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THE ACUTE EFFECTS OF KINESIOTAPE ON THROWING VELOCITY IN
COLLEGIATE BASEBALL ATHLETES
A THESIS
Submitted to the Faculty of the School of Graduate Studies
and Research
of
California University of Pennsylvania in partial
fulfillment of the requirements for the degree of
Master of Science
by
Ryan F. Davis, ATC, PES
Research Advisor, Dr. Thomas F. West
California, Pennsylvania
2013
ii
iii
ACKNOWLEDGEMENTS
I would like to sincerely thank my family; especially
my father Bob, mother Diane, and brother Andrew for their
continued love and support; without it, this all would not
be possible.
I would also like to thank my thesis chair: Dr. Thomas
F. West, as well as the rest of my thesis committee: Mr.
Jason Edsall, and Dr. Ellen West for their time and
commitment in helping me achieve this accomplishment. I
would also like to thank Ms. Erin Podroskey for her
assistance and cooperation between our studies.
iv
TABLE OF CONTENTS
Page
SIGNATURE PAGE
. . . . . . . . . . . . . . . ii
AKNOWLEDGEMENTS . . . . . . . . . . . . . . . iii
TABLE OF CONTENTS
LIST OF TABLES
. . . . . . . . . . . . . . . vii
LIST OF FIGURES .
INTRODUCTION
METHODS
. . . . . . . . . . . . . . iv
. . . . . . . . . . . . . . vii
. . . . . . . . . . . . . . . . 1
. . . . . . . . . . . . . . . . . . 4
Research Design
Subjects
. . . . . . . . . . . . . . 4
. . . . . . . . . . . . . . . . . 4
Preliminary Research. . . . . . . . . . . . . 6
Instruments . . . . . . . . . . . . . . . . 7
Procedures
. . . . . . . . . . . . . . . . 7
Hypothesis
. . . . . . . . . . . . . . . . 7
Data Analysis
RESULTS
. . . . . . . . . . . . . . . 9
. . . . . . . . . . . . . . . . . . 10
Demographic Data . . . . . . . . . . . . . . 10
Hypothesis Testing
. . . . . . . . . . . . . 11
Additional Findings . . . . . . . . . . . . . 12
DISCUSSION . . . . . . . . . . . . . . . . . 14
Discussion of Results . . . . . . . . . . . . 14
Conclusions . . . . . . . . . . . . . . . . 17
Recommendations. . . . . . . . . . . . . . . 18
v
REFERENCES . . . . . . . . . . . . . . . . . 19
APPENDICES . . . . . . . . . . . . . . . . . 22
APPENDIX A: Review of Literature
APPENDIX B: The Problem .
. . . . . . . . 23
. . . . . . . . . . 38
Statement of the Problem . . . . . . . . . . . 39
Definition of Terms . . . . . . . . . . . . . 39
Basic Assumptions . . . . . . . . . . . . . . 40
Limitations of the Study . . . . . . . . . . . 40
Delimitations of the Study .
Significance of the Study
. . . . . . . . . 41
. . . . . . . . . . 41
APPENDIX C: Additional Methods .
. . . . . . . . 42
IRB Approval California University of PA(C1). 43
Individual Data Collection Sheet (C2) . . . . . . 45
Taping Protocol (C3) . . . . . . . . . . . .
47
Spec Sheet for Radar Gun (C4) . . . . . . . . . 49
REFERENCES . . . . . . . . . . . . . . . . . 51
ABSTRACT
. . . . . . . . . . . . . . . . . 55
vi
LIST OF TABLES
Table
Title
Page
1
A Repeated Measures ANOVA Examining the Acute Effect
of Kinesiotape on Throwing Velocity . . . . . 12
2
A Mixed-Design ANOVA Examining the Acute Effect of
Kinesiotape on Throwing Velocity by Position . . 13
vii
LIST OF FIGURES
Figure
Title
Page
1
Pectoralis Major Inhibition Taping . . . . 52
2
Rhomboid Major Facilitation Taping . . . . 52
3
Radar Gun Specifications . . . . . . . . 54
1
INTRODUCTION
Kinesiotape is among the most popular and fastest
growing modalities in the sports medicine realm.
Kinesiotape is an elastic cotton tape with heat activated,
acrylic based adhesive. It is latex free and has been
reported to stretch 40%-60% of its resting length.1
The
prevalence and utilization of kinesiotape has seen a
significant spike and evidence based research has also
followed suit, and has began examining practical
applications as well as the validity and clinical
effectiveness.
Numerous researchers have observed kinesiotape’s use
in the treatment of myofascial pain, lymphatic drainage,
range of motion increases, and proprioception.1-17 For
instance, in a study by Kalter et al,17 kinesiotape was
found to be an effective means of improving outcomes
associated with pain relief and functional improvement
associated with SAIS (subacromial impingement syndrome).
Though there have been published articles regarding the
effectiveness of kinesiotape for SAIS, inadequate
examination of methods has been recognized.
2
The effectiveness of kinesiotape on muscular strength
at various anatomical structures has been investigated in
clinical research,19-24 but few have looked specifically at
the shoulder and specifically the overhand throw. In the
athletic realm, baseball is a sport which can benefit from
improvement to muscular strength increasing throwing
velocity. The increase in throwing velocity can be useful
not only to the pitching positions, but others as well
since timing of throws is a large part of the sport.
Examining muscular strength/velocity of the glenohumeral
joint, which is inherently dynamic and commonly injured,
can have practical clinical outcomes.
The shortcomings in literature have shown the need for
research relating to muscular strength and throwing
velocity and if kinesiotape may impact these performance
measures. Previous research has demonstrated a potential
effect. As research by Aktas and Baltaci demonstrated,
kinesiotape had a positive effect on knee muscular strength
at 180°/s PT values by isokinetic measures.25 In light of
this encouraging research seen within the lower extremity,
there is a need for upper extremity testing which could
potentially report similar positive outcomes.
Research examining the effect of kinesiotape on
athletic performance would be useful in guiding the
3
athletic trainer as treatment decisions are made.
Therefore, the purpose of this study is to examine the
effects of kinesiotape on throwing velocity of NCAA
Division II collegiate baseball and softball players.
4
METHODS
The primary purpose of this study was to examine the
effect of kinesiotape on throwing velocity as it relates to
athletic performance. This section will include the
following subsections:
research design, subjects,
instruments, procedures, hypotheses, and data analysis.
Research Design
This research utilized a quasi-experimental, within
subjects, repeated measures design.
variable was taping condition.
The independent
This condition had three
levels; no intervention (control), placebo tape, and
kinesiotape. The dependent variable was throwing velocity
as measured by the radar gun.
Subjects
The subjects used for this study were approximately 30
volunteer male and female student athletes from California
University of Pennsylvania, with a minimum requirement of
15 volunteers needed. Varsity level athletes will be
5
preferred and subject height, weight, age, position in
sport, and throwing arm dominance will also be recorded.
All subjects will have been screened for disability or
dysfunction as it relates to performing this study.
Subjects were excluded if they were under the age of 18,
not medically cleared to participate in their sport or had
a condition that could affect their performance in this
study.
Each subject will be required to participate in one
45-minute testing session. All subjects in the study will
sign an Informed Consent Form (Appendix C2) prior to
participation in the study. The subjects will also attend
an information meeting detailing the purpose, procedure,
and risks involved in volunteering. After subjects have
been obtained, a practice session will be held for the
volunteers to become familiar with the research set up and
data collection measures. The subjects will have the option
to opt out of the study at any time. The study was approved
by the Institutional Review Board at California University
of Pennsylvania (approval #12-042) prior to any data
collection.
Each participant’s identity will remain
confidential and will not be included in the study.
6
Preliminary Research
There will be a preliminary study conducted with this
research project.
protocol.
Up to 3 subjects will used to review the
The subject will perform the warm up procedure
as described in the procedure section. They will also get
10 warm up throws just as the participants would be
allotted. To keep in accordance with the procedure of the
research, the preliminary researchers will also have just
finished 5 submaximal accuracy throws for another study.
