Rotator Cuff Tear Clinical Trial
Official title:
Immediate and Short-term Effects of Kinesiotaping on Muscular Activity, Mobility, Strength and Pain After Rotator Cuff Surgery: A Cross-over Clinical Trial
Kinesiotape (KT) is widely used in musculoskeletal rehabilitation as an adjuvant to treatment
but minimal evidence supports its use. The aim of this study is to determine the immediate
and short-term effects of shoulder KT on muscular activity, mobility, strength and pain after
rotator cuff surgery. Our hypotheses were that KT should not improve muscle function,
mobility, strength or pain in a clinically meaningful way.
Methods: Thirty-nine subjects with shoulder rotator cuff surgery were tested 6 and 12 weeks
post-surgery, without tape, with KT and with a sham tape (ST). KT and ST were applied in a
randomized order. For each condition, muscular activity of upper trapezius, three parts of
deltoid and infraspinatus during shoulder flexion, range of motion (ROM) and pain intensity
were assessed. At 12 weeks, isometric strength at 90° of shoulder flexion, with related
muscular activity and pain intensity were also measured. Subjects maintained the last tape
applied for three days and recorded pain intensity at wake-up and during the day.
Sample size was calculated a priori using STATA Version 13.1 software (StataCorp, College
Station, USA). Based on data of muscular activity from the article of Hsu et al 20 and
considering a statistical power of 80% and a Type I error of .05, a need for at least 36
subjects was necessary to highlight a group difference. We finally enrolled 39 subjects
between January 2013 and October 2016. Informed written consent was obtained from all
subjects and all rights of the participants were protected.
Testing procedure:
Subjects were invited to come at the Clinique romande de réadaptation in Sion (Switzerland)
on two occasions: 6 and 12 weeks after their surgery. Each time, they first filled the French
version of the quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire in order
to assess their physical function and symptoms. This 11-item questionnaire is valid, reliable
and responsive in shoulder disorders.14, 17 They also estimated their pain intensity at rest
using a 100-mm visual analogue scale (VAS).
A baseline measurement was then realized, without any tape (NT). The subjects were seated on
a chair without resting on the backrest, the arms along the body. Shoulder rotation was
neutral, elbow extended and forearm in neutral position. The subjects had to lift their arm
in the sagittal plane as high as possible, hold the position for 5 seconds and then return at
initial position. The movement was repeated once after one minute rest.
During the second session, at 12 weeks, the subjects realized in addition a maximal voluntary
isometric contraction measure (MVIC). The measure was realized at 90° of shoulder flexion,
neutral rotation, elbow extended, pronation of the forearm and fist closed. The strap of the
dynamometer was applied at the level of the wrist.5 The subjects had to develop the maximal
force during a 5-seconds period. After one minute rest, a second trial took place. The whole
session was videotaped for further analysis. At the end of the testing sessions, the subjects
were instructed not to remove the last tape applied for 72 hours.
The sequence always began with the NT condition. Then the two tapes were applied in a
randomized order and the subjects repeated the same procedure. Group allocation, KT vs ST
group, corresponded to the last tape the subject received and had to wear for the next three
days. A computer block (n=8) randomization process was performed and sealed opaque envelopes
were used. The physiotherapist who applied the tape was not blinded but he did not
participate in outcome assessment. The main investigator (first author) who collected the
data was blind as subjects wore a long-sleeve shirt which hid the tape and the tape was
administered behind a folding screen.
Statistical analysis:
Comparisons between baseline characteristics of the two groups were computed using
nonparametric tests comparing the medians for continuous variables or chi-squared tests for
categorical variables.
The outcome variables measured during the mobility and the strength tests were compared
between the three taping conditions. For the VAS outcomes during the three days after tape
application, comparisons were realized between KT and ST solely. As the distributions of the
outcome variables were not normal, nonparametric tests comparing the medians were performed.
All analyses were done using Stata 13.1 software.
As multiple comparisons were realized, the level of statistical significance was set at
P<.017 (.05/3) for the comparisons between the three conditions of tape (comparison of NT vs
KT, NT vs ST, KT vs ST). For comparison between KT group and ST group only, the level of
significance was set at P<.05.
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