A canna’ change the laws of physics

Scotty, The Naked Time, stardate 1704.3, Episode 7

The Guardian and Dr Kase’s magic tape

Posted by apgaylard on July 3, 2011

Apparently, around 30 years ago a chiropractor called ‘Dr’ Kenzo Kase invented a ‘magic tape’ that can work all sorts of wonders on muscles and joints.  Rather than being a stiff, supportive, structure, it allegedly mimics the flexibility of skin.

Today, the science section of the guardian provided an extended advertorial for this product under the heading, “Dr Kenzo Kase: My magic tape can aid injured muscles.” (frozen page, change log)

It’s in the usually reliable science section of the Guardian, so I would hope that there is some pretty strong evidence to support the use of the word ‘magic’.

So, I thought that I would share the results of five minutes ‘googling’ and a bit of thought.  The sort of thing I’d expect from a proper professional journalist.  It’s not a happy story.

Any evidence cited?

Tim Lewis’s article starts off by name checking sports celebrities who use and/or endorse this product: Beach volleyball champion Kerri Walsh, David Beckham, Lance Armstrong, Gareth Bale, Serena Williams.  Musician Chester Bennington also gets a mention.

In a balanced piece, this would be fine.  However, Lewis’s uncritical work transforms this list into a celebrity-based endorsement of the credibility of this product.  After all, famous sports people wouldn’t use something that doesn’t work, would they?  It’s a tempting thought, but the evidence says otherwise.  In essence, this is a special kind of argumentum ad popularum, argumentum ad eligere perhaps?

The only mention of any evidence comes next.  It’s brief and misleading:

“Beyond the big-name endorsements, studies suggest that it does offer protection to injured muscles and joints – at least in the short term: a study of 42 people with shoulder problems in 2008 indicated that Kinesio taping offered immediate pain relief.”

The study is not cited, however, a few minutes on PubMed shows that it appears to be Thelen, Dauber and Stoneman (2008).  They took forty-two army cadets, ranging from 18 to 24 years of age, with shoulder injury and randomized them to treatment with either a standard Kinesio taping (KT) protocol or sham protocol using the same tape.

So, this looks like Lewis’s only bit of evidence: the right number of participants, published in the right year and looking at shoulder problems.  However, there is an immediate problem with using it to say that this specific tape does anything helpful:  there is no control group.  This trial is actually a test of how a shoulder is taped up, not whether it is taped up, or what tape is used.  This is clearly not a test of whether the ‘magic tape’ works.

Also, this is a small trial on young, fit people, with an average age of around 20 years, on a specific injury.  Therefore it cannot offer general support for KT.

It’s fair to say that it is likely to be optimistic as well.  The authors’ note that their selection criteria sought to, “eliminate subjects with pathology that would be less likely to respond to the selected taping intervention”.

So, actually it’s a small uncontrolled trial of taping technique for shoulder injuries in fit young people who are most likely to respond to taping in general.

Interestingly the paper’s introduction mentions that, “minimal evidence exists to support the use of this type of tape in the treatment of musculoskeletal disorders”.  This is not a good sign for Lewis’s use of the plural, “studies”.

What did this study measure?  It looked at three primary outcomes:

“Shoulder Pain and Disability Index (SPADI), pain-free active range of motion (ROM), and a 100-mm visual analogue scale (VAS) to assess pain intensity at the endpoint of pain-free active shoulder ROM. “

The study had a “repeated measures design”:

“All measures were obtained at baseline, immediately after taping (except the SPADI), 3 days and 6 days after tape application.”

The authors’ assessment of the results was that they may indicate that the:

“…potential benefits of KT application are limited to partially improving pain-free ROM of shoulder abduction immediately after application.  No short- or long term benefit related to pain or function occurred over the 6-day period of tape application.”

They also provide a balanced overview of the results:

“Pain and disability measures, as a result of taping, were not different between groups in our study.”

This trial delivered a limited, positive result on one of three main outcome measures at one of the three measurement points.  Although this is statistically significant result (and the authors did apply a simple control for multiple inferences) at least the authors resist the temptation to over-sell the outcome.  They show a good awareness of the limitations of their work:

“The possibility that some component of the overall observed effect is that of a placebo effect must also be considered.  Further research is required to better understand the mechanisms at play for the initial improvement in abduction ROM.”

