43(3):182-200.
    Pubmed
  31. Ouyang JH, Chang KH, Hsu WY, Cho YT, Liou TH, Lin YN. Non-elastic taping, but not elastic taping, provides benefits for patients with knee osteoarthritis: systemic review and meta-analysis. Clin Rehabil 2018;32(1):3-17.
    Pubmed CrossRef
  32. Lin CH, Lee M, Lu KY, Chang CH, Huang SS, Chen CM. Comparative effects of combined physical therapy with kinesio taping and physical therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Clin Rehabil 2020;34(8):1014-27.
    Pubmed CrossRef
  33. Pinheiro YT, de Almeida Silva HJ, de Araújo TAB, da Silva RS, de Souza MC, et al.; E Silva RL. Does current evidence support the use of kinesiology taping in people with knee osteoarthritis? Explore (NY) 2021;17(6):574-7.
    Pubmed CrossRef
  34. Ghozy S, Dung NM, Morra ME, Morsy S, Elsayed GG, Tran L, et al. Efficacy of kinesio taping in treatment of shoulder pain and disability: a systematic review and meta-analysis of randomised controlled trials. Physiotherapy 2020;107:176-88.
    Pubmed CrossRef
  35. Deng P, Zhao Z, Zhang S, Xiao T, Li Y. Effect of kinesio taping on hemiplegic shoulder pain: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2021;35(3):317-31.
    Pubmed CrossRef
  36. Ravichandran H, Janakiraman B, Sundaram S, Fisseha B, Gebreyesus T, Yitayeh Gelaw A. Systematic review on effectiveness of shoulder taping in hemiplegia. J Stroke Cerebrovasc Dis 2019;28(6):1463-73.
    Pubmed CrossRef
  37. Saracoglu I, Emuk Y, Taspinar F. Does taping in addition to physiotherapy improve the outcomes in subacromial impingement syndrome? A systematic review. Physiother Theory Pract 2018;34(4):251-63.
    Pubmed CrossRef
  38. Celik D, Karaborklu Argut S, Coban O, Eren I. The clinical efficacy of kinesio taping in shoulder disorders: a systematic review and meta analysis. Clin Rehabil 2020;34(6):723-40.
    Pubmed CrossRef
  39. Abouelazayem M, Elkorety M, Monib S. Breast lymphedema after conservative breast surgery: an up-to-date systematic review. Clin Breast Cancer 2021;21(3):156-61.
    Pubmed CrossRef
  40. Hu Y, Zhong D, Xiao Q, Chen Q, Li J, Jin R. Kinesio taping for balance function after stroke: a systematic review and meta-analysis. Evid Based Complement Alternat Med 2019;2019:8470235.
    Pubmed KoreaMed CrossRef
  41. Wang M, Pei ZW, Xiong BD, Meng XM, Chen XL, Liao WJ. Use of kinesio taping in lower-extremity rehabilitation of post-stroke patients: a systematic review and meta-analysis. Complement Ther Clin Pract 2019;35:22-32.
    Pubmed CrossRef
  42. Wang Y, Li X, Sun C, Xu R. Effectiveness of kinesiology taping on the functions of upper limbs in patients with stroke: a meta-analysis of randomized trial. Neurol Sci 2022;43(7):4145-56.
    Pubmed KoreaMed CrossRef
  43. Wang Y, Zhu X, Guo J, Sun J. Can kinesio taping improve discomfort after mandibular third molar surgery? A systematic review and meta-analysis. Clin Oral Investig 2021;25(9):5139-48.
    Pubmed CrossRef
  44. Marhofer D, Jaksch W, Aigmüller T, Jochberger S, Urlesberger B, Pils K, et al. [Pain management during pregnancy: an expert-based interdisciplinary consensus recommendation]. Schmerz 2021;35(6):382-90. German.
    Pubmed KoreaMed CrossRef
  45. Qi J, Yue H, Liu E, Chen G, Liu Y, Chen J. Effects of kinesio tape on pain and edema following surgical extraction of the third molar: a meta-analysis and systematic review. J Back Musculoskelet Rehabil 2022. [Epub]. https://doi.org/10.3233/BMR-210209.
    Pubmed CrossRef
  46. Yurttutan ME, Sancak KT. The effect of kinesio taping with the web strip technique on pain, edema, and trismus after impacted mandibular third molar surgery. Niger J Clin Pract 2020;23(9):1260-5.
    Pubmed CrossRef
  47. Yuksel E, Unver B, Karatosun V. Comparison of kinesio taping and cold therapy in patients with total knee arthroplasty: a randomized controlled trial. Clin Rehabil 2022;36(3):359-68.
    Pubmed CrossRef
  48. Nunes GS, Vargas VZ, Wageck B, Hauphental DP, da Luz CM, de Noronha M. Kinesio taping does not decrease swelling in acute, lateral ankle sprain of athletes: a randomised trial. J Physiother 2015;61(1):28-33.
    Pubmed CrossRef
  49. Donec V, Kriščiūnas A. The effectiveness of Kinesio Taping® after total knee replacement in early postoperative rehabilitation period. A randomized controlled trial. Eur J Phys Rehabil Med 2014;50(4):363-71.
    Pubmed
  50. Windisch C, Brodt S, Röhner E, Matziolis G. Effects of kinesio taping compared to arterio-venous Impulse System™ on limb swelling and skin temperature after total knee arthroplasty. Int Orthop 2017;41(2):301-7.
    Pubmed CrossRef
  51. Wageck B, Nunes GS, Bohlen NB, Santos GM, de Noronha M. Kinesio taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial. J Physiother 2016;62(3):153-8.
    Pubmed CrossRef
  52. Baltaci G, Ozunlu Pekyavas N, Atay OA. Short-time effect of sterile kinesio tape applied during anterior cruciate ligament reconstruction on edema, pain and range of motion. Res Sports Med 2021. [Epub]. https://doi.org/10.1080/15438627.2021.2010203.
    Pubmed CrossRef
  53. Serbest S, Tiftikci U, Durgut E, Vergili Ö, Yalın Kılınc C. The effect of kinesio taping versus splint techniques on pain and functional scores in children with hand PIP joint sprain. J Invest Surg 2020;33(4):375-80.
    Pubmed CrossRef
  54. Aguilar-Ferrándiz ME, Castro-Sánchez AM, Matarán-Peñarrocha GA, Guisado-Barrilao R, García-Ríos MC, Moreno-Lorenzo C. A randomized controlled trial of a mixed kinesio taping-compression technique on venous symptoms, pain, peripheral venous flow, clinical severity and overall health status in postmenopausal women with chronic venous insufficiency. Clin Rehabil 2014;28(1):69-81.
    Pubmed CrossRef
  55. Labropoulos N, Giannoukas AD, Nicolaides AN, Veller M, Leon M, Volteas N. The role of venous reflux and calf muscle pump function in nonthrombotic chronic venous insufficiency. Correlation with severity of signs and symptoms. Arch Surg 1996;131(4):403-6.
    Pubmed CrossRef