They will then be asked to complete 5 successive
throws from a distance of 60 ft 6 in (18.44m), with a 1minute rest period between throws. The preliminary
researchers will throw with 3 different interventions just
as the subjects will be asked to. They will perform five 5
throws with a randomized intervention order. They will also
throw at a designated target and their velocities will be
recorded. The researcher will be looking for the subject’s
ability to understand directions, the amount of time used
to complete the tasks and if the warm-up protocol before
service testing is accurate.
Data will be collected on the
data collection sheet (Appendix C3).
7
Instruments
Instruments used within the study will include a speed
radar gun (Model #1235982), a tape measure to determine the
appropriate distance of 60 ft 6 in (18.44m), a netting
which the subjects will throw into, official NCAA standard
size collegiate baseballs and softballs, and specific
taping techniques for muscular strength. These techniques
will include a pectoralis major inhibition taping (Figure
1) incorporation with a rhomboid major facilitation taping
(Figure 2) procedure.
Procedures
The researcher applied and obtained approval from the
IRB at California University of Pennsylvania before any
research was conducted. Subjects completed an informed
consent in their first meeting with the research.
The testing protocol will follow the example as set
forth by Carter, Kaminski, Douex Jr, Knight, and Richards.26
Subjects were instructed to complete a warm-up of 10-15
minutes, focusing on baseball specific stretching of the
shoulder musculature as well as a cardiovascular component.
This took place before the subjects participated in a
8
similar study involving kinesiotape and its effects on
throwing accuracy. The subjects were only asked to partake
in the warm up protocol once, therefore they were not asked
to fulfill this procedure a second time in any given
session. Optimal throwing velocity was assessed over a
distance of 60 ft 6 in (18.44m), the distance from the
center of the pitcher’s mound to home plate in a standard
intercollegiate baseball field using official NCAA standard
size collegiate baseballs and softballs. Subjects threw in
a temperature controlled enclosed room to rule out and
effects from the elements. Subjects threw from flat ground
to a designated target with a catching net as a background.
Participants were allowed to perform 5 warm up throws, for
verification purposes, the radar gun also recorded each
warm up throw to ensure the functionality of the equipment.
Each subject was given 5 throws with a 1-minute rest period
established between throws. Any throws out of the range of
the target or radar gun where discarded. The highest speed,
measured in kilometers per hour (kph) was deemed as maximal
throwing velocity and utilized as the test statistic.
Taping intervention application was applied using a
counter balance order. Each taping intervention was
assigned a number, 1-no taping procedure applied, this will
also be known as the control in the study; 2-placebo tape,
9
and 3-kinesiotape. This was necessary in order to prevent
any biasing factor from occurring. In addition, all of the
tapings were applied by the same researcher to prevent any
crossover effect.
Hypothesis
The following hypothesis was constructed on previous
research and the researcher’s intuition based on a review
of the literature.
1. Kinesiotape will have no significant difference on
throwing velocity as compared to the control, and
placebo taping groups.
Data Analysis
All data will be analyzed utilizing SPSS version 18.0
for Windows at an alpha level of 0.05.
The research
hypothesis will be analyzed using repeated measures ANOVA.
10
RESULTS
The primary purpose of this study was to examine the
effect of kinesiotape on throwing velocity as it relates to
athletic performance on three levels. The three variables
were a control with no tape, a placebo tape (Elasikon®),
and kinesiotape (Kinesio® Tex Gold™. Sixteen male subjects
volunteered to be a part of this study. Each informed
subject completed a dynamic warm up protocol at each
session prior to testing. Each subject completed five
trails under each condition; and the greatest velocity
measured under each variable was deemed optimal throwing
velocity for that condition. This section will include the
following subsections:
Demographic Information, Hypothesis
Testing, and Additional Findings.
Demographic Information
Subjects used in this study (N=16) were volunteers
from California University of Pennsylvania’s varsity
baseball team. The subject’s were all at least 18 years old
at the time of testing. All subjects were screened for
disability or dysfunction as it relates to performing this
11
study. The playing positions of the subjects were mixed
with three pitchers, and 13 classified as fielders
(infield, outfield, and catcher).
Hypothesis Testing
The following hypothesis was tested in this study. An
α<.05 was used for statistical testing.
1. Kinesiotape will have no significant difference on
throwing velocity as compared to the control, and
placebo taping groups.
Conclusion: To test the hypothesis, each subject’s
greatest velocity (best performance) was recorded for each
of the three taping conditions. These include the no tape
(control), the placebo tape, and the kinesiotape. A
repeated measures ANOVA was calculated to compare the
velocities for the subjects under each condition. Table 1
illustrates the mean velocities for each condition.
A one-way repeated measures ANOVA was calculated
comparing the velocities of subjects under three different
taping conditions: no tape, placebo tape, and kinesiotape.
No significant effect of taping condition was found
12
(F(2,28) = .64 , p > .05). No significant difference exists
among no tape (m = 120.8kph, se = 2.13), placebo tape (m =
123.0kph, se = 2.94), and kinesiotape (m = 122.2kph, se =
2.23) means.
Table 1. A Repeated Measures ANOVA Examining The Acute
Effect of Kinesiotape on Throwing Velocity
Taping
Mean
Std.
95% Confidence Interval
Condition
(kph)
Error
Lower
Upper
Bound
Bound
No Tape
120.8
2.1
116.3
125.4
Placebo
Tape
123.0
2.9
116.7
129.3
Kinesiotape
122.2
2.2
117.4
126.9
Additional Findings
An examination of the effect of playing position and
tape condition on throwing velocity was also conducted. The
positions were broken up into 2 categories: pitchers
(position 1) and fielders (position 2). A repeated measures
ANOVA was used to compare the velocities for the subjects
under each condition. Table 2 illustrates the mean
velocities for each condition. A 2 X 3 mixed design ANOVA
was calculated to examine the effects of position
13
(Positions 1 and 2) and taping condition (no tape, placebo
tape (Elastikon), and kinesiotape) on throwing velocity. No
significant main effects or interactions were found. The
tape x position interaction (F(2,28) = .97, p >.05), the
main effect for taping condition (F(2,28) = .64, P >.05),
and the main effect for position (F(1,14) = .48, p > .05)
were all not significant. Throwing velocity was not
influenced by either taping condition or position at the p
= .05.
Table 2. A Mixed-Design ANOVA Examining The Acute Effect of
Kinesiotape on Throwing Velocity by Position
Position
Taping
Mean
95% Confidence Interval
Condition
(kph)
Std.
Lower
Upper
Error
Bound
Bound
1*
NT*
121.7
3.8
113.5
130.0
PT*
126.0
5.3
114.6
137.4
KT*
122.8
4.0
114.2
131.4
2*
NT*
119.9
1.8
116.0
123.9
PT*
119.9
2.5
114.4
125.4
KT*
121.5
1.9
117.4
125.7
*1 (Pitchers), *2 (Fielders), NT* (No Tape), PT* (Placebo
Tape), KT* (Kinesiotape)
14
DISCUSSION
Discussion of Results
The primary purpose of this study was to examine the
effect of kinesiotape on throwing velocity as it relates to
athletic performance on three levels. The three variables
were a control with no tape, a placebo tape, and
kinesiotape. Each volunteer subject completed a dynamic
warm up protocol at each session prior to testing. Each
subject completed five trials under each condition; and the
greatest velocity measured under each variable was deemed
optimal throwing velocity for that condition. When
examining the effects of kinesiotape on throwing velocity,
no significant differences were observed within subjects
under three different taping conditions. This is supported
by studies that concurrently examined kinesiotape and its
effect on muscular output and velocity.
A study by Fu, Wong, Pei, et al21 assessed kinesiotape
in a similar measure by examining muscular strength. The
researchers also perceived the subjects under three
different taping conditions: no tape, immediately after
taping, and twelve hours after taping. They found that
15
there were no significant differences observed in muscle
power among the three conditions by evaluation of
concentric quadriceps contractions at 60°/s; eccentric
quadriceps contractions at 60°/s; concentric quadriceps
contractions at 180°/s and eccentric quadriceps
contractions at 180°/s; with testing protocol repeated to
test the hamstrings muscle strength. The study inspected a
similar measure of muscular production, and found no
notable changes within the subjects due to the taping
condition. A concurrent study by
Vithoulka et al,23 assessed kinesiotape efficacy on
quadriceps strength at maximum concentric and eccentric
isokinetic exercise mode in healthy, non-athlete woman. The
researcher tested subjects analogous to the protocol used
in this thesis. Under three different taping conditions: no
tape, placebo tape, and kinesiotape; there was found to be
no significant differences in max concentric torque within
subjects.