They also note that both the sham treatment and KT group showed improvement and comment that, “we may have underestimated the extent of the changes related to the natural history of the condition”.  They go on to concede:

“The improvement noted in both groups makes it difficult to determine any specificity of effect the intended therapeutic tape application may have had over the sham application for all outcome measures in this study.”

So it’s not clear, from this study, that it matters how the ‘magic tape’ is applied.  They also say that:

“The lack of a control group and a seemingly near identical improvement in both groups raise the possibility that tape application might or might not have been beneficial, regardless of how it was applied.”

This emphasizes that this study cannot be used as evidence for the efficacy of the ‘magic tape’.  Further, they point to reasons for expecting a significant placebo effect from taping per se:

“A strong placebo effect of taping has been well documented in subjects with patellofemoral joint pain.”

This is a big problem for this study.  They used no untreated, usual treatment or conventional tape control groups.  So, there is no way of knowing whether the small immediate benefit they recorded would have been obtained with any old tape, or is any better than usual treatment or no treatment.

What does this study really show?  It’s a small trial in young and fit individuals with, “shoulder pain and clinical diagnosis of rotator cuff tendinitis” which addresses the question of whether it makes any difference to specific outcome measures how the ‘magic tape’ is applied.

It can say nothing about whether the, “immediate improvement in pain-free abduction ROM after a therapeutic KT application” was the result of the specific tape, the effect of applying a tape, or the act of taping.

Neither does it address whether “therapeutic KT application” is better than usual or no treatment.

So when Lewis says:

“a study of 42 people with shoulder problems in 2008 indicated that Kinesio taping offered immediate pain relief.”

He is plain wrong.  The study indicates that “therapeutic KT application” might be associated with immediate pain-free abduction range of motion.  The trial does not show any general pain relief.

The implication in the piece that this is evidence that there is something special or ‘magic’ about this tape is also incorrect.  This trial assessed the effect of how the tape is applied, not whether it’s better than any other treatment, or no treatment.

So, what of Lewis’s claims that, “studies suggest that it does offer protection to injured muscles and joints”?  Well, I would hope that Lewis has a folder with a number of randomized, controlled trials to support this claim.  Given that I’d expect he’s already cited the best study he could find, and that doesn’t provide any real support, I’m not optimistic.

Any evidence at all?

I searched PubMed, The Cochrane Library and consulted the Elastic therapeutic tape article on Wikipedia.  Looking specifically for “Kinesio tape” I turned up fifteen references, including the paper already discussed.

Case Study

Starting with the lowest form of evidence, a single case report, García-Muro, Rodríguez-Fernández and Herrero-de-Lucas (2010) outline the treatment of myofascial pain in the shoulder of a twenty year-old female with KT.  They contended that, “Data on pain, joint motion and shoulder function obtained from this study may suggest that treatment with Kinesio Taping contributed to the resolution of the patient’s pathology, producing an immediate improvement and resolving the problem in the following days.”

The pain took nine days to resolve.  There is no way of knowing if this young person would not have recovered anyway.  At most, a single case study can start to form the justification required for a pilot study.

Uncontrolled trials

There are a number of uncontrolled or poorly controlled clinical trails in the literature.  For instance, Yashukawa, Patel and Sisung (2006) reported a small uncontrolled trail of KT on fifteen children (10 females and 5 males; 4 to 16 years of age), who were receiving rehabilitation.  In thirteen of the fifteen this was initial rehabilitation “following an acquired disability, which included encephalitis, brain tumor, cerebral vascular accident, traumatic brain injury, and spinal cord injury”.

The Melbourne Assessment of Unilateral Upper Limb, “was used to measure upper-limb functional change prior to use of Kinesio Tape ®, immediately after application of the tape, and 3 days after wearing tape.”

The authors reported statistically significant improvement from pre- to post taping was statistically significant, (p < .02)  But they also cautioned:

“The continued improvement in upper-limb functional skills observed on day 3 may be the combination of the sensorimotor input of the tape, the continued therapy program {including medication}, or the natural recovery that is likely occurring at the same time spontaneously.”

