The Effects of Kinesio Tape® on Arthrogenic Muscle Inhibition and Rate of Torque Development

Decreased ability to voluntarily activate the entire motoneuron (MN) pool following joint
injury is known as arthrogenic muscle inhibition (AMI), which is commonly quantified by
measuring central activation ratio (CAR). AMI is not only observed immediately after joint
injury, but has been shown to persist during and after rehabilitation. It is proposed that
AMI, by negatively impacting neuromuscular factors such as muscle strength, muscle
activation, and rate of torque development (RTD), contributes to a prolonged rehabilitation
process and higher risk of re-injury. Unfortunately, AMI cannot be reduced by traditional
rehabilitation interventions such as strength training alone. Therefore, it is necessary to
identify an intervention that can effectively decrease AMI in order to facilitate
improvements in muscle function in individuals with AMI.

Kinesio Tape® is commonly used to facilitate muscle contraction in athletic populations. This
elastic therapeutic tape is popular in the athletic setting because it can be applied and
used continually during exercise and activities of daily living for up to 2-3 days without
restricting movement. It has been suggested that Kinesio Tape® facilitates muscle contraction
by inducing increased sensory input via skin stimulation. The tape activates cutaneous
mechanoreceptors with the greater afferent feedback thought to improve the efferent output
from the central nervous system to the target muscles. While this technique is widely used in
the clinical setting to improve muscle function, the facilitative effect of Kinesio Tape® has
not been demonstrated- perhaps due to three key limitations of previous investigations.
First, previous studies have predominantly recruited healthy participants without muscle
function deficits. Therefore, there could have been a ceiling effect whereby there was no
observable effect of Kinesio Tape® due to a lack of muscle dysfunction in these healthy
individuals. Second, most investigators have generally taken outcome measurements immediately
before Kinesio Tape® application and less than 24 hours later. This is much shorter than the
2-3 days that Kinesio Tape® is used clinically and may not be long enough to induce an
observable, facilitative effect. Finally, the protocols utilized in previous investigations
also failed to mimic clinical practice by not combining Kinesio Tape® application with a
therapeutic exercise protocol targeting the inhibited muscle.

Therefore, the purpose of this study is to investigate the effects of prolonged application
(> 48hours) of Kinesio Tape® incorporated with a therapeutic exercise protocol on AMI and
muscle function. To do so, we will use the peroneus longus muscle in individuals with
functional ankle instability (FAI) as a model, given that AMI has been shown to exist in this
muscle in individuals with FAI.

The following specific aims will be tested:

Aim#1. To investigate the effect of prolonged application (> 48hours) of Kinesio Tape®
incorporated with a therapeutic exercise protocol on AMI of the peroneus longus in
individuals with FAI.

Aim#2. To investigate the effect of prolonged application(> 48hours) of Kinesio Tape®
incorporated with a therapeutic exercise protocol on peroneus longus muscle function in
individuals with FAI.

Our central hypothesis is that prolonged application of Kinesio Tape® in combination with
therapeutic exercise will diminish AMI and improve muscle function of the inhibited peroneus
longus muscle.

Inclusion Criteria:

1. A history of at least one significant ankle sprain on the involved (injured) limb i.
The initial sprain must have occurred at least 12 months prior to the study enrollment
ii. Was associated with inflammatory symptoms (pain, swelling, etc.) iii. Created at
least one interrupted day of desired physical activity.

2. The most recent injury on the involved (injured) ankle must have occurred more than 3
months prior to the study enrollment.

3. A history of the involved (injured) ankle joint 'giving way', and/or recurrent sprain
and/or 'feelings of instability' on the involved (injured) limb Participants should
report at least 2 episodes of 'giving way' in the 6 months prior to the study
enrolment.

4. Be 18-35 years of age

5. Have not had a past allergic reaction to Kinesio Tape®

Exclusion Criteria:

1. Have a history of previous surgeries to the musculoskeletal structures (i.e., bones,
joint structures, nerves, etc.) in either lower extremity.

2. Have a history of a fracture in either lower extremity requiring realignment.

3. Had acute injury to the musculoskeletal structures of other joints of either lower
extremity in the previous 3 months which impacted joint integrity and function (i.e.,
sprains, fractures, etc.) and resulted in at least 1 interrupted day of desired
physical activity.

4. Are not able to be matched according to our group allocation procedure

5. Have had a past allergic reaction to Kinesio Tape®

6. Currently display symptoms of an acute sprain including swelling, heat, redness, pain,
discoloration, and/or loss of range of motion or function

7. Any diagnosed vestibular disorder, Charcot-Marie-Tooth disorder, Ehlers-Danlos, or
other hereditary nerve, balance or connective tissue disorder

8. Report a possibility that they may be pregnant as hormonal changes may affect
ligamentous laxity

9. Have suffered more than one ankle sprain on the uninvolved limb

10. Have had an ankle sprain on the uninvolved limb within the past 12 months

11. Have episodes of giving way of the ankle on the uninvolved limb besides the single
time when they may have sprained this ankle.