Physical Therapy Korea
eISSN 2287-982X
QR Code
eISSN 2287-982X
Article
Article Tools
Share this article on :
Starts or metrics
Article
Original Article
Split Viewer
Phys. Ther. Korea 2023; 30(4): 288-305
Published online November 20, 2023
https://doi.org/10.12674/ptk.2023.30.4.288
© Korean Research Society of Physical Therapy
A Systematic Review of Kinesiology Taping in Patients With Lymphedema
Jaehee Yang 
, RN, CLT, MSc, Eun Jin Lim , MPH, PhD
Department of Integrative Medicine, The Graduate School of Integrative Medicine, CHA University, Pochun, Korea
Correspondence to: Eun Jin Lim
E-mail: eunjinlim@chamc.co.kr
https://orcid.org/0000-0002-7841-7389
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 compression therapy, which is the standard treatment for lymphedema patients, may be difficult to implement and contraindicated to some patients depending on their health condition. Objects: The purpose of this study is to investigate whether kinesiology taping (KT) can be used effectively and safely in the management of lymphedema as an alternative treatment through systematic review and meta-analysis.
Methods: In February 2023, the literature was systematically collected through eight search engines with a combination of terms, ‘lymphedema’ and ‘kinesiology taping.’ We qualitatively analyzed the differences and safety of KT methods, and quantitatively meta-analyzed the effects of volume reduction in edema, range of motion (ROM), and pain improvement using Review Manager ver. 5. 4. To assess the risk of bias in the randomized controlled trial (RCT) studies, Risk of Bias was used.
Results: A total of 616 articles searched and 20 studies were selected, including 12 RCTs and eight case studies. KT intervention could not replace multilayer compression bandage (MLB), but it demonstrated similar or better results compared to compression garment (CG), with reduced pain and improved intervention comfort. Studies reported skin adverse events ranging from 2.5% to 20.68%, with a total adverse event incidence of 7.7%. There was no significant difference in the application method of KT. As a result of the meta-analysis from the 8 RCTs, the KT intervention showed a mean difference (MD) of –7.18 with a 95% confidence interval (CI) [–12.64 to –1.72] in the volume change of lymphedema, while the pain difference was MD 0.82 with CI 95% [0.50 to 1.15], in comparison to the MLB and CG intervention.
Conclusion: KT therapy led to a reduction in edema size, volume, pain, and improved ROM and quality of life. KT may be a viable option for lymphedema patients who have trouble applying traditional compression therapies.
Keywords: Compression bandage, Kinesiotape, Lymphedema
PDF
Standard view
Export citation
Share Article
Original Article
Phys. Ther. Korea 2023; 30(4): 288-305
Published online November 20, 2023 https://doi.org/10.12674/ptk.2023.30.4.288
Copyright © Korean Research Society of Physical Therapy.
A Systematic Review of Kinesiology Taping in Patients With Lymphedema
Jaehee Yang , RN, CLT, MSc, Eun Jin Lim , MPH, PhD
Department of Integrative Medicine, The Graduate School of Integrative Medicine, CHA University, Pochun, Korea
Correspondence to:Eun Jin Lim
E-mail: eunjinlim@chamc.co.kr
https://orcid.org/0000-0002-7841-7389
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 compression therapy, which is the standard treatment for lymphedema patients, may be difficult to implement and contraindicated to some patients depending on their health condition. Objects: The purpose of this study is to investigate whether kinesiology taping (KT) can be used effectively and safely in the management of lymphedema as an alternative treatment through systematic review and meta-analysis.
Methods: In February 2023, the literature was systematically collected through eight search engines with a combination of terms, ‘lymphedema’ and ‘kinesiology taping.’ We qualitatively analyzed the differences and safety of KT methods, and quantitatively meta-analyzed the effects of volume reduction in edema, range of motion (ROM), and pain improvement using Review Manager ver. 5. 4. To assess the risk of bias in the randomized controlled trial (RCT) studies, Risk of Bias was used.