{comment mine}

As the paper notes in its title, this was a pilot study conducted over three days.  As such it can only ever indicate the need for further research: it can never be the basis of clinical recommendation.  The few patients, a wide range of conditions, short duration, the use of (mostly) the initial rehabilitation period, medication, natural recovery, and the lack of a control make this study useless as evidence to support the efficacy of KT.

That there has been no larger follow-up study since 2006 is also a cause for concern.  If this was really seen as a promising intervention, then the lack of further trials could be seen as surprising.

We’ve already dealt with Thelen, Dauber and Stoneman (2008) in detail.  As we have seen, in the context of whether KT works, it addresses the wrong question.  This small, uncontrolled trial shows an association between ‘properly’ applying the magic tape and applying it in some other way and “partially improving pain-free ROM [range of movement] of shoulder abduction immediately after application”.  The authors themselves acknowledge, “Pain and disability measures, as a result of taping, were not different between groups in our study.”

Hsu et al (2009) applied either KT or an an undisclosed type of ‘placebo taping’ to seventeen Taiwanese baseball players with “shoulder impingement syndrome.”  It was a “A cross-over, pretest/posttest repeated measures design.”  Measurements were made of, “of muscle strength, EMG and scapular motion.”

Allegedly statistically significant differences were found between the two types of taping in the mean post-taping changes in the scapular orientations for posterior tilt at two of eight humeral elevations (4 angles, 2 repeats) and in the mean post-taping changes in the scapular muscle electromyographic activity (Upper trapezius) at only one of six humeral elevations (3 angles, 2 repeats).  Given the large number of inferences made and the lack of disclosure of specific p-values, asserting a few significant results at p<0.05 is wholly unconvincing.

This is a small study on seventeen professional athletes. The type of tape used for the ‘placebo taping’ is not disclosed.  The trial could well be another comparison of taping techniques, rather than different tapes.  Two statistically significant results (p<0.05) were obtained from 24 comparisons of mean post-taping changes  in the scapular orientations.  Another was obtained from 18 comparisons of mean post-taping changes in the scapular muscle electromyographic activity.  Neither is there any assessment against standard or no treatment.

Finally the authors note that, “unexpected injuries between two testing sessions and a relatively short off-season period for the data collection left us only seventeen subjects completing the study.”  This appears to indicate that they are reporting on the remaining subjects in a larger trial with a very large drop-out rate.  It would not really be honest to construe this as a positive result for KT.

González-Iglesias and co-workers (2009) tested the effectiveness of KT applied with tension to the skin, against the same tape applied without tension, on whiplash injuries.  Forty-one patients were randomly assigned to receive either ‘proper’ KT or the ‘sham’ KT.

They concluded:

“Patients with acute WAD receiving an application of Kinesio Taping, applied with proper tension, exhibited statistically significant improvements immediately following application of the Kinesio Tape and at a 24-hour follow-up. However, the improvements in pain and cervical range of motion were small and may not be clinically meaningful.”

[italics mine]

Given that there was no placebo control, this is unimpressive.  Failure to achieve clinical signifcance in a small and uncontrolled study cannot be counted as a positive result for KT.

Kalichman, Vered and Volchek (2010) have recently published a small feasibility study to investigate the effect of KT on meralgia paresthetica (MP) symptoms.  They made repeated measurements of three main outcomes (Visual analog scale (VAS) of MP symptoms (pain/burning sensation/paresthesia), VAS global quality of life (QOL), and the longest and broadest parts of the symptom area were measured) on ten participants over a four week period.

Kinesio tape was applied twice a week.  They reported that, “All outcome measures significantly improved after 4 weeks of treatment.  However they concluded that, “Future randomized placebo-controlled trials should be designed with patients and assessors blind to the type of intervention”.

This is a tiny trial whose only implications are for the design of larger, double blind RCTs for this condition.

Simek and co-workers (2011) have reported on, “The effects of Kinesio ® taping on sitting posture, functional independence and gross motor function in children with cerebral palsy.”

