Effect of McConnell Taping on Perceived Pain and Knee Extensor Torques During Isokinetic Exercise Performed by Patients With Patellofemoral Pain Syndrome.

Handfield T, Kramer J (Action Sport Physiotherapy, Montreal, Quebec; School of Physical Therapy, Elborn College, University of Western Ontario, London, Ontario, Canada), Physiotherapy Canada. Winter 2000:39-44.

According to the authors, numerous studies have documented the beneficial effects of McConnell taping for patients with patellofemoral pain syndrome (PFPS). Purported to correct the orientation of the patella and improve patellar tracking, stated the authors, this taping technique has been shown to decrease subjective complaints of pain, result in earlier electromyographic activation of the vastus medialis oblique muscle, and allow for the production of greater knee extensor force. The purpose of this study was to compare perceived pain and peak knee extension torque measured isokinetically at 60 [degrees]/s and 180 [degrees]/s under tape and no-tape conditions in patients with PFPS.

Thirty-six patients (26 women, 10 men; mean age=29 years) referred to physical therapy with a diagnosis of PFPS were included in the study. The inclusion criteria consisted of at least 2 of the following: pain on direct compression of the patella with the knee extended, tenderness with palpation along the posterior surface of the patella, pain with resisted knee extension, and pain during isometric knee extension with suprapatellar resistance. A Cybex isokinetic dynamometer was used to record knee extensor peak torque, and a 10-cm visual analog scale (VAS) was used to measure perceived pain.

Each subject was tested for isokinetic knee extensor peak torque at 60 [degrees]/s and 180 [degrees]/s under 2 conditions, tape and no-tape, with a 30-minute rest period between each condition. Subjects were asked to rate their pain level on the VAS before and after each testing velocity. Pain levels were also determined by a phone call 24 hours after testing.

The order of testing for condition and velocity was randomized for each subject. For the tape condition, Hypafix under-roll tape (a self-adhesive hypoallergenic skin tape) and Leucospore tape was applied to the patella by a therapist who was trained and experienced in the application of the McConnell taping technique. The Leucospore tape was applied based on the results of a pretesting assessment of patellar alignment with respect to patellar glide, tilt, and rotation. For the no-tape condition, only Hypafix tape was wrapped around the patella in order to control for the possibility that sensory input alone may affect pain and torque output. Four practice contractions (3 submaximal, 1 maximal) were performed prior to the recorded tests. The 3 maximal effort test contractions were averaged to determine the peak knee extensor torque.

The results of the study revealed that pain scores were significantly greater after testing than before and that posttest pain scores were higher at 60 [degrees]/s than at 180 [degrees]/s. When comparing test conditions, the results indicate significantly lower pain scores after testing at both testing velocities during the tape condition when compared to the no-tape condition. The tape condition was also shown to produce significantly greater peak torque values than the no-tape condition. Results of the follow-up phone call 24 hours after testing revealed that no subjects reported an increase in pain level as a result of the testing.

According to the authors, the results of this study support the premise that the McConnell taping technique can be useful in decreasing pain and improving the concentric force of the knee extensors in subjects with PFPS. The authors also suggested that, due to the absence of any residual increase in pain 24 hours following testing, isokinetic training may be a safe and effective method for strength training when used in conjunction with McConnell taping.

Barbara Belyea, PT, MS Ithaca College Ithaca, NY