Results: A total of 616 articles searched and 20 studies were selected, including 12 RCTs and eight case studies. KT intervention could not replace multilayer compression bandage (MLB), but it demonstrated similar or better results compared to compression garment (CG), with reduced pain and improved intervention comfort. Studies reported skin adverse events ranging from 2.5% to 20.68%, with a total adverse event incidence of 7.7%. There was no significant difference in the application method of KT. As a result of the meta-analysis from the 8 RCTs, the KT intervention showed a mean difference (MD) of –7.18 with a 95% confidence interval (CI) [–12.64 to –1.72] in the volume change of lymphedema, while the pain difference was MD 0.82 with CI 95% [0.50 to 1.15], in comparison to the MLB and CG intervention.
Conclusion: KT therapy led to a reduction in edema size, volume, pain, and improved ROM and quality of life. KT may be a viable option for lymphedema patients who have trouble applying traditional compression therapies.
Keywords: Compression bandage, Kinesiotape, Lymphedema
Fig 1.
Download
Fig 2.
Download
Fig 3.
Download
Fig 4.
Download
Fig 5.
Download-
Table 1 . Characteristics of included studies.
Study Study
designDiagnosis LE status Participants
descriptionTreatment protocol & *intervention of control group Evaluation tool Outcome Atar et al. [32] RCT double blind sham control HNL stage I & II 51.3 years (female: 23/male: 35)
KT (n = 30)
SKT (n = 28)4 weeks (11 times)
5/w (1st week) & 2/w (2–4th week) with MLD 45 min & home exercise
*sham KT① Circumference of face and neck & edema scale by MDACC HNL
② Fiberoptic endoscopic images
③ VAS: comfort conception
④ EORTC QLQ-C30: QOL① Significant reduction in both groups (p < 0.01) edema scale: KT = 76.7%↓, control = 57.1%↓
② No difference in both group (p = 0.860)
③ No difference between groups in discomfort but significant improvement of global health status & swallowing in the KT
④ Decrease of pain scale in the KT onlySelcuk Yilmaz and Ayhan [31] RCT BCRL stage II 54.7 years (female)
KT (n = 15)
MLD (n = 15)
LLLT (n = 15)3 weeks, KT = 2/w, MLD = 5/w, LLLT = 5/w with MLB + lymphedema remedial exercise + education/CCL2 flat knit CG after the intervention
*MLD/LLLT① Circumference & PDV
② DASH
③ LYMQoL-Arm: QOL
④ PDQ: pain① Significantly higher PDV measurement in the KT group compared to the MLD group at every measurement time (p = 0.009, p = 0.039, p = 0.042)
② Improvements across all three measurements in both KT and LLLT groups
③ No difference between groups
④ Decrease in all three groupsTorres-Lacomba et al. [28] RCT BCRL stage I & II 58.4 years (female)
KT (n = 29)
MLB (n = 28)
S.MLB (n = 30)
Cohesive (n = 29)
Adhesive (n = 30)3 weeks, 5/w (1–2nd week) & for 3-day interval/w with CDT intensive: MLD + IPC 30 min + exercise
15 min + education
*4 different bandages types of bandages① % excess volume change via Frustrum formula
② Heaviness and tightness
③ 11 point numerical scale perceived comfort① Volume reduction most effective in SMLB (59.5%), least effective in KT (4.9%)Difference between two groups' vol. reduction & access vol. %: 107.7 ml & 54.6%
② No difference in heaviness & tightness
③ KT: Most comfortable (1.4)/ MLD: most uncomfortable (6.7)Pajero Otero et al. [26] RCT cross-over BCRL stage II 67 years (female)
KT (n = 15)
CG (n = 15)Wash out 4 weeks & 4 weeks, 1/w & wash out 4 weeks & 4 weeks, 1/w with self-care education: skin care & exercise
*compression garment① Relative Volume (change & difference)
② ROM
③ Self-perception of comfort
④ LE related symptoms① RVC: KT = 5.7%↓/CG = 3.4%↓
② ROM: only improved in KT 5.8°–16.7°↑(p < 0.05)
③ KT: more comfortable (p < 0.001)
④ KT: more improved LE symptoms (p < 0.05)Ozsoy-Unubol et al. [22] RCT BCRL stage I 52.7 years (female)
KT (n = 16)
CG (n = 19)4 weeks, every 3–4 days with skin and nail care education + home exercise 20 min 2/d
*compression garment① Circumference measurement
② ROM
③ VAS: pain, heaviness, tightness① Arm circumference differences at all levels decreased in both groups
② Similar effects between groups
③ Pain score: KT improves over CGTantawy et al. [19] RCT BCRL stage II & III 54.7 years (female)
KT (n = 30)
CG (n = 29)3 weeks, 2/w with home exercise
*compression garment① Sum of limb circumference
② SPADI: shoulder pain & disability
③ Hand grip strength
④ QLQC30: QOL① KT: 177.5 → 153.5 (24 cm↓), CG: 172.2 → 163.4 (8.8 cm↓)
② Significant improvement only at KT
③ KT: 23.43 kg↑, CG: 2.18 kg↑
④ Significant improvement only at KTErgin et al. [34] RCT BCRL significant (≤ 250 ml & marked (250–500 ml) 56.24 years (female)
KT + CDT (n = 18)
CDT (n = 14)4 weeks (20 times), 5/w (1 hr/d) with CDT: MLD + MLB + exercise + skin care/ KT is maintained for 3 days and then reapplied.
