kinesio taping ( kt ) is an alternative taping technique developed in the 1970s by dr .
, kt may improve strength , control , and performance ; reduce pain ; 
 prevent injury ; inhibit and facilitate motor activity ; and increase range of motion 
 ( rom)1,2,3 .
kt has lately gained popularity among 
 sports professionals for injury prevention and performance enhancement4 . however , the mechanism through which kt exerts its 
 hypothesized effects is unclear , and studies have not confirmed on the effectiveness of the 
 methodology .
kt has been shown to support muscle movement and relieve abnormal feeling or 
 pain in the skin .
mori et al.5 suggested 
 kt normalizes muscle function , and kase et al.2 showed that the stretch rate and width of the kt affects the fascia 
 and flow of lymph fluid .
kt also reduces cervical pain and increases rom 24 hours after 
 whiplash injury6 , and according to slupik 
 et al.7 , it has a preliminary effect on 
 quadriceps peak torque and electromyographic activity in healthy subjects .
chang et al . 
 found no significant difference in maximal wrist flexor strength among 10 baseball players 
 who received kt , a placebo , or no tape8 . 

only a study by lee et al . has reported a positive acute effect of kt on isometric muscle 
 strength9 .
although kt is widely used in clinical practice , several studies show no any change in 
 muscle strength with kt application in healthy individuals10,11,12 .
a few research studies have evaluated the biomechanical 
 effectiveness of kt during walking or running .
howe et al . showed that kt does not change 
 hip or knee kinematics or kinetics in asymptomatic runners compared with the no tape 
 condition13 .
indicate that 
 kt does not alter the muscle peak torque generation or total work done in healthy 
 subjects14 .
the current investigation 
 compared the effects of kt facilitation and inhibition applications on spatiotemporal knee 
 kinematics and kinetics during walking .
all subjects were completely inactive . those who reported active knee pain ; lower limb 
 trauma ; a history of spinal , hip , knee , or foot pathology ; or any neurological impairment 
 were excluded .
average age , body weight , and height were 19.7  0.4  years old , 51.5  
 4.8  kg , and 1.64  3.4  cm , respectively .
all participants provided informed consent , and the 
 study was approved by the orthopedic prosthetic and orthotic department review board 
 commission of the university of ankara .
the kinesio tape was a hypoallergenic , nonmedicated , waterproof , porous , adhesive tape made 
 of cotton that could be stretched longitudinally up to 3040% of its original length .
the 
 subject s skin was shaved , cleaned with alcohol , and dried before the tape was applied .
1.facilitation application ) : y - shaped kt was applied the quadriceps of each subject , according to kenso kase s 
 kinesio taping manual , by the same physical therapist .
the two extremities of the subject s 
 knees were taped while the subject lay in the supine position with the hip flexed 30 degrees 
 and the knee flexed 60 degrees .
the tape was applied with no tension approximately 5  cm 
 below the origin of the rectus femoris and with moderate tension ( 2550% of available 
 tension ) along the two tails .
the tails were placed on the skin without tension when they 
 were approximately 25  cm from the end .
2.inhibitation application ) : kt was applied from muscle insertion to origin using light tension ( 1525% of 
 available tension ) .
the tape was a y - shaped strip , with the tail that surrounded the 
 quadriceps muscle held in the stretching position .
inhibitation application a three - dimensional quantitative gait evaluation was performed in the motion analysis 
 laboratory at the ankara university department of prosthetics and orthotics using a vicon 
 nexus system ( oxford metrics , oxford , uk ) by the same experienced physiotherapist ( sg ) using 
 six infrared jai cameras at 250  hz and one force plate ( amti ) .
the standard plug - in gait 
 marker set was used to capture kinematic data : a total of 16 reflective markers were placed 
 on the anterior superior iliac spine , mid - lateral thigh , lateral knee joint , lateral shank , 
 lateral malleolus , and second metatarsal head , over the posterior calcaneus bilaterally , and 
 on the posterior superior iliac spine .
subjects were 
 asked to walk barefoot at a comfortable , self - selected walking speed without tape and then 
 application of facilitation and inhibition kt , respectively . at least five good trials in 
 which the subject s footfalls landed completely on the force plates were captured .
the nonparametric wilcoxon test was used to compare baseline measurements 
 and measurements for the two taping applications , respectively , within each subject .
spatiotemporal parameters were significantly different among the trials ( table 1table 1.spatiotemporal parametersno tapen=16facilitation ktn=16inhibition ktn=16cadence ( steps / min)110  7.4113 7.4**115  8.5*stride length ( m)1.29  0.071.30  0.06 * 1.27  0.07*walking speed ( m / s)1.20  0.81.23  0.5 * 1.21  0.8 * *
comparison of the no tape condition , facilitation kt , and 
 inhibition kt by nonparametric wilcoxon testcadence : the number of steps per minute .
step length : the distance along the line of 
 progression from opposite foot contact to current foot contact . walking speed : the 
 speed of the current foot based on the stride time and stride length . ) .
cadence walking speed and stride length increased with the facilitation kt 
 application compared with the no tape condition ( p<0.05 ) .
cadences significantly 
 increased and stride length decreased with the inhibition kt application compared with the 
 no tape condition ( p < 0.05 ) . * * p < 0.001 ; * p<0.05
. comparison of the no tape condition , facilitation kt , and 
 inhibition kt by nonparametric wilcoxon test cadence : the number of steps per minute .
step length : the distance along the line of 
 progression from opposite foot contact to current foot contact . walking speed : the 
 speed of the current foot based on the stride time and stride length .
kinematic data are displayed in table 
 2table 2.sagittal plane joint angles ( degrees)kinematic parameterssagittal planeno tapen=16facilitation ktn=16inhibition ktn=16knee flexion- extension rom ( )60.7  3.461.2  3.860.4  3.9max knee flexion ( )57.1  2.957.1  2.656.2  3.2**max knee extension ( )3.3  3.33.8  4.1*3.6  4.0 * * * p < 0.001 ; * p<0.05 .
comparison of the no tape condition , facilitation kt , and 
 inhibition kt by nonparametric wilcoxon test .
sagittal plane knee joint kinematics were significantly different with both 
