Effects of Kinesiotaping and Mulligan Tapping on PFPS
Condition: Patellofemoral Pain Syndrome
MeSH terms: Patellofemoral Pain Syndrome; Syndrome
Study type: Interventional

Summary: 
      The aim of this research is to compare the effects of kinesiotaping and mulligan taping on
      pain, hamstring flexibility, cadence and physical performance of lower limb in patients
      suffering from patellofemoral pain syndrome according to time duration 24, 48 and 72 hours.
      Randomized controlled trial done at Riphah International University Rawalpindi campus,
      Pakistan Railway Hospital and private clinics of twin cities. The sample size was 20. The
      subjects were divided in two groups, 10 subjects in kinesiotaping group and 10 in mulligan
      taping group. Study duration was 1 year. Sampling technique applied was non probability
      convenient sampling technique. Both males and females of 20-35 age bracket having anterior
      knee pain for more than 2 months and ≥3 pain on NPRS while performing activities i.e.
      ascending descending stairs, squatting and sitting for extending periods of time were
      included in study. Tools used in study are NPRS, Kujala pain rating sale, goniometer, active
      knee extension test, time up and go test.
    

Detailed description: 
      Patellofemoral pain syndrome (PFPS) is a frequent musculoskeletal pathology affecting
      population like adults, teenage boys/girls, military and athletic individuals. It is a
      probable reason for anterior knee pain in individuals, also known as runner's knee. It is
      mainly defined as the individuals experience anterior knee pain, including other structural
      pathology like of patella and retinaculum. There is no related problem of intra articular and
      peri-patellar impairments. The causes of PFPS includes muscular imbalance of vastus lateralis
      and vastus medialis, maltracking of patella, instability of hip joint and hind most foot
      eversion. According to literature the PFPS is mostly common in active young population along
      with that women are more prone to develop this disease condition as compare to males because
      of their pelvis anatomy. Wider pelvis area in women causes more stress on knees. The reason
      of knee joint pain in older people is arthritis (age related degenerative changes). KT
      tapping has elastic properties like skin, stretching 30 % to 40 % stretching lengthwise. KT
      has water proof qualities and can be applied for 3 to 5 days. By applying KT over the skin of
      affected muscle or on joint surface, it reduces the pain, improves the circulation by giving
      positional impulse through skin, and modify interstitial tissue to reduce skin tension.
      Mulligan introduced a tapping technique called Mulligan tapping along with Mobilization with
      Movement technique development. Mulligan tape method prevents the positional malalignment in
      the joint. Tape may be applied for a week or two and not cause any harm along with
      mobilization Literature review: Anne Hickey et al. conducted a study in Australia in 2016. In
      this study effects of mulligan knee tapping technique on pain and lower limb biomechanics was
      determined. The study concluded that the technique successfully reduced the knee pain,
      decreased hip internal rotation and active gluteal muscles earlier. Leticia Lopes Aguiar et
      al. conducted a study in which he determines the effect of mulligan concept among ballet
      dancers. The study concluded that mulligan concept had significant results to improve pain
      threshold. Samara Alencar Melo et al. in which KT taping effects was determined on pain and
      muscular performance in patellofemoral pain syndrome patients did a study in 2018. In this
      RCT, the results showed that KT causes reduction in pain within 72 hours after its
      application without causing tension around skin. In 2017, Neelam Rehman et al. in Pakistan
      conducted a study. In this research the immediate effects of KT on pain in athletic
      population having PFPS was determined. The study concluded that KT had immediate effects in
      reducing pain and it can be used to treat immediate post injuries in athletic population.
    

Intervention name(s): kinesiotaping group; mulligan taping group
Intervention type(s): Other; Other
Intervention description(s): Kinesio-taping with conventional therapy 24, 48 and 72 hours standardized therapeutic KT application along with conventional therapy (hot pack, strengthening and stretching exercises). The patient laid supine.To maintain proprioceptive stimulation in the quadriceps (from origin towards insertion) and to alleviate the tension of hamstring muscle, a 'Y'-shaped kinesiotaping will be applied. Afterward, 2 pieces of 'I'-shaped tapes were stretched by 75% through the mechanical correction technique and will be applied around the patellar circumference in the way that it would allow the patella to move naturally in the femoral cavity while the knee was in 45 flexion
CONVENTIONAL THERAPY:
Stretching of hamstrings 10 reps 10 sec hold. Straight leg raise 3 sets* 10 reps, 1 min interval. Strengthening of Quadriceps (quads isometric) and VMO with 10 reps and 3 sets, 1 min interval) Squatting (10 reps* 3 sets, 1 min interval); Mulligan taping will be applied while patient in standing position and the hip, knee will be internally rotated and flexed to 20 degree. Rigid tape will be applied from neck of fibula which will be passing anteriorly over the tibia to secure internal rotation of tibia at the knee, and passing below the medial joint line and behind the knee, 2 superimposed layers of 38-mm rigid tape will be applied in a spiral fashion. Tape will be applied for 24, 48 and 72 hours. And it must come off immediately if any pain and skin irritation is experienced. Along with conventional therapy.
Stretching of hamstrings 10 reps 10 sec hold. Straight leg raise 3 sets* 10 reps, 1 min interval. Strengthening of Quadriceps (quads isometric) and VMO with 10 reps and 3 sets, 1 min interval) Squatting (10 reps* 3 sets, 1 min interval)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Patellofemoral pain syndrome; Range of motion; Kinesiotaping; Mulligan taping; Physical performance measure