*CDT① Each 5 cm, 7 points circumference measurement & limb volume ① Reduced circumference & volume at all points in both group (p ≤ 0.001/p ≤ 0.001)
No difference between groupsHassan and Ismail [27] RCT BCRL 54.1 years (female)
KT (n = 15)
CG (n = 15)4 weeks (12 times), 3/w with MLD 45 min + exercise
*compression garment① Circumference of arm and forearm
② ROM: flexion and abduction① Arm: KT = 18.6%↓, CG = 13.7%↓/forearm: KT = 12.28%↓, CG = 18.62%↓
② ROM: flexion, KT = 75.4%↑ CG = 19.6%/abduction, KT = 72.52%↑, CG = 47.51%↑Taradaj et al. [11] RCT BCRL stage II & III 62 years (female)
KT (n = 22)
qKT (n = 23)
MLB (n = 25)4 weeks (12 times), 3/w with MLD 50 min + IPC 45 min
Tape on every Monday and take it off on Friday
*quasi-KT/bandages① Optoelectronic perometer 40T
② ROM
③ Hand grip strength① % of volume decreased in all groups (MLB = 45.02%↓, KT = 22.45%↓, qKT = 24.04%↓)
② Similar results in ROM
③ KT: 128.34 N → 140.23 N, qKT: 130.45 N → 138.93 N, MLB: 128.88 N → 168.76 NPekyavas et al. [29] RCT BCRL grade 2, 3 54.6 years (female)
KT (n = 14)
MLB + KT (n = 13)
MLB (n = 14)2 weeks (10 times), 5/w with CDT: MLD 30 min + skin care + exercise 20 min/KT daily application
*bandages/combination of bandages and KT① VAS: LE symptoms & itching and wound formation
② Circumference & volume
③ SF-36: QOL① Reduced lymphedema related symptoms in all groups (p < 0.05) pain reduced only in KT
② After 1 month of the intervention: KT + MLB = 547.94 ml↓, KT = 379.04 ml↓, MLB = 358.31 ml↓, only KT + MLB (p < 0.05)
③ No difference between groupsPop et al. [33] RCT preliminary study BCRL soft oedema 62 years (female)
ownKT (n = 22)
KT (n = 22)3 weeks (3 times), 1/w with home exercise 2/d
*KT with different directions① Circumference & volume
② ROM
③ Hand grip strength
④ Self-prepared questionnaire about the therapy① ownKT = 55%↓, KT=27%↓
② More improved in ownKT (between 0°–15°)
③ ownKT: 14 kg → 22 kg, KT: 13 kg → 18 kg
④ Very good: ownKT (n = 10), KT (n = 4)good: an equal number of 9 each, bad: no oneSmykla et al. [30] RCT single blind pilot study BCRL stage II & III 66.3 years (female)
KT (n = 20)
qKT (n = 22)
MLB (n = 23)4 weeks (12 times), 3/w with MLD 1 hr + IPC 45 min + skin care
*quasi-KT/bandages① Optoelectronic perometer 40T ① KT: 9410.01 cm2 → 8051.15 cm2 (19.36↓)/qKT: 9621.33 cm2 → 8041.02 cm2 (19.19%↓)/MLB: 10089.41 cm2 → 5021.22 cm2 (54.48%↓)(p = 0.005/0.005/0.000003) Özçete and Eyigör [36] Case study BCRL 57 years
Female (n = 1)
A-V fistula4 weeks (12 times), 3/w (+3 extra sessions) with LLLT + self MLD, home ex. ① Tape measurement & difference of arm volume ① Volume difference: 691 ml → 461 ml (230 ml↓)/3 months later: 454 ml from baseline (237 ml↓)/17 months later: 267 ml from baseline (424 ml↓) Tantawy [41] Pilot experimental study BCRL stage II & III 52.7 years
Female (n=7)3 weeks (6 times), 2/w with home exercise 2/w ① Sum of limb circumference ① 174.8 cm → 155.6 cm (p = 0.02) Özçete et al. [39] Case study HNL stage II 58 years