A similar study examining kinesiotape’s effect on
muscle contractility was conducted under a similar threecondition design. No tape, Elastikon tape, and kinesiotape
we used to scrutinize grip strength in male subjects. The
researchers also found no significant in strength between
the control and kinesiotape groups.27
16
The results of these studies are important to consider
for athletic trainers’ in future use of the kinesiotape on
our patients or athletes because there is not substantial
evidence-based research to propagate an established
practice of kinesiotape and its techniques.
The goal of this study was to examine the effects of
kinesiotape on throwing velocity. Through successful
testing and statistical analysis, no significant difference
was noted between the three taping conditions. This new
knowledge is meaningful because evidence-based research is
lacking in the dynamic field of kinesiotape. However, more
and more studies are being conducted which examine the
various proposed uses this tape claim to be effective for.
It would be advantageous for future research to examine not
only the effect of kinesiotape on muscular strength as
demonstrated in this thesis, but also for the other
qualities which the tape advertises such as edema
reduction, proprioception, joint stability, and lympodemic
potentials. Forthcoming studies should also adhere to a
randomized, double-blind, controlled study; to maintain the
highest level of quality and the most accurate results for
the prospective of this tape.
17
Conclusions
In conclusion, there is little evidence to support
that the use of kinesiotape increases throwing velocity.
The findings indicate that there are no significant
differences in throwing velocity between any of the three
taping conditions, as well as no significant differences in
throwing velocity for the taping conditions by position.
The kinesiotape conditions threw slower than the placebo
tape condition, but faster than the no tape condition. The
no tape circumstance, overall, threw slower than both the
placebo tape and kinesiotape. Performance tests within
subjects on a larger scale in future studies could provide
more evidence in this area of interest.
Impacts on clinical practice would be significant if
future research continues to examine all of the stated
claims for kinesiotape. If studies are able to relate an
evidence-base supporting the use of kinesiotape within
rehabilitation practice, more clinicians, and patients,
would benefit greatly from its efficacy. As it relates to
throwing velocity, athletic trainers’ and other
professionals would find this information useful. This
study alone cannot support or deny claims of increased
18
muscular output. However, future studies have the ability
to solidify this tapes effectiveness.
Recommendations
Current literature is still in its infancy as it
relates to kinesiotape. There are very little studies that
examine kinesiotape within an athletic realm. Some studies
inspect how kinesiotape would affect specific muscles
during a unilateral activity under low to moderate
intensity. However, in athletics there are multiple muscles
working at high rate of movement. This is an opportunity
for future studies to examine the multiplanar movements and
how kinesiotape may affect athletes or physically active
people under these specific conditions.
If another study was conducted, a double-blind study
type with more subjects would be preferred. It would also
be advantageous to observe kinesiotapes effects within a
softball populace due to the difference in throwing
mechanics. A future study could also examine this study
with a different taping procedure applied. Activating
different muscle groups compared to this study could yield
different results.
19
REFERENCES
1.
Schoene LM. The Kinesio Taping Method: Here’s a New
Treatment Modality for Podiatry. Sports Podiatry.
2009; 149-156.
2.
O’Sullivan D, Bird SP. Utilization of Kinesio Taping
for Fascia Unloading. Athl Ther Today. 2011; 21: 2127.
3.
Yoshida A, Kahanov L. The Effect of Kinesio Taping on
Lower Trunk Ranges of Motions. Research in Sports
Medicine. 2007; 15: 103-112.
4.
Kahanov L. Kinesio Taping, Part 1: An Overview of Its
Use in Athletes. Athl Ther Today. 2007; 12(3): 17-18.
5.
Bassett KT, Lingman SA, Ellis RF. The Use and
Treatment Efficacy of Kinaesthetic Taping for
Musculoskeletal Conditions; A Systematic Review. NZ J
Physiother. 2010; 28(2): 56-62.
6.
Hendrick CR. The Therapeutic Effects of Kinesio Tape
on a Grade I Lateral Ankle Sprain. [Doctoral
Dissertation]. 2010; 1-54.
7.
Bicici S, Karatas N, Baltaci G. Effect of Athletic
Taping and Kinesiotaping on Measurements of Functional
Performance in Basketball Players With Chronic
Inversion Ankle Sprains. Int J Sports Phys Ther. 2012;
7(2): 154-166.
8.
Witkowski KR. Sticking to Rehab: Though Recently
Popular, Elastic Therapeutic Taping Has Long Been Used
to Provide Pain Relief and Injury Protection and
Prevention. [Web Access]. 2012; 8-12.
9.
Kaya E, Zinnuroglu M, Tugeu I. Kinesio Taping Compared
to Physical Therapy Modalities for the Treatment of
Shoulder Impingement Syndrome. Clin Rheumatol. 2011;
30: 201-207.
20
10.
Aytar A, Ozunlu N, Surenkok O, Baltaci G, Oztop P,
Karatas M. Initial Effects of Kinesio Taping in
Patients with Patellofemoral Pain Syndrome: A
Randomized, Double-Blind Study. Isokinet Exerc Sci.
2011; 19: 135-142.
11.
Kwiatkowska JZ, Labon ER, Skrobot W, Bakula S,
Szamotulska J. Application of Kinesio Taping for
Treatment of Sports Injuries. Research Yearbook. 2007;
13(1): 130-134.
12.
Osterhues DJ. The Use of Kinesio Taping in the
Management of traumatic Patella Dislocation. A Case
Study. Physiother Theory Pract. 2004; 20: 267-270.
13.
Kahanoc L. Kinesio Taping: An Overview of use With
Athletes, Part II. Athl Ther Today. 2007; 12(4): 5-7.
14.
Pope ML, Baker A, Grindstaff TL. Kinesio Taping
Technique for Patellar Tendinopathy. Athletic Training
& Sports Health Care: The Journal for the Practicing
Clinician. 2010; 2(3): 98-99.
15.
Bishop BN. Sports Specific: Products and Treatments to
Assist in Pain Relief and Proper Muscle Activation in
Athletes. [Web Acess]. 2011; 12-15.
16.
Kalter J, Apeldoorn AT, Ostelo RW, Henschke N, Knol
DL, Van Tulder MW. Taping Patients with Clinical Signs
of Subacromial Impingement Syndrome: the Design of a
Randomized Controlled Trail. Musculoskeletal
Disorders. 2011; 12: 1-8.
17.
An H, Miller C, McElveen M, Lynch J. The Effect of
Kinesio Tape on Lower Extremity Functional Movement
Screen Scores. Int J Exerc Sci. 2012; 5(3): 196-204.
18.
Firth BL, Dingley P, Davies ER, Lewis JS, Alexander
CM. The Effect of Kinesiotape on Function, Pain, and
Motoneural Excitability in Healthy People and People
with Achilles Tendinopathy. Clin J Sport Med. 2010;
20: 416-421.
19.
Huang CY, Hsieh TH, Lu SC, Su FC. Effect of the
Kinesio Tape to Muscle Activity and Vertical Jump
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Engineering Online. 2011; 10: 1-11.
21
20.
Hsu YH, Chen WY, Lin HC, Want WT, Shih YF. The Effects
of Taping on Scapular Kinematics and Muscle
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21.
Fu TC, Wong AM, Pei YC, Wu KP, Chou SW, Lin YC. Effect
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22.
Lee JH, Yoo WG, Lee KS. Effects of Head-Neck Rotation
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23.
Vithoulka I, Beneka A, Malliou P, Aggelousis N,
Karatsolis K, Diamantopoulos K. The Effects of
Kinesio-Taping on Quadriceps Strength During
Isokinetic Exercise in Healthy Non Athlete Women.
Isokinet Exerc Sci. 2010; 18: 1-6.
24.
Schneider M, Rhea M, Bay C. The Effect of Kinesio Tex
Tape on Muscular Strength of the Forearm Extensors on
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25.