They studied thirty-one children with cerebral palsy.  The subjects were randomly assigned to KT plus physiotherapy or a physiotherapy only control.  The trial period was twelve weeks during which time the following outcomes were measured:

“Gross motor function measure (GMFM), functional independence measure for children (WeeFIM) and Sitting Assessment Scale (SAS)”

The authors reported significant improvement in both groups and that:

“At the end of 12 weeks, only SAS scores were significantly different in favour of the study group when the groups were compared (p < 0.05). Also, post-intervention WeeFIM scores of the study group were significantly higher compared to initial assessment (p < 0.05), however, no difference was detected in the control group (p > 0.05).”

They concluded that:

No direct effects of KT were observed on gross motor function and functional independence, though sitting posture (head, neck, foot position and arm, hand function) was affected positively. These results may imply that in clinical settings KT may be a beneficial assistive treatment approach when combined with physiotherapy.”

[italics mine]

It’s a positive conclusion for a largely negative study.  I’ve only been able to locate the abstract, so I cannot tell whether any corrections were made for multiple statistical inferences, or what the actual p-values are.  At any rate, it is another small pilot study.

Kaya et al (2011) compared KT and physical therapy for shoulder impingement syndrome.  The methodology is described as follows:

“Patients (n = 55) were treated with kinesio tape (n = 30) three times by intervals of 3 days or a daily program of local modalities (n = 25) for 2 weeks.”

The measurements made were:

“Disability of Arm, Shoulder, and Hand scale. Patients were questioned for the night pain, daily pain, and pain with motion. Outcome measures except for the Disability of Arm, Shoulder, and Hand scale were assessed at baseline, first, and second weeks of the treatment. Disability of Arm, Shoulder, and Hand scale was evaluated only before and after the treatment. Disability of Arm, Shoulder, and Hand scale and visual analog scale scores decreased significantly in both treatment groups as compared with the baseline levels. “

The authors reported the following results:

“The rest, night, and movement median pain scores of the kinesio taping … group were statistically significantly lower (p values were 0.001, 0.01, and 0.001, respectively) at the first week examination as compared with the physical therapy group (50, 70, and 70, respectively).  However, there was no significant difference in the same parameters between two groups at the second week … “

[italics mine]

Though, on a positive note:

Disability of Arm, Shoulder, and Hand scale scores of the kinesio taping group were significantly lower at the second week as compared with the physical therapy group.  No side effects were observed. Kinesio tape has been found to be more effective than the local modalities at the first week and was similarly effective at the second week of the treatment.  Kinesio taping may be an alternative treatment option in the treatment of shoulder impingement syndrome especially when an immediate effect is needed.”

[italics mine]

The design did not, of course, account for any taping placebo effect.  This is a major weakness.  Again, this is a pilot study.  Larger trials would be needed before clinical recommendations could be made.

Healthy Individuals

There are a number of studies that look at the effect of KT on healthy individuals.  They are not necessarily relevant to the debate about protection of injured muscles and joints, but do potentially address claims for protecting the health of people participating in sports.

Yoshida and Kahanov (2007) on published a study on the effect of KT on lower trunk range of motions.  This was an uncontrolled trial in thirty healthy individuals, so has no relevance on whether KT really helps people with injuries or other health problems.  Of the three measures they made, they only obtained a significant improvement in one.  There conclusion was that, “KT applied over the lower trunk may increase active lower trunk flexion range of motion”.  Again, it provides nothing more than a preliminary hint.

Słupik and co-workers (2007) examined the effect of KT on changes in the tone of the vastus medialis muscle during isometric contractions.  This was based on transdermal EMG measurements made on 27 subjects.  They concluded that they had seen clinically significant effects on bioelectrical activity in the muscle after 24 hours of KT which was maintained for 48 hours after the tape was removed.  Muscle tone, however, decreased to baseline during the 4th day of KT.  This led them to conclude that the time over which KT may be effective is, “shorter than previously believed”.  Interestingly they didn’t see any immediate effect leading them to note that KT, “used shortly before the motor activity … may fail to fulfill its function”.

It’s an interesting piece of work, but does not address the efficacy of KT as a clinical intervention.

The trail design does not enable the following questions to be answered: Were the improvements really due to KT, or did the subjects improve as they were exercised?  Was it a matter of having more confidence to stretch once they knew they had been ‘taped’?  Is KT better than any other kind of tape?  Was the outcome a statistical fluke (no actual P values are given and no attempt was made to correct for multiple inferences, i.e. three measures made on each person)?