Male (n = 1)1/w (12 times) with self MLD + exercise keep KT for 4–5 days ① Földi scale edema assessment
② ROM① Edema scale II → 0
② Extension: 20˚ → 35˚/right rotation: 40˚ → 45˚/left lateral flexion: 25˚ → 35˚/right lateral flexion: 30˚ → 35˚Taradaj et al. [37] Case study BCRL 62 years (female)
Permanent nerve damage by DM3 weeks, 1/w KT put it on Friday and keep it for 3 days with IPC + MLD 3/w ① Optoelectronic perometer 40T ① Volume: 627 cm2↓(2,733 cm2 → 2,106 cm2) The decrease in the period during which KT was applied is significantly larger (31↓/194↓/51↓/206↓/40↓/105↓) Chou et al. [35] Case study BCRL stage 2 48 years (female)
AV-fistula3/w (12 times) with MLD 45 min ① Circumference & volume
② PEV & PERV① Circumference: 37.6 cm → 19.8 cm, excess volume: 992 ml → 536 ml
② PEV: 79.95% → 36.43%, PREV: 54%↓Simone [40] Case study HNL 52 years (male)
Oropharyngeal cancer9 weeks, 2–3/w, KT started from the 8th session with MLD + CG+ home exercise ① The sum of neck circumferences
② NDI: neck disability
③ FACIT-F
④ ROM
⑤ PIVM① 129.9 cm → 121.9 cm
② 8% → 6%
③ 126 → 134
④ Improvement between 4°–13°
⑤ Improvement in all directionsVan Wyk [42] Case study BCRL 37 years (female) 2 months, 1/w keep 5 days, remove for 2 days with exercise ① Circumference
② Assessment of skin texture① Upper arm: 41.5 cm → 38.5 cm, forearm: 38.1 cm → 35.1 cm
② Softer to the touch and more flexible to usePyszora and Krajnik [38] Case study Lower limb LE 56 years (male)
Malignant tumor of pancreas1/3–5 days applied & 24 hours rest during palliative care ① Verbal evaluation of patient satisfaction
② Visual check by the therapist① Reduced swelling, pain, and heavy symptoms, satisfied with the intervention
② Reduced skin tension, stripy marks on the skinRCT, randomized controlled trial; KT, kinesiology taping; SKT, sham kinesiology taping; MLB, multilayer bandage; CG, compression garment; MLD, manual lymph drainage; LLLT, low level laser therapy; IPC, intermittent pneumatic compression therapy; MDACC, MD Anderson cancer center; BCRL, breast cancer related lymphedema; HNL, head and neck lymphedema; VAS, visual analog scale; CCL, compression class level; QOL, quality of life; EORTC QLQ-C30, the European organization for research and treatment of cancer’s quality of life questionnaire consisting of 30 question; DASH, disability of shoulder and arm; PDQ, pain detect questionnaire; SMLB, simplified multilayer bandage; ROM, range of motion; PDV, percentage decrease of volume; RVC, relative volume change; SPADI, shoulder pain and disability; NDI, neck disability index; FACIT-F, functional assessment of chronic illness therapy and cancer; PIVM, passive intervertebral motion; PEV, percentage of excess volume; PREV, percentage reduction of excess volume; A-V fistula, arterio venous fistula. Age is estimated in mean number..