Aktas G, Baltaci G. Does Kinesiotape Increase Knee
Muscles Strength and Functional Performance? Isokinet
Exerc Sci. 2011; 19: 149-155.
26.
Carter A, Kaminski T, Douex A, Knight C, Richards J.
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27.
Baker C, Laiderman B, Paunicka E, Simpson R, Weaver R.
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Contraction. [Web Based Study]. 2011; 1-9.
22
APPENDICES
23
APPENDIX A
Review of Literature
24
REVIEW OF LITERATURE
Kinesiotape has been the subject of a lot controversy
within the medical field in recent years. Its popularity
has increased with the explosion of its prevalence of usage
within the sports medicine and physical therapy fields. The
proposed study will examine how kinesiotape will affect the
velocity of a throw or overhead movement in athletes
involved in such sports. Though research examining the
effectiveness of kinesiotape is in its infancy in terms of
publication, there still is a need to observe whether this
new technology is clinically useful in the athletic
training realm.
The purpose of this review is to examine published
literature evaluating the relationship between kinesiotape
and throwing velocity. The information obtained within this
study can aid clinicians in their practical decision
making; in regards to using this tool within their
practice. This will be accomplished using the following
sections: kinesiotape basics, defining muscular strength,
biomechanics of the throwing motion, effects of kinesiotape
on muscular strength, and effects of kinesiotape on
25
proprioception, endurance, and swelling or lymphatic
drainage.
Kinesiotape Basics
The researcher in this article examined the original
research of Dr. Kenzo Kase, known as the original pioneer
of kinesiotape. The investigator detailed the various
techniques outlined and also explained, in detail, the
purposes for applying this type of tape. She also theorized
the potential uses of this modality within the field of
podiatry.1
In a study by Kahanoc, a more in depth examination was
performed examining the use of kinesiotape with athletes.
The researcher concluded that kinesiotape is considered a
safe technique with limited associated side effects to
athletes. However, using this technique takes significant
practice and certification with kinesiotape in order to be
performed for optimal outcome for patients.2
In a concurrent systematic review by Kahanov, the
study examined the use of kinesiotape within the athletic
realm. The researcher detailed the proposed effects that
this method can have upon athletes who are competing at
multiple levels and its effectiveness within a
26
rehabilitation program. The examiner concludes that
kinesiotape can be very effective in athletes and sports
medicine although further research is warranted.3
Effects on Muscular Strength on Velocity
The examination of muscular strength in relation to
kinesiotape intervention has begun to increase in frequency
in peer reviewed journals. With this rise in popularity and
evidence based effects of the tape, researchers should now
begin to focus their energies to determining if kinesiotape
is as effective in terms of velocity as it is with others.
Using specific techniques, the utilization of this method
could potentially have a great effect on a vast population.
A systematic review was performed, using a critique of
all randomized controlled trials within the EBSCO Database,
where kinesiotape and its effects were put under scrutiny.
Out of the three published studies that met the inclusion
criteria, two of them exhibited a high methodological
quality status with the other one receiving a score of
“limited” using the 11-item PEDro scale. According to the
research none of the literature showed clinical
significance (p<0.05) in relation to the use of
kinesiotaping.4
27
In an article by Firth, Davies, Lewis, and Alexander6,
the researcher examined kinesiotaping’s effect on hop
distance, pain, and motoneural excitability in both a
healthy population and a population with achilles
tendinopathy. Twenty-six healthy and twenty-nine subjects
with achilles tendinopathy were used for this withinsubject study. Results found no changes in hop distance
when tape was applied and no changes in reported pain. The
Hoffman (H) reflex amplitude of the lateral soleus and
middle gastrocnemius increased in healthy people after the
tape was removed, as collected using electromyographical
activity measurements by utilization of surface electrodes.
There was no change in activity in subjects with Achilles
tendinopathy.5
In another report6, the authors detailed the initial
effects of kinesiotape on strength, joint position sense
and balance in patients with patellofemoral pain syndrome.
Using a randomized double-blind study methodology, twentytwo subjects were separated into two groups: kinesiotape,
and placebo kinesiotape. Forty-five minutes after
application, positive significant differences were noted in
muscle strength, joint position sense, static and dynamic
balance, and pain intensity showing statistical increase in
the kinesiotape groups.6
28
An additional report7 attempted to determine the
effectiveness of kinesiotape in relation to muscle activity
and vertical jump height performance. This study utilized
thirty-one healthy adults which were divided into four
groups: two elastic tapes, kinesiotape, and an MPlacebo (3M
Micropore) tape. Results showed kinesiotape increased
ground reaction forces, and EMG activity in the medial
gastrocnemius. Height of jump, however, remained constant
for all the groups18. This shows positive results in favor
of kinesiotapes effect on muscular strength.
Fu, Wong, Pei, et al8 examined the effects of
kinesiotape on muscular strength in athletes. This pilot
study divided subjects into three conditions: no taping,
immediately after taping, and twelve hours after taping.
Results showed no significant difference in muscle power
among the three conditions by evaluation of concentric
quadriceps contractions at 60°/s; eccentric quadriceps
contractions at 60°/s; concentric quadriceps contractions
at 180°/s and eccentric quadriceps contractions at 180°/s;
with testing protocol repeated to test the hamstrings
muscle strength.
Additionally researchers9 examined the effect of
kinesiotape on head-neck rotation and flexor muscle group
dominant hand grip strength. Forty subjects (20 men,
29
20women) were tested and the results found that grip
strength increased in the dominant hand after application
of kinesiotape when compared to that of the no tape
condition.
In a study by Vithoulka et al, the effect of
kinesiotape on quadriceps strength at maximum concentric
and eccentric isokinetic exercise mode in healthy nonathlete woman, using three different taping groups: no
tape, placebo tape, kinesiotape; results showed that there
were no significant differences in max concentric torque
between the three groups, but there was a significant
difference in max eccentric torque during the concentric
and eccentric modes of the quadriceps muscle group with the
kinesiotape.10
Further research was conducted observing the
kinesiotape in healthy colligate tennis athletes could
decrease fatigue by maintaining strength in the forearm
extensor group. Using fourteen Division I tennis athletes,
results showed that grip strength was increased in the
kinesiotape group as compared to the control group.11
An additional report examined the influence of taping
with a flexible tape (kinesiotape) on performance and its
effect on the impulse in a stretch-shortening cycle
movement. Twenty-three subjects were broken up into
30
kinesiotape and no tape groups. The results showed no
significant difference in the jumping performance of the
intervention group as compared to the control group.12
Yet another study was launched to view the effects of
kinesiotaping on muscle contractility when compared to no
tape and Elastikon taping applications on grip strength.
Results showed significant differences between the
Elastikon and kinesiotape groups in male subjects in that
the Elastikon actually decreased performance. There was no
reported significant difference in strength between the
control and kinesiotape groups.13
The purpose of the following study was to investigate
if kinesiotaping has an influence on the motor nerve
conduction velocity. Seventeen healthy subjects were tested
for this study. Results showed no significant differences
between the kinesiotape and control groups with respect to
latency, amplitude, and motor nerve conduction.14
Another study was conducted in order to test
kinesiotape on bioelectrical activity of the vastus
medialis muscle in the quadriceps muscle group. Twentyseven healthy persons were tested and twenty-four hours
after kinesiotaping revealed significantly increased
recruitment of muscle’s motor units (peak torque). After
31
seventy-two hours after taping there was significantly
increased bioelectric activity.15
The researchers16 in this study examined how taping
influenced electromyographic activity in the scapular
rotators in healthy shoulders. The movement, direction, and
tape were all randomized. Results showed no significant
difference between the taping groups as it relates to
scapular muscle activity.
Looking at the immediate effects of applied
kinesiotaping to the forearm in maximal grip strength and
force sense of healthy colligate athletes, twenty-one
healthy athletes were used as subjects. Results showed no
significant differences in maximal strength of grip between
the three conditions: kinesiotape, placebo tape, no tape.17
In summary, the effect of kinesiotape on muscular
strength is becoming more prevalent in current research.
With the results showing the positive correlation between
specific taping methods and other benefits of the tape,
this aspect of the interventions potential must be
explored. It would not only be clinically relevant, it
would also open the doors to further research on possible
other tapings or prophylactic methods for performance
enhancement.