Fu et al (2008) reported a trial on “fourteen healthy young athletes” which examined “muscle strength in quadriceps and hamstring … under three conditions: (1) without taping; (2) immediately after taping; (3) 12h after taping with the tape remaining in situ”.  The result:

“no significant difference in muscle power among the three conditions. Kinesio taping on the anterior thigh neither decreased nor increased muscle strength in healthy non-injured young athletes.”

Chang et al (2010) tested the “immediate effect of forearm Kinesio taping on maximal grip strength and force sense in healthy collegiate athletes”.  Twenty-one healthy volunteers took part.

The main outcome measure was “maximal grip strength of the dominant hand … measured under three conditions: (1) without taping; (2) with placebo taping; and (3) with Kinesio taping.”

The results showed no significant differences in maximal grip strength between the three conditions (p = 0.936).  The authors concluded:

“Forearm Kinesio taping may enhance either related or absolute force sense in healthy collegiate athletes.  However, Kinesio taping did not result in changes in maximal grip strength in healthy subjects.”

[italics mine]

The first sentence in the conclusion is just a statement of possibility, not backed up by their data.  The second sentence again shows a negative outcome for KT.

Briem et al (2011) have recently published a trial that examines the effect of two “adhesive tape conditions compared to a no-tape condition on muscle activity of the fibularis longus during a sudden inversion perturbation in male athletes”.  The trail screened fifty-one “male premier-league athletes” for functional stability of both ankles with the Star Excursion Balance Test and selected the fifteen highest and lowest individuals (n=30) for further testing.  The details of this controlled laboratory study were:

“Muscle activity of the fibularis longus was recorded with surface electromyography during a sudden inversion perturbation.  Each participant was tested under 3 conditions: ankle taped with nonelastic white sports tape, ankle taped with Kinesio Tape, and no ankle taping. “

The authors reported that:

“Significantly greater mean muscle activity was found when ankles were taped with non-elastic tape compared to no tape, while Kinesio Tape had no significant effect on mean or maximum muscle activity compared to the no-tape condition.  Neither stability level nor taping condition had a significant effect on the amount of time from perturbation to maximum activity of the fibularis longus muscle.”

Concluding that:

“Nonelastic sports tape may enhance dynamic muscle support of the ankle.  The efficacy of Kinesio Tape in preventing ankle sprains via the same mechanism is unlikely, as it had no effect on muscle activation of the fibularis longus.”

A small study, but another negative result for KT.

Bandage replacement

It’s not unreasonable to think that tape could replace bandage, under some circumstances.  Tsai et al (2009) addressed the question “Could Kinesio tape replace the bandage in decongestive lymphatic therapy for breast-cancer-related lymphedema?”  This was a pilot study with fourty-one patients randomized to either standard therapy or standard therapy with the usual stretch bandage replaced by KT.  There was no significant difference between the clinical outcome measures for the two groups, though KT scored more highly for patient acceptance than the conventional bandage.

They concluded:

“The study results suggest that K-tape [KT] could replace the bandage in DLT, and it could be an alternative choice for the breast-cancer-related lymphedema patient with poor short-stretch bandage compliance after 1-month intervention.  If the intervention period was prolonged, we might get different conclusion.  Moreover, these two treatment protocols are inefficient and cost time in application.  More efficient treatment protocol is needed for clinical practice.”

Interesting, though not relevant to the question at hand; this is some evidence that Kinesio tape is a comfortable, well-tolerated and effective tape; not a magic tape.

Measurement methods

Finally, I found a measurement methods study.  Liu and colleagues (2007) used a motion tracking system to assess the range of wrist motion of “two volunteers who had slightly lateral epicondylitis … before taping, just after taping, taping after 24 hours, and just removing tape”.  They noted that,

“the experimental results show that the motion in the extending movement after taping 24 hours is smaller than that before taping.  It is reasonable results in clinical, since the motion of muscle is constrained by the taping.”

This is just a methods study.  The clinical results on just two patients cannot be reliably interpreted.  In any event, they found a reduced range of motion after taping, which is the reverse of the usual claims associated with KT.

“studies suggest that it does offer protection to injured muscles and joints”

No, they don’t:

García-Muro, Rodríguez-Fernández and Herrero-de-Lucas (2010) report a single case of treating shoulder pain with KT.  They have no way of knowing if the improvements were caused by the KT.