-
Table 2 . Methods of applying kinesiology taping.
Study Anastomosis Style
(number)Application
areaDirection Stretching (%) Skin adverse
(n = drop out)Patch
testResult Atar et al. [32] Ｘ Fan (4) Neck, face Lymphatic 5–25 Temporary itching & redness 16.6% (n = 0) ○ KT > SKT Selcuk Yilmaz and Ayhan [31] Ｘ Fan (6) Arm, forearm, hand Lymphatic 10–15 Drop out by allergy 16.66% (n = 3) ○ KT ≥ MLD, LLLT Torres-Lacomba et al. [28] Ｘ Fan (4) Arm, forearm, hand Lymphatic 15–20 Drop out by irritation 3.4% (n = 1) ○ KT < B (comfortable KT > B) Pajero Otero et al. [26] Posterior 1
(A-A)Spiral Arm to wrist Lymphatic 0 Skin peeling 20% (n = 0) ○ KT > CG Ozsoy-Unubol et al. [22] Ｘ Fan (4) Arm, forearm Lymphatic 15 Drop out by allergy 2.5% (n = 1) KT ≥ CG Tantawy et al. [19] Anterior 1
(A-A)Fan (6) Arm, forearm, hand Lymphatic 5–25/15–20 (anastomosis) No mention KT > CG Ergin et al. [34] Anterior 2
Posterior 1
(A-A, I-A)Fan (3) Only on the anastomosis Lymphatic 0–15 Ｘ KT using anastomosis only, no effect Hassan and Ismail [27] Fan (5) Arm, forearm, hand Lymphatic No mention No mention ○ KT ≥ CG Taradaj et al. [11] Anterior 2
(A-A & A-I)Fan (6) Arm, forearm Lymphatic 0–15 Drop out by allergy inflammatory 20.68% (n = 6) KT < MLB
KT ≑ qKTPekyavas et al. [29] Anterior 1
(A-A)Fan (6) Arm, forearm, hand Lymphatic No mention No mention KT + MLB > KT
(pain) KT >Pop et al. [33] Anterior 1
(A-A)Fan (1) & spiral Fingers to arm *ownKT: reverse
KT: lymphatic10 No mention ownKT > KT Smykla et al. [30] Anterior 2
(A-A, A-I)Fan (6) Arm, forearm Reverse 5–15 Drop out by allergy 15.38% (n = 4) MLB > KT
KT = qKTÖzçete and Eyigör [36] Anterior 2
Posterior 1
(A-A, A-I)Fan (7) Arm, forearm, hand Lymphatic No mention No mention Alternatives to pressure contraindications Tantawy [41] Anterior 1
(A-A)Fan (6) Arm, forearm hand Lymphatic 15–20/5–25 (anastomosis) No mention Effective & comfortable Özçete et al. [39] Ｘ Fan (2) Neck Cross application reverse No mention Pruritis but not wound ○ Very effective Taradaj et al. [37] Anterior 1
(A-A)Fan (6) Arm, forearm Lymphatic 0–15 No mention Safe & effective without side effects Simone [40] Ｘ Fan (2) Neck Lymphatic 15 Ｘ ○ Safe & effective Chou et al. [35] Posterior 1
(A-A)Fan (2) Arm, forearm Lymphatic No mention Itching & wound formation Alternative for hospice management Van Wyk [42] Ｘ Spiral Arm, forearm Lymphatic No mention Ｘ Symptoms relief, patient satisfaction Pyszora and Krajnik [38] Ｘ Fan (2) Dorsum of foot to knee Lymphatic 15 Ｘ ○ Suitable for palliative tx. A-A, axillo-axillary anastomosis; A-I, axillo-inguinal anastomosis; CG, compression garment; KT, kinesiology taping; LLLT, low level laser treatment; MLB, multilayer bandage; MLD, manual lymph drainage; qKT, quasi kinesiology taping; SKT, sham KT; Lymphatic, from proximal to distal..