32
Effects on Proprioception, Endurance, Swelling
When examining effects of kinesiotape on proprioception,
endurance, and swelling; the researchers of the following
article studied the effect of fascia unload when
kinesiotape was applied. The examiners performed a
systematic review of kinesiotape and its effects on
muscular events related to fascia injury. Through their
research they found that this technique helps lower pain
levels and increases range of motion, however there is
inconclusive research related to its muscle power effect
through fascia unloading.18
Additionally, examiners conducted research on
kinesiotape and its effect on lower trunk ranges of motion.
They studied thirty healthy individuals with no history of
lower trunk or back issues and performed range of motion
measurements pre-taping and post-taping. They concluded
that trunk flexion was significantly improved as compared
to the non tape group, with lateral flexion or extension
showing now noteworthy improvement.19
More research was performed looking at the therapeutic
effects of kinesiotape on Grade I lateral ankle sprains.
Using twenty-five high school aged students who suffered
grade I lateral ankle sprains. Using a control group who
33
used ASO tape, results found no significant difference
between the two groups for pain or when performing single
leg hop for distance, box drills or the Illinois test. Yet,
the ASO group showed they could perform more squats than
the kinesiotape group at four and eight weeks.20
This study looked at the effects of different types of
taping on functional performance in athletes with chronic
inversion sprains of the ankle. Using a crossover study
design method, fifteen athletes were used and split into
kinesiotape; athletic tape, placebo, and no tape. There
were no significant differences among the groups for SEBT.
Kinesiotape and athletic tape yielded faster performance
times in single limb hurdle as compared to the other
groups. However, there was lower performance in the heel
raise and vertical jump tests from the groups who had the
tape.21
When examining shoulder pain, multiple techniques were
used that including kinesiotape. The researcher also
examined the clinical application and outcomes. Using
supporting evidential research, she concluded that it could
be a viable treatment adjunct.22
In an additional study looking to determine and
compare the efficacy of kinesiotape and physical therapy
modalities in patients with shoulder impingement. Using a
34
DASH (Disability of the Arm, Shoulder, and Hand) as a
subjective measurement, along with a visual analog scale,
scores significantly decreased in both treatment groups as
compared to baseline levels. The kinesiotape group scores
significantly decreased with night, rest, and movement10.
Supplementary research examined the effect of kinesiotape
on calf injury prevention in triathletes during
competition.23
This pilot study observed the subjective perception of
local pain after competition. It was observed that none of
the athletes suffered contractures or cramps in the calves
and pain was no more than a 2 on the CR10 scale in subjects
with kinesiotape12. Further examinations looked to determine
how kinesiotape can be effective in the field of athletics
and sports medicine. Using clinical observations, the
researcher found that after kinesiotape application,
injured athletes had decreased pain levels, as well as
decreased visible edema, as well as no visible allergic
reactions.24
In a case report examining the use of kinesiotaping in
the management of traumatic patella dislocations, the
researcher found that the use of kinesiotape could be
beneficial to decrease pain, and enhanced quadriceps
35
activity and weight bearing stability during functional
activities.25
Another study observed how kinesiotaping affected
patients with patellar tendinopathy. Using a U-strip
technique the researcher determined that the use of the
tape could be beneficial due to the fact that the final
position of the tape does not restrict range of motion.26
In this additional article describing how kinesiotape
can be used to aid in pain relief and also allow proper
muscle activation in an athletic population, the
researchers found that its biggest aid was in the ability
of the tape to act as a constant treatment that the athlete
can wear between treatments and still receiving an
advantage.27
Additional research examined the effect of elastic
taping on kinematics, muscle activity, and strength of the
scapular region in baseball players with shoulder
impingement. Seventeen baseball players were tested.
All
subjects received kinesiotape and the placebo tape. Results
showed that kinesiotaping significantly increase scapular
posterior tilt at 30° and 60° during arm raising and
increased the lower trapezius muscle activity in the arm
lowering phase in comparison to the placebo tape.28
36
Supplementary research examined the signs of
subacromial impingement syndrome and the effect of taping
these patients. Using a randomized controlled study
methodology, One hundred and forty patients were assessed
as subjects. The results indicated that taping patients
with this condition improved outcomes on pain relief and
functional improvement.29
Throwing Velocity
There are multiple ways in which throwing velocity can
be assessed. Freeston and Rooney30 detailed a method which
involved the incorporation of a radar gun measuring
velocity as a percentage of the individual’s maximal
throwing velocity, rather than expressing the number of
throws at a set distance or percentage of perceived maximal
exertion.
Marques et al determined throwing velocity by the use
of a Doppler radar gun which was located behind a target
with intraclass correlation coefficient for throwing
velocity at 0.95 (95% confidence interval: 0.91-0.96) and
coefficient of variation of 3.5%.31
37
For the purposes of this study we will examine
throwing velocity as detailed by Carter et al as detailed
in the methods section.
In summary, current evidence based research relating
to kinesiotape’s wide range of use is lacking. While other
aspects such as edema control, lymphatic drainage, and pain
have become more relevant; studies involving muscular
strength are still in their infancy. It is imperative that
testing procedures are performed on any and all
characteristics of this modality. The evidence based
outcomes of a study such as this could help add another
tool which practicing clinicians may be able to employ
within an ever dynamic field.
38
APPENDIX B
The Problem
39
STATEMENT OF THE PROBLEM
The purpose of the study is to examine the effect of
kinesiotape on throwing velocity.
It is important to
examine this intervention because kinesiotape has become
very popular within the medical community but there is
still little current research in regards to its effect on
throwing velocity or muscular strength.
We already are
aware of the positive effects of this tape on lymphatic
drainage, edema control, and myofascial symptoms; yet, if
it is possible to definitively state whether kinesiotape
will increase this variant of muscular strength, we can
possibly relate it to other joints within the body and the
specific demands of a therapeutic rehabilitation program. I
also believe that this study could clarify exactly what the
kinesiotape’s role in relation to the human anatomy and the
effects on any power production systems within the body.
Definition of Terms
The following definitions of terms will be defined for
this study:
1)
Kinesiotape – a special type of tape manufactured with
a special weave and viscosity that allows ventilation
40
and water resistance, with more expanded elasticity
and a minimization of skin discomfort.18
2)
Throwing Velocity- mainly contributed by internal
rotation of the shoulder and elbow external rotation;
in addition maximal pelvis, trunk rotation and flexion
correlate positively with ball release velocity.36
Basic Assumptions
The following are basic assumptions of this study:
1)
The subjects will be honest when they complete their
demographic sheets.
2)
The subjects will perform to the best of their ability
during testing sessions.
3)
All taping procedures will be applied with a high
degree of consistency.
Limitations of the Study
The following are possible limitations of the study:
1)
The validity of kinesiotape and specific techniques to
increase muscular performance has yet to be
definitively determined.
2)
The velocity of the throws from the subjects will
differ based upon many variables.
41
Delimitations of the Study
The following are possible delimitations of the study:
1)
The subjects will be California University of
Pennsylvania Division II male and female varsity
athletes.
Significance of the Study
The significance of this study will be multi-tiered.
First, if any positive correlation can be made, the
implications with the use of kinesiotape in athletics can
be expanded to beyond baseball and softball. Secondly,
within the rehabilitation realm, this intervention can be
used to increase muscular strength or velocity in those
involved in injury recovery.
42
APPENDIX C
Additional Methods
43
APPENDIX C1
IRB APPROVAL: CALIFORNIA UNIVERSITY OF PENNSYLVANIA
44
From : instreviewboard
Subject : IRB approval for proposal # 12-042
Institutional Review Board
California University of Pennsylvania
Morgan Hall, Room 310
250 University Avenue
California, PA 15419
instreviewboard@calu.edu
Robert Skwarecki, Ph.D., CCC-SLP,Chair
Dear Erin Podroskey and Ryan Davis:
Please consider this email as official notification that your proposal titled
"The Acute Effects of Kinesiotape on Throwing Accuracy in Overhead
Sport Athletes” & "The Acute Effects of Kinesiotape on Throwing Velocity"
(Proposal #12-042) has been approved by the California University of
Pennsylvania Institutional Review Board as submitted.