Liu et al (2007) found that taping the wrists of two subjects reduced the extension of wrist muscles.  This might be construed as protective, but there is no clinical data to suggest any actual protection being offered.

Thelen, Dauber and Stoneman (2008), relied on in the article by Lewis, only tests two different ways of using the special tape.  It shows little difference between the two groups.

Hsu et al (2009) looked at “shoulder impingement syndrome”  on seventeen taiwanese baseball players.  It’s not stated what the “placebo taping” was.  At any rate, there were no convincing differences between this and KT.

González-Iglesias et al (2009) examined at the difference between ‘proper’ and ‘improper’ use of KT in whiplash injuries.  Although they found some statistically significant differences, they conceded that, “the improvements in pain and cervical range of motion were small and may not be clinically meaningful.”

Kalichman, Vered and Volchek (2010) studied the effect of KT on meralgia paresthetica (MP) symptoms.  They had only ten participants, no blinding, and no control group.  This provides no evidence of the type asserted by Lewis.

Finally, Tsai et al (2009) show that it might be feasible to replace a bandage with KT during decongestive lymphatic therapy for breast-cancer-related lymphedema.

The rest of the studies either focus on performance improvements in healthy individuals or disability.  None of these provide any real support for the use of KT either.

It could also be argued that Briem et al (2011) failed to find any evidence that KT can protect ankles in sportsmen.  They came to the view that, “The efficacy of Kinesio Tape in preventing ankle sprains via the same mechanism is unlikely”.

Other problems

The article has other problems too.  They are mostly the result of Lewis uncritically quoting Kase with the whole article predicated on the magic tape actually working as advertised.  Under the heading, “How does Kinesio tape work?” Kase opines:

“Your pain sensors are located between the epidermis and the dermis, the first and second layers of your skin, so I thought that if I applied tape to the pain it would lift the epidermis slightly up and make a space between the two layers. This would in turn allow blood to flow more easily to the injured area.”

Given the structure of the skin (opposite), I don’t think externally applied tape is going to pull the dermis and epidermis apart.  Also, any external force will be a tension applied parallel to the layers of skin: this cannot pull them apart.  Even if one could apply a force perpendicular to the layers, unless the dermis is anchored to something that can’t move (it isn’t) both layers of skin will be pulled vertically.

Addressing the question, “Why has it taken so long to make its breakthrough?” Kase is allowed to state without challenge:

“… in Japan we are very open to alternative treatments, whether it’s shiatsu massage, acupuncture or herbal medicines; many people combine natural, traditional remedies with modern medicine.  Europeans and Americans have perhaps taken longer to come round to that idea.”

This really puts Kase’s credibility in perspective: there is no good evidence to suppose that most herbal remedies are actually remedies for anything.  The evidence for acupuncture shows that it doesn’t matter where the needles are inserted or whether they are inserted at all; and that, at best, it only has a modest placebo effect on some pain and nausea anyway.  Frankly, it’s not a very good idea to be “very open” to treatments that don’t work.

He is also allowed to make unsubstantiated claims about treating various animals.  One has to wonder at the ethics of this.

The wild claims about the relationship between body temperature, jet lag and the life expectancy of Olympic athletes also pass without challenge.

All this nonsense is uncritically presented by Lewis.  This is terrible journalism of any sort, as science or technology based journalism: it’s a joke.

Finally, Kase’s website is referenced.  This leaves me with the impression that this piece is nothing more than an advertorial.  It contains no real journalism.  Lewis appears to have been taken in by Kase and would seem to have failed to carry out even the most cursory fact checking.

It’s really sad to see a mainstream news platform perform worse than much less well resourced blogs on this topic.  The Science of Soccer Online blog reviewed this ‘magic tape’ back in 2008 and concluded:

“The underlying basis behind Kinesio Tape is for the most part theoretical and has not been proven. Also, the few well designed research trials fail to show any significant effects on pain relief, strength, range of motion or proprioception.”

I hope that this isn’t a trend …

I am really disappointed that the Guardian has run this ridiculous nonsense in its science/technology section.  I’d be appalled if it was in the lifestyle section; but I’d always thought that the Guardian’s quality control on science and technology pieces was pretty good.

