Effect of Kinesio Tape on Pain, Muscle Strength, Functionality and Kinesiophobia in Shoulder Impingement Syndrome

The aim of the study is to compare the effects of different kinesiotape applications in addition to traditional physiotherapy on shoulder pain, joint range of motion, muscle strength, functionality and kinesiophobia in patients diagnosed with shoulder impingement syndrome within and between groups.

Subacromial space; At the bottom, it is the region limited by the humeral head and tuberculum major, acromion (anterior 1/3 of the acromion), coracoacromial ligament, coracoid process and acromioclavicular joint and acromioclavicular ligament. The rotator cuff muscles pass through this area and move within it. In anteroposterior radiographs taken with the shoulder in 0° abduction, the distance between the acromion and the humeral head is approximately 1.1 cm (1.0-1.5 cm). Between these two structures are the rotator cuff (mostly the supraspinatus tendon), the long head of the biceps muscle, the bursa, and the coracoacromial ligament.

When incompatibility is observed between the mentioned bone structures, it causes pressure on the subacromial structures. Subacromial impingement syndrome is one of the most common causes of shoulder pain. The complaint of the majority of patients is pain radiating to the shoulder and arm, especially during overhead movements.

Examples of overhead activities in these people include hanging curtains, reaching on a shelf, combing hair, or lifting an object. Subacromial impingement syndrome is a complex disease that occurs not only as a result of compression of the rotator cuff muscles under the acromion, but also due to a combination of external and internal causes. While the diagnosis of the disease can be made with a good history and physical examination, the diagnosis must also be supported by imaging methods.

When applied to the skin and muscle, kinesiology tape affects the mechanoreceptors sensitive to tension, loading, pressure and shear forces by changing the length of the skin and superficial fascia and the tension of the muscle fibers.

This can lead to significant changes in muscle movement and tone. In particular, slow pressure stimulation on connective tissue alters the effect on mechanoreceptors and may affect gamma motor neuron firing and muscle tone regulation. Kinesio tape can be effective in increasing proprioceptive ability, especially in the middle of movement. In this range, muscle receptors are active while ligament mechanoreceptors are inactive. Understanding joint movement and position can be effective in improving proprioception by stimulating sensory afferent transmission.

Inhibition techniques are divided into two; Autogenic and reciprocal inhibition. It occurs when the contraction of certain muscles is inhibited due to activation of the Golgi tendon and muscle spindle. These two myotendinous proprioceptors, located in and around joints and muscles, help manage muscle control and coordination by responding to changes in muscle tension and length.

Although there are studies in the literature on traditional physiotherapy and kinesio taping in patients with shoulder impingement syndrome, no study has been found that includes different kinesio taping techniques and all evaluation parameters.

Eligibility Criteria:
Inclusion Criteria:

* Diagnosed with subacromial impingement syndrome,
* Between the ages of 45-65, without a history of shoulder injury other than subacromial impingement and/or shoulder symptoms requiring treatment for the last 1 year,
* Those who have not had any shoulder surgery before,
* Patients who agree to participate in the study will be included in the study.

Exclusion Criteria:

* Those who do not meet the inclusion criteria and have a history of shoulder fracture, dislocation and/or cervical radiculopathy,
* Presence of frozen shoulder, previous shoulder surgery,
* Having received local corticosteroid injection/treatment to the shoulder joint in the last 3 months,
* Presence of neuromuscular disease, pregnancy,
* Those with a history of cancer, unstable angina, systemic inflammatory joint disease,
* Situations where exercise is contraindicated,
* Patients with orthopedic, rheumatic or congenital disease in the affected upper extremity and communication problems will be excluded from the study.