The effective date of the approval is 3-1-2013 and the expiration date is 228-2014. These dates must appear on the consent form.
Please note that Federal Policy requires that you notify the IRB promptly
regarding any of the following:
(1) Any additions or changes in procedures you might wish for
your study (additions or changes must be approved by the IRB
before they are implemented)
(2) Any events that affect the safety or well-being of subjects
(3) Any modifications of your study or other responses that are
necessitated by any events reported in (2).
(4) To continue your research beyond the approval expiration date
of 2-28-2014 you must file additional information to be
considered for continuing review. Please contact
instreviewboard@calu.edu
Please notify the Board when data collection is complete.
Regards,
Robert Skwarecki, Ph.D., CCC-SLP
Chair, Institutional Review Board
45
APPENDIX C2
Individual Data Collection Sheet
46
Subject Number______________________
Gender_______________________________
Position______________________ ______
Taping Condition_______________________
Training Session Number__________________________
Throwing
Condition
Accuracy
(CM)
Velocity
(KPH)
Comments:
Notes:
Warm
5
Warm
Throw
Up
Up
1
Complete
Throws
Complete
Throw
2
Throw
3
Throw
4
Throw
5
47
APPENDIX C3
Taping Protocol
48
Figure 1. Pectoralis Major Inhibition Taping
Figure 2. Rhomboid Major Facilitation Taping
49
APPENDIX C4
Spec Sheet for Radar Gun
50
Figure 3. Radar Gun Specifications.
51
REFERENCES
1.
Schoene LM. The Kinesio Taping Method: Here’s a New
Treatment Modality for Podiatry. Sports Podiatry.
2009; 149-156.
2.
Kahanoc L. Kinesio Taping: An Overview of use With
Athletes, Part II. Athl Ther Today. 2007; 12(4): 5-7.
3.
Kahanov L. Kinesio Taping, Part 1: An Overview of Its
Use in Athletes. Athl Ther Today. 2007; 12(3): 17-18.
4.
Bassett KT, Lingman SA, Ellis RF. The Use and
Treatment Efficacy of Kinaesthetic Taping for
Musculoskeletal Conditions; A Systematic Review. NZ J
Physiother. 2010; 28(2): 56-62.
5.
Firth BL, Dingley P, Davies ER, Lewis JS, Alexander
CM. The Effect of Kinesiotape on Function, Pain, and
Motoneural Excitability in Healthy People and People
with Achilles Tendinopathy. Clin J Sport Med. 2010;
20: 416-421.
6.
Aytar A, Ozunlu N, Surenkok O, Baltaci G, Oztop P,
Karatas M. Initial Effects of Kinesio Taping in
Patients with Patellofemoral Pain Syndrome: A
Randomized, Double-Blind Study. Isokinet Exerc Sci.
2011; 19: 135-142.
7.
Huang CY, Hsieh TH, Lu SC, Su FC. Effect of the
Kinesio Tape to Muscle Activity and Vertical Jump
Performance in Healthy Inactive People. Biomedical
Engineering Online. 2011; 10: 1-11.
8.
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.
2008; 11: 198-201.
9.
Lee JH, Yoo WG, Lee KS. Effects of Head-Neck Rotation
and Kinesio taping of the Flexor Muscles on DominantHand Grip Strength. J Phys Ther Sci. 2010; 22: 285298.
52
10.
Vithoulka I, Beneka A, Malliou P, Aggelousis N,
Karatsolis K, Diamantopoulos K. The Effects of
Kinesio-Taping on Quadriceps Strength During
Isokinetic Exercise in Healthy Non Athlete Women.
Isokinet Exerc Sci. 2010; 18: 1-6.
11.
Schneider M, Rhea M, Bay C. The Effect of Kinesio Tex
Tape on Muscular Strength of the Forearm Extensors on
Collegiate Tennis Athletes. [Web Based Study]. 1-9.
12.
Kummel J, Mauz D, Blab F, Vieten M. Effect of Kinesio
Taping on Performance in Counter-Movement Jump.
Biomechanics in Sports. 2011; 29: 605-607.
13.
Baker C, Laiderman B, Paunicka E, Simpson R, Weaver R.
The Effect of tape on Fascial Planes on Muscle
Contraction. [Web Based Study]. 2011; 1-9.
14.
Lee MH, Lee CR, Park JS, et al. Influence of Kinesio
Taping on the Motor Neuron Conduction Velocity. J Phys
Ther Sci. 2011; 23: 313-315.
15.
Slupik A, Dwornik M, Bialoszewski D, Zych E. Effect of
Kinesio Taping on Bioelectrical Activity of Vastus
Medialis Muscle. Preliminary Report. MedSportsPress.
2007; 6(6): 644-651.
16.
Cools AM, Witvrouw EE, Danneels LA, Cambier DC. Does
Taping Influence Electromyographical Muscle Activity
in the Scapular Rotators in Health Shoulders. Manual
Therapy. 2002; 7(3): 154-162.
17.
Chang HY, Chou KY, Lin JJ, Lin CF, Wang CH. Immediate
Effect of Forearm Kinesio Taping on Maximal Grip
Strength and Force Sense in Healthy Collegiate
Athletes. Phys Ther Sport. 2010; 11: 122-127.
18.
O’Sullivan D, Bird SP. Utilization of Kinesio Taping
for Fascia Unloading. Athl Ther Today. 2011; 21: 2127.
19.
Yoshida A, Kahanov L. The Effect of Kinesio Taping on
Lower Trunk Ranges of Motions. Research in Sports
Medicine. 2007; 15: 103-112.
53
20.
Hendrick CR. The Therapeutic Effects of Kinesio Tape
on a Grade I Lateral Ankle Sprain. [Doctoral
Dissertation]. 2010; 1-54.
21.
Bicici S, Karatas N, Baltaci G. Effect of Athletic
Taping and Kinesiotaping on Measurements of Functional
Performance in Basketball Players With Chronic
Inversion Ankle Sprains. Int J Sports Phys Ther. 2012;
7(2): 154-166.
22.
Witkowski KR. Sticking to Rehab: Though Recently
Popular, Elastic Therapeutic Taping Has Long Been Used
to Provide Pain Relief and Injury Protection and
Prevention. [Web Access]. 2012; 8-12.
23.
Kaya E, Zinnuroglu M, Tugeu I. Kinesio Taping Compared
to Physical Therapy Modalities for the Treatment of
Shoulder Impingement Syndrome. Clin Rheumatol. 2011;
30: 201-207.
24.
Kwiatkowska JZ, Labon ER, Skrobot W, Bakula S,
Szamotulska J. Application of Kinesio Taping for
Treatment of Sports Injuries. Research Yearbook. 2007;
13(1): 130-134.
25.
Osterhues DJ. The Use of Kinesio Taping in the
Management of traumatic Patella Dislocation. A Case
Study. Physiother Theory Pract. 2004; 20: 267-270.
26.
Pope ML, Baker A, Grindstaff TL. Kinesio Taping
Technique for Patellar Tendinopathy. Athletic Training
& Sports Health Care: The Journal for the Practicing
Clinician. 2010; 2(3): 98-99.
27.
Bishop BN. Sports Specific: Products and Treatments to
Assist in Pain Relief and Proper Muscle Activation in
Athletes. [Web Acess]. 2011; 12-15.
28.
Hsu YH, Chen WY, Lin HC, Want WT, Shih YF. The Effects
of Taping on Scapular Kinematics and Muscle
Performance in Baseball Players with Shoulder
Impingement Syndrome. J Electromyogr Kinesiol. 2009;
19: 1092-1099.
54
29.
Kalter J, Apeldoorn AT, Ostelo RW, Henschke N, Knol
DL, Van Tulder MW. Taping Patients with Clinical Signs
of Subacromial Impingement Syndrome: the Design of a
Randomized Controlled Trail. Musculoskeletal
Disorders. 2011; 12: 1-8.
30.
Freeston J, Rooney K. Progressive Velocity Throwing
Training Increases Velocity Without Detriment to
Accuracy in Sub-Elite Cricket Players: A Randomized
Controlled Trial. EJSS. 2008; 8(6): 373-378.