As this comes hot on the heels of a dangerous advertorial for osteopathic treatment of asthma and pneumonia*, I do hope that this is not the beginning of a trend.  I wonder whether the pressure put on peddlers of nonsense by the ASA since they took over regulating marketing claims on UK websites is leading to a change of tactics by those who need to make false and misleading claims to sell their products or services:  Is there going to be a more concerted effort to put them beyond the reach of the ASA and into newspapers?  I hope not.

Silly advertorials do appear from time to time in the press, and even on the BBC.  I really hope that the Guardian will set the record strait on Dr Kase’s magic tape: it’s not magic, there is no good evidence to suggest that it’s useful for very much at all.

I await a response from the Readers’ Editor with interest.


I try to make sure that what I write is both accurate and fair.  If you think that I have got anything wrong please let me know.  If you are right I will happily change what I have written.

This is not medical advice.  If you need that see a properly qualified and registered doctor.


*See Josephine Jones’s excellent blog for the gory details (here, here, here and here) and Martin Robbins excellent riposte “Osteopathy for asthma? The results may take your breath away”.


Briem K, Eythörsdöttir H, Magnúsdóttir RG, Pálmarsson R, Rúnarsdöttir T, Sveinsson T. Effects of kinesio tape compared with nonelastic sports tape and the untaped ankle during a sudden inversion perturbation in male athletes. The Journal of orthopaedic and sports physical therapy. 2011 May;41(5):328–335. Available from: http://dx.doi.org/10.2519/jospt.2011.3501.

Chang HY, Kun-Yu, Lin JJ, Lin CF, Wang CH. Immediate effect of forearm Kinesio taping on maximal grip strength and force sense in healthy collegiate athletes. Physical therapy in sport. 2010 Nov;11(4):122–127. Available from: http://dx.doi.org/10.1016/j.ptsp.2010.06.007.

Fu TC, Wong AM, Pei YC, Wu KP, Chou SW, Lin YC. Effect of Kinesio taping on muscle strength in athletes-a pilot study. Journal of science and medicine in sport / Sports Medicine Australia. 2008 Apr;11(2):198–201. Available from: http://dx.doi.org/10.1016/j.jsams.2007.02.011.

García-Muro F, Rodríguez-Fernández AL, Herrero-de Lucas A. Treatment of myofascial pain in the shoulder with Kinesio taping. A case report. Manual therapy. 2010 Jun;15(3):292–295. Available from: http://dx.doi.org/10.1016/j.math.2009.09.002.

González-Iglesias J, Fernández-de Las-Peñas C, Cleland JA, Huijbregts P, Del Rosario Gutiérrez-Vega M. Short-Term Effects of Cervical Kinesio Taping on Pain and Cervical Range of Motion in Patients With Acute Whiplash Injury: A Randomized Clinical Trial. Journal of Orthopaedic and Sports Physical Therapy. 2009 Jul;39(7):515–521. Available from: http://dx.doi.org/10.2519/jospt.2009.3072.

Hsu YH, Chen WY, Lin HC, Wang WT, Shih YF. The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome. Journal of electromyography and kinesiology. 2009 Dec;19(6):1092–1099. Available from: http://dx.doi.org/10.1016/j.jelekin.2008.11.003.

Kalichman L, Vered E, Volchek L. Relieving symptoms of meralgia paresthetica using Kinesio taping: a pilot study. Archives of physical medicine and rehabilitation. 2010 Jul;91(7):1137–1139. Available from: http://dx.doi.org/10.1016/j.apmr.2010.03.013.

Kaya E, Zinnuroglu M, Tugcu I. Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome. Clinical rheumatology. 2011 Feb;30(2):201–207. Available from: http://dx.doi.org/10.1007/s10067-010-1475-6.

Liu YH, Chen SM, Lin CY, Huang C, Sun YN. Motion tracking on elbow tissue from ultrasonic image sequence for patients with lateral epicondylitis. Conference proceedings : Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Conference. 2007;2007:95–98. Available from: http://dx.doi.org/10.1109/IEMBS.2007.4352231.

Simek TTT, Türkücüolu B, Cokal N, Ustünba G, Simek IEE. The effects of Kinesio® taping on sitting posture, functional independence and gross motor function in children with cerebral palsy. Disability and rehabilitation. 2011 Mar;Available from: http://dx.doi.org/10.3109/09638288.2011.560331.

Slupik A, Dwornik M, Bia[l]oszewski D, Zych E. Effect of Kinesio Taping on bioelectrical activity of vastus medialis muscle. Preliminary report. Ortopedia, traumatologia, rehabilitacja. 2007;9(6):644–651. Available from: http://view.ncbi.nlm.nih.gov/pubmed/18227756.

Thelen MD, Dauber JA, Stoneman PD. The Clinical Efficacy of Kinesio Tape for Shoulder Pain: A Randomized, Double-Blinded, Clinical Trial. Journal of Orthopaedic and Sports Physical Therapy. 2008 Jul;38(7):389–395. Available from: http://dx.doi.org/10.2519/jospt.2008.2791.

Tsai HJ, Hung HC, Yang JL, Huang CS, Tsauo JY. Could Kinesio tape replace the bandage in decongestive lymphatic therapy for breast-cancer-related lymphedema?  A pilot study. Supportive care in cancer. 2009 Nov;17(11):1353–1360. Available from: http://dx.doi.org/10.1007/s00520-009-0592-8.

Yasukawa A, Patel P, Sisung C. Pilot study: investigating the effects of Kinesio Taping in an acute pediatric rehabilitation setting. The American journal of occupational therapy. 2006;60(1):104–110. Available from: http://view.ncbi.nlm.nih.gov/pubmed/16541989.

Yoshida A, Kahanov L. The effect of kinesio taping on lower trunk range of motions. Research in sports medicine (Print). 2007;15(2):103–112. Available from: http://dx.doi.org/10.1080/15438620701405206.


None yet!


7 Responses to “The Guardian and Dr Kase’s magic tape”

  1. Dr*T said

    An excellent, overwhleming, comprehensive strip-down of the article and the evidence.

    What I particulary enjoyed was the fact the Thelen (2008) paper mentioned in the article was titled “The Clinical Efficacy of Kinesio Tape for Shoulder Pain: A Randomized, Double-Blinded, Clinical Trial.”

    (You can get the paper from their website here: http://www.kinesiotaping.com/kta/research/2008-4.pdf )

    With regards to the double-blinding, the paper states “The primary author is a certified Kinesio Tape practitioner and applied all taping procedures”. Apart from the obvious vested interest, it’s clearly not double blinded. The paper also has pictures of the taping procedures – it’s very, very obvious which is the sham. So it’s not even single-blinded! This should have been picked up by any peer review worth its salt?

    If everyone in the trial knows which is the “control” then the randomisation becomes irrelevant and of course, as you say, they use the same tape……

    It’s such an obviously flawed paper, I’m surprised a journal touched it!


  2. draust said

    The Graun website tells us that

    ‘Tim Lewis is editor of the Observer magazine’

    – and a bit of digging around finds:

    ‘Tim Lewis – formerly editor of the Independent’s Sunday Review has been named as the new editor of Observer Sport Monthly and will join the paper in September.

    Lewis said: “ It is a huge honour to be joining Observer Sport Monthly. The magazine has set new standards in what we expect from sports journalism, and I am looking forward to ensuring that it continues to innovate and surprise.”

    Before joining the Independent on Sunday, Lewis was deputy editor of Esquire and before that he was Health and Sports editor of GQ.’


    So Lewis is a sportswriter and magazine journalist. That would fit with the feature you can find with his name on them, which are mostly interviews with sportspeople and a bit of general lifestyle stuff

  3. Apgaylard says ‘It’s really sad to see a mainstream news platform perform worse than much less well resourced blogs on this topic.’
    But not surprising, you and other bloggers strive for accuracy, journalists with some honourable exceptions, strive to sell either the article or their chosen media.

    And a point about Thelen MD, Dauber JA, Stoneman PD, it is possible that the control tape worsened the condition. Proper blinding and significant differences would make no difference to the value of the results.

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  5. angie said

    It is a very nice post to share. and quite informative as lots of people are unaware of such facts. really appreciating.
    Keep sharing such information. will be looking forward for some more. thanks

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