 kt applications , respectively , compared with the no tape condition .
the degree of maximal 
 knee flexion was significantly lower with the inhibition kt application , and degree of 
 maximum knee extension was significantly increased with both kt applications compared with 
 the no tape condition .
knee joint sagittal plane rom was not different with either kt 
 application . * * p < 0.001 ; * p<0.05
. comparison of the no tape condition , facilitation kt , and 
 inhibition kt by nonparametric wilcoxon test kinetic data are displayed in table 
 3table 3.sagittal plane moments ( nm / kg ) and powers ( w)kinetic parameterssagittal planeno tapen=16facilitation ktn=16inhibition ktn=16km10.21  0.10.15  0.11 * 0.31  0.0*km20.26  0.160.32  0.15*0.07  0.2kp10.24  0.20.31  0.30.27  0.2kp20.13  0.10.10  0.70.03  0.07kp30.15  0.130.19 
0.20.19  0.1*kp41.47  0.571.45  0.50.74  1.1 * * * p < 0.001 ; * p<0.05
. comparison of the no tape condition , facilitation kt , and 
 inhibition kt by nonparametric wilcoxon testkm1 : maximum knee flexion moment ; km2 : maximum knee extension moment ; kp1 : eccentric 
 knee extensor activity during the loading response phase ; kp2 : concentric knee 
 extensor activity during the mid - stance phase ; kp3 : eccentric activity in the rectus 
 femoris during the pre - swing phase ; kp4 : eccentric activity in the hamstrings during 
 terminal swing .
knee external flexion moment during the early stance phase ( km1 ) decreased 
 significantly with the facilitation kt ( p<0.05 ) and increased with the inhibition kt 
 ( p<0.05 ) .
knee external extension moment during mid - stance phase ( km2 ) increased with the 
 facilitation kt ( p<0.05 ) .
knee power parameters , including eccentric knee extensor 
 activity during loading response ( i.e. , eccentric quadriceps activity , kp1 ) and concentric 
 knee extensor activity during mid - stance ( i.e. , concentric quadriceps activity , kp2 ) were 
 not significantly different after either kt application .
eccentric activity in the rectus 
 femoris during the pre - swing phase ( kp3 ) was significantly increased with the inhibition kt 
 application ( p < 0.05 ) , while eccentric activity of the hamstrings during the terminal 
 swing of gait ( kp4 ) was decreased ( p < 0.05 ) . * * p < 0.001 ; * p<0.05 .
comparison of the no tape condition , facilitation kt , and 
 inhibition kt by nonparametric wilcoxon test km1 : maximum knee flexion moment ; km2 : maximum knee extension moment ; kp1 : eccentric 
 knee extensor activity during the loading response phase ; kp2 : concentric knee 
 extensor activity during the mid - stance phase ; kp3 : eccentric activity in the rectus 
 femoris during the pre - swing phase ; kp4 : eccentric activity in the hamstrings during 
 terminal swing
the main purpose of the current study was to determine whether kt had short - term effects on 
 knee kinematics and kinetics parameters using two different kt techniques in the knees of 
 healthy individuals .
our study showed significant differences in spatiotemporal parameters , 
 knee kinematics , and kinetics gait analysis parameters with facilitation and inhibition kt 
 applications .
facilitation kt application enhanced cadence , stride length , walking speed , and the degree 
 of maximal knee extension compared with the no - tape condition .
this application also 
 increased knee extensor moment , which suggests increased quadriceps muscle torque 
 generation , and decreased knee flexor moment .
an elevation in the quadriceps lever arm in the taped condition may 
 have augmented knee extensor moment without increasing quadriceps muscle force . a 
 meta - analysis by williams et al.4 
 indicates that seven out of ten studies they examined showed an increase in muscle strength 
 with kt application ;
however , three isokinetic studies did not show a significant effect of 
 kt application on quadriceps muscle strength in healthy subjects . according to lumbroso et 
 al.15 , application of kt to the 
 gastrocnemius
increased the muscle s peak force immediately and after application of kt for 
 2 days , and rom increased in all of the lower - extremity joints measured .
kt may increase blood circulation within the taped area , which may influence the muscle and 
 myofascial functions that increase rom within the muscle16 .
kt application may stretch or increase pressure applied to the 
 skin , and this external load may stimulate cutaneous mechanoreceptors that impact knee 
 flexion / extension rom .
another possibility is that fear of movement is related to pain 
 intensity in patients and that application of kt provides sensory feedback that increases 
 rom6 .
kt is used to correct 
 biomechanical movements , allowing individuals to improve performance by increasing the power 
 created through their movements .
hsu et al . showed that kt significantly improved scapular 
 orientations compared with a placebo treatment in baseball players with shoulder impingement 
 syndrome17 .
showed a 54% 
 increase in vastus medialis muscle activity 24 hours after kt application7 .
karatas et al . reported that kt may be an 
 effective method for reducing neck and low back pain and improving functional 
 performance18 . in a study of 40 
 asymptomatic trained amateur cyclists , nelson found that kt application above the rectus 
 femoris significantly increased knee flexion19 .
suggested that kt shortens the time to reach peak 
 torque generation during isometric knee extension , which has important implications for 
 sports performances that require the rapid generation of peak muscular force20 .
our results demonstrated that 
 facilitation kt application improved gait performance by increasing cadence , walking speed , 
 and knee extension moment .
research has shown that application of kt to healthy tennis players decreased fatigue by 
 maintaining forearm extensor strength21 , 
 and this suggests that kt may have also affected proprioception in addition to improving 
 muscular strength and power in present study .
however , other studies have shown that kt did 
 not improve proprioceptive response in the ankle , as determined by reproductive measures of 
 joint position sense1 .
the proprioceptive 
 effect of kt is unclear , but kt may stimulate the cutaneous mechanoreceptors by applying 
 pressure to , and stretching , the skin ; thus , an elastic tape such as kinesio tape may cause 
 proprioceptive stimulation while improving joint rom and muscle function , further enhancing 
 cadence22 .
our results suggest that 
 facilitation kt application may enhance an individual s gait performance during walking or 
 sportive activities due to its assistance of the terminal stance in the gait cycle . 

the inhibition kt technique increased knee flexor moment , decreased knee power ( i.e. , 
 eccentric activity of the hamstrings ) during the terminal swing phase , and decreased knee 
 flexion during walking .
suggest that the inhibition kt application increases motor 
 unit recruitment in asymptomatic individuals several hours after kt is applied , which would 
 justify the lack of biomechanical changes resulting from this method of kt .
we propose that the inhibition kt 
 application technique improves minor soft tissue injury recovery and prevents overuse 
 injuries in the joint of interest .
inhibition kt application had a positive effect on knee 
 kinetics and kinematics compared with the no - tape condition in our study .
inhibition kt 
 application with physical therapy rehabilitation treatment in the acute phase or with 
 orthotic treatment may be valuable , and it may also help control knee hyperextension in 
 paralytic patients with knee - ankle foot orthosis ( kafo ) without the need for orthotic 
 popliteal straps . also , patients with equinus have prevalent knee hyperextension and may 
 benefit from inhibition kt application along with ankle - foot orthosis ( afo ) .
first , the study had small sample sizes , 
 which may limit the translatability of our findings to other populations .
second , placebo 
 effects may have contributed to the observed differences because we did not apply placebo 
 taping to eliminate the psychological effect of the tape .
further research is recommended to 
 examine the association between sports performance with therapeutic tape and the acute and 
 chronic effects of kt on the function , balance , and neuromuscular performance of patients 
 under a rehabilitation program .
 [ purpose ] the application of kinesio taping may improve strength and performance , inhibit 
 and facilitate motor activity , and increase range of motion . 
 the aim of this study was to 
 compare the effects of kinesio taping facilitation and inhibition applications on 
 spatiotemporal knee kinematics and kinetics during walking activity in healthy subjects . 
 
 [ subjects and methods ] a three - dimensional quantitative gait evaluation was performed 
 without tape and with , facilitation and inhibition kinesio taping application on the knee . 
 
 sixteen healthy female college students ( age , 19.7  0.4  years ; height , 1.64  3.4  cm ; 
 body mass , 51.5  4.8  kg ) participated in the study . 
 [ results ] spatiotemporal parameters 
 ( cadence , walking speed , stride length ) were significantly different among the trials . 
 
 knee joint sagittal plane range of motion was not different with either kinesio taping 
 application . 
 knee external flexion moment during the early stance phase decreased 
 significantly with facilitation kinesio taping and increased with the inhibition kinesio 
 taping . 
 knee external extension moment during the mid - stance phase increased with 
 facilitation kinesio taping . 
 knee power parameters , eccentric activity in the rectus 
 femoris during the pre - swing phase was significantly increased with inhibition kinesio 
 taping application , while eccentric activity of the hamstrings during the terminal swing 
 of gait was decreased . 
 [ conclusion ] these findings showed that facilitation kinesio taping 
 application affected the terminal stance phase and that inhibition kinesio taping 
 influenced the terminal swing phase compared with the no tape condition . 
INTRODUCTION
SUBJECTS AND METHODS
RESULTS
DISCUSSION