31.
Marques M, Saavedra F, Abrantes C, Aidar F.
Associations Between Rate of Force Development Metrics
and Throwing velocity in Elute Team Handball Players:
A Short Research Project. J Human Kinet Special Issue.
2011; 53-57.
55
ABSTRACT
TITLE:
THE ACUTE EFFECTS OF KINESIOTAPE ON THROWING
VELOCITY IN COLLEGIATE BASEBALL ATHLETES
RESEARCHER:
Ryan F. Davis, ATC, PES
ADVISOR:
Thomas F. West, PhD, ATC
PURPOSE:
To determine the acute efficacy of
kinesiotape on throwing velocity.
METHODS:
Sixteen volunteer subjects were asked to
make five successive throws under three
different taping conditions; no tape,
placebo tape (Elaskiton®), and kinesiotape
(Kinesio® Tex Gold™). The velocity for each
throw was measured by a radar gun and
recorded. The highest speed, measured in
kilometers per hour (kph), was deemed
optimal throwing velocity under the specific
condition.
FINDINGS:
The primary purpose of this study was to
examine the effect of kinesiotape on
throwing velocity as it relates to athletic
performance on three levels. The three
variables were a control with no tape, a
placebo tape, and kinesiotape. Sixteen male
subjects volunteered to be a part of this
study. Each informed subject completed a
dynamic warm up protocol at each session
prior to testing. Each subject completed
five trails under each condition; and the
greatest velocity measured under each
variable was deemed optimal throwing
velocity for that condition. There was no
significant effect found (F(2,28) = .64 , p
> .05). No significant difference exists
among no tape (m = 120.88, se = 2.13),
placebo tape (m = 123.01, se = 2.94), and
kinesiotape (m = 122.21, se = 2.23) means.
CONCLUSION:
After reviewing the results of this study it
is concluded that kinesiotape does not have
a significant effect on throwing velocity.
Testing specific claims of this tape still
56
remain in their infancy; however, this leads
to a large opportunity for future evidencebased research to examine not only the
muscular output assertions, but also the
many other therapeutic goals this tape has
been used for.
COLLEGIATE BASEBALL ATHLETES
A THESIS
Submitted to the Faculty of the School of Graduate Studies
and Research
of
California University of Pennsylvania in partial
fulfillment of the requirements for the degree of
Master of Science
by
Ryan F. Davis, ATC, PES
Research Advisor, Dr. Thomas F. West
California, Pennsylvania
2013
ii
iii
ACKNOWLEDGEMENTS
I would like to sincerely thank my family; especially
my father Bob, mother Diane, and brother Andrew for their
continued love and support; without it, this all would not
be possible.
I would also like to thank my thesis chair: Dr. Thomas
F. West, as well as the rest of my thesis committee: Mr.
Jason Edsall, and Dr. Ellen West for their time and
commitment in helping me achieve this accomplishment. I
would also like to thank Ms. Erin Podroskey for her
assistance and cooperation between our studies.
iv
TABLE OF CONTENTS
Page
SIGNATURE PAGE
. . . . . . . . . . . . . . . ii
AKNOWLEDGEMENTS . . . . . . . . . . . . . . . iii
TABLE OF CONTENTS
LIST OF TABLES
. . . . . . . . . . . . . . . vii
LIST OF FIGURES .
INTRODUCTION
METHODS
. . . . . . . . . . . . . . iv
. . . . . . . . . . . . . . vii
. . . . . . . . . . . . . . . . 1
. . . . . . . . . . . . . . . . . . 4
Research Design
Subjects
. . . . . . . . . . . . . . 4
. . . . . . . . . . . . . . . . . 4
Preliminary Research. . . . . . . . . . . . . 6
Instruments . . . . . . . . . . . . . . . . 7
Procedures
. . . . . . . . . . . . . . . . 7
Hypothesis
. . . . . . . . . . . . . . . . 7
Data Analysis
RESULTS
. . . . . . . . . . . . . . . 9
. . . . . . . . . . . . . . . . . . 10
Demographic Data . . . . . . . . . . . . . . 10
Hypothesis Testing
. . . . . . . . . . . . . 11
Additional Findings . . . . . . . . . . . . . 12
DISCUSSION . . . . . . . . . . . . . . . . . 14
Discussion of Results . . . . . . . . . . . . 14
Conclusions . . . . . . . . . . . . . . . . 17
Recommendations. . . . . . . . . . . . . . . 18
v
REFERENCES . . . . . . . . . . . . . . . . . 19
APPENDICES . . . . . . . . . . . . . . . . . 22
APPENDIX A: Review of Literature
APPENDIX B: The Problem .
. . . . . . . . 23
. . . . . . . . . . 38
Statement of the Problem . . . . . . . . . . . 39
Definition of Terms . . . . . . . . . . . . . 39
Basic Assumptions . . . . . . . . . . . . . . 40
Limitations of the Study . . . . . . . . . . . 40
Delimitations of the Study .
Significance of the Study
. . . . . . . . . 41
. . . . . . . . . . 41
APPENDIX C: Additional Methods .
. . . . . . . . 42
IRB Approval California University of PA(C1). 43
Individual Data Collection Sheet (C2) . . . . . . 45
Taping Protocol (C3) . . . . . . . . . . . .
47
Spec Sheet for Radar Gun (C4) . . . . . . . . . 49
REFERENCES . . . . . . . . . . . . . . . . . 51
ABSTRACT
. . . . . . . . . . . . . . . . . 55
vi
LIST OF TABLES
Table
Title
Page
1
A Repeated Measures ANOVA Examining the Acute Effect
of Kinesiotape on Throwing Velocity . . . . . 12
2
A Mixed-Design ANOVA Examining the Acute Effect of
Kinesiotape on Throwing Velocity by Position . . 13
vii
LIST OF FIGURES
Figure
Title
Page
1
Pectoralis Major Inhibition Taping . . . . 52
2
Rhomboid Major Facilitation Taping . . . . 52
3
Radar Gun Specifications . . . . . . . . 54
1
INTRODUCTION
Kinesiotape is among the most popular and fastest
growing modalities in the sports medicine realm.
Kinesiotape is an elastic cotton tape with heat activated,
acrylic based adhesive. It is latex free and has been
reported to stretch 40%-60% of its resting length.1
The
prevalence and utilization of kinesiotape has seen a
significant spike and evidence based research has also
followed suit, and has began examining practical
applications as well as the validity and clinical
effectiveness.
Numerous researchers have observed kinesiotape’s use
in the treatment of myofascial pain, lymphatic drainage,
range of motion increases, and proprioception.1-17 For
instance, in a study by Kalter et al,17 kinesiotape was
found to be an effective means of improving outcomes
associated with pain relief and functional improvement
associated with SAIS (subacromial impingement syndrome).
Though there have been published articles regarding the
effectiveness of kinesiotape for SAIS, inadequate
examination of methods has been recognized.
2
The effectiveness of kinesiotape on muscular strength
at various anatomical structures has been investigated in
clinical research,19-24 but few have looked specifically at
the shoulder and specifically the overhand throw. In the
athletic realm, baseball is a sport which can benefit from
improvement to muscular strength increasing throwing
velocity. The increase in throwing velocity can be useful
not only to the pitching positions, but others as well
since timing of throws is a large part of the sport.
Examining muscular strength/velocity of the glenohumeral
joint, which is inherently dynamic and commonly injured,
can have practical clinical outcomes.
The shortcomings in literature have shown the need for
research relating to muscular strength and throwing
velocity and if kinesiotape may impact these performance
measures. Previous research has demonstrated a potential
effect. As research by Aktas and Baltaci demonstrated,
kinesiotape had a positive effect on knee muscular strength
at 180°/s PT values by isokinetic measures.25 In light of
this encouraging research seen within the lower extremity,
there is a need for upper extremity testing which could
potentially report similar positive outcomes.
Research examining the effect of kinesiotape on
athletic performance would be useful in guiding the
3
athletic trainer as treatment decisions are made.
Therefore, the purpose of this study is to examine the
effects of kinesiotape on throwing velocity of NCAA
Division II collegiate baseball and softball players.
4
METHODS
The primary purpose of this study was to examine the
effect of kinesiotape on throwing velocity as it relates to
athletic performance. This section will include the
following subsections:
research design, subjects,
instruments, procedures, hypotheses, and data analysis.
Research Design
This research utilized a quasi-experimental, within
subjects, repeated measures design.
variable was taping condition.
The independent
This condition had three
levels; no intervention (control), placebo tape, and
kinesiotape. The dependent variable was throwing velocity
as measured by the radar gun.
Subjects
The subjects used for this study were approximately 30
volunteer male and female student athletes from California
University of Pennsylvania, with a minimum requirement of
15 volunteers needed. Varsity level athletes will be
5
preferred and subject height, weight, age, position in
sport, and throwing arm dominance will also be recorded.
All subjects will have been screened for disability or
dysfunction as it relates to performing this study.
Subjects were excluded if they were under the age of 18,
not medically cleared to participate in their sport or had
a condition that could affect their performance in this
study.
Each subject will be required to participate in one
45-minute testing session. All subjects in the study will
sign an Informed Consent Form (Appendix C2) prior to
participation in the study. The subjects will also attend
an information meeting detailing the purpose, procedure,
and risks involved in volunteering. After subjects have
been obtained, a practice session will be held for the
volunteers to become familiar with the research set up and
data collection measures. The subjects will have the option
to opt out of the study at any time. The study was approved
by the Institutional Review Board at California University
of Pennsylvania (approval #12-042) prior to any data
collection.
Each participant’s identity will remain
confidential and will not be included in the study.
6
Preliminary Research
There will be a preliminary study conducted with this
research project.
protocol.
Up to 3 subjects will used to review the
The subject will perform the warm up procedure
as described in the procedure section. They will also get
10 warm up throws just as the participants would be
allotted. To keep in accordance with the procedure of the
research, the preliminary researchers will also have just
finished 5 submaximal accuracy throws for another study.
They will then be asked to complete 5 successive
throws from a distance of 60 ft 6 in (18.44m), with a 1minute rest period between throws. The preliminary
researchers will throw with 3 different interventions just
as the subjects will be asked to. They will perform five 5
throws with a randomized intervention order. They will also
throw at a designated target and their velocities will be
recorded. The researcher will be looking for the subject’s
ability to understand directions, the amount of time used
to complete the tasks and if the warm-up protocol before
service testing is accurate.
Data will be collected on the
data collection sheet (Appendix C3).
7
Instruments
Instruments used within the study will include a speed
radar gun (Model #1235982), a tape measure to determine the
appropriate distance of 60 ft 6 in (18.44m), a netting
which the subjects will throw into, official NCAA standard
size collegiate baseballs and softballs, and specific
taping techniques for muscular strength. These techniques
will include a pectoralis major inhibition taping (Figure
1) incorporation with a rhomboid major facilitation taping
(Figure 2) procedure.
Procedures
The researcher applied and obtained approval from the
IRB at California University of Pennsylvania before any
research was conducted. Subjects completed an informed
consent in their first meeting with the research.
The testing protocol will follow the example as set
forth by Carter, Kaminski, Douex Jr, Knight, and Richards.26
Subjects were instructed to complete a warm-up of 10-15
minutes, focusing on baseball specific stretching of the
shoulder musculature as well as a cardiovascular component.
This took place before the subjects participated in a
8
similar study involving kinesiotape and its effects on
throwing accuracy. The subjects were only asked to partake
in the warm up protocol once, therefore they were not asked
to fulfill this procedure a second time in any given
session. Optimal throwing velocity was assessed over a
distance of 60 ft 6 in (18.44m), the distance from the
center of the pitcher’s mound to home plate in a standard
intercollegiate baseball field using official NCAA standard
size collegiate baseballs and softballs. Subjects threw in
a temperature controlled enclosed room to rule out and
effects from the elements. Subjects threw from flat ground
to a designated target with a catching net as a background.
Participants were allowed to perform 5 warm up throws, for
verification purposes, the radar gun also recorded each
warm up throw to ensure the functionality of the equipment.
Each subject was given 5 throws with a 1-minute rest period
established between throws. Any throws out of the range of
the target or radar gun where discarded. The highest speed,
measured in kilometers per hour (kph) was deemed as maximal
throwing velocity and utilized as the test statistic.
Taping intervention application was applied using a
counter balance order. Each taping intervention was
assigned a number, 1-no taping procedure applied, this will
also be known as the control in the study; 2-placebo tape,
9
and 3-kinesiotape. This was necessary in order to prevent
any biasing factor from occurring. In addition, all of the
tapings were applied by the same researcher to prevent any
crossover effect.
Hypothesis
The following hypothesis was constructed on previous
research and the researcher’s intuition based on a review
of the literature.
1. Kinesiotape will have no significant difference on
throwing velocity as compared to the control, and
placebo taping groups.
Data Analysis
All data will be analyzed utilizing SPSS version 18.0
for Windows at an alpha level of 0.05.
The research
hypothesis will be analyzed using repeated measures ANOVA.
10
RESULTS
The primary purpose of this study was to examine the
effect of kinesiotape on throwing velocity as it relates to
athletic performance on three levels. The three variables
were a control with no tape, a placebo tape (Elasikon®),
and kinesiotape (Kinesio® Tex Gold™. Sixteen male subjects
volunteered to be a part of this study. Each informed
subject completed a dynamic warm up protocol at each
session prior to testing. Each subject completed five
trails under each condition; and the greatest velocity
measured under each variable was deemed optimal throwing
velocity for that condition. This section will include the
following subsections:
Demographic Information, Hypothesis
Testing, and Additional Findings.
Demographic Information
Subjects used in this study (N=16) were volunteers
from California University of Pennsylvania’s varsity
baseball team. The subject’s were all at least 18 years old
at the time of testing. All subjects were screened for
disability or dysfunction as it relates to performing this
11
study. The playing positions of the subjects were mixed
with three pitchers, and 13 classified as fielders
(infield, outfield, and catcher).
Hypothesis Testing
The following hypothesis was tested in this study. An
α<.05 was used for statistical testing.
1. Kinesiotape will have no significant difference on
throwing velocity as compared to the control, and
placebo taping groups.
Conclusion: To test the hypothesis, each subject’s
greatest velocity (best performance) was recorded for each
of the three taping conditions. These include the no tape
(control), the placebo tape, and the kinesiotape. A
repeated measures ANOVA was calculated to compare the
velocities for the subjects under each condition. Table 1
illustrates the mean velocities for each condition.
A one-way repeated measures ANOVA was calculated
comparing the velocities of subjects under three different
taping conditions: no tape, placebo tape, and kinesiotape.
No significant effect of taping condition was found
12
(F(2,28) = .64 , p > .05). No significant difference exists
among no tape (m = 120.8kph, se = 2.13), placebo tape (m =
123.0kph, se = 2.94), and kinesiotape (m = 122.2kph, se =
2.23) means.
Table 1. A Repeated Measures ANOVA Examining The Acute
Effect of Kinesiotape on Throwing Velocity
Taping
Mean
Std.
95% Confidence Interval
Condition
(kph)
Error
Lower
Upper
Bound
Bound
No Tape
120.8
2.1
116.3
125.4
Placebo
Tape
123.0
2.9
116.7
129.3
Kinesiotape
122.2
2.2
117.4
126.9
Additional Findings
An examination of the effect of playing position and
tape condition on throwing velocity was also conducted. The
positions were broken up into 2 categories: pitchers
(position 1) and fielders (position 2). A repeated measures
ANOVA was used to compare the velocities for the subjects
under each condition. Table 2 illustrates the mean
velocities for each condition. A 2 X 3 mixed design ANOVA
was calculated to examine the effects of position
13
(Positions 1 and 2) and taping condition (no tape, placebo
tape (Elastikon), and kinesiotape) on throwing velocity. No
significant main effects or interactions were found. The
tape x position interaction (F(2,28) = .97, p >.05), the
main effect for taping condition (F(2,28) = .64, P >.05),
and the main effect for position (F(1,14) = .48, p > .05)
were all not significant. Throwing velocity was not
influenced by either taping condition or position at the p
= .05.
Table 2. A Mixed-Design ANOVA Examining The Acute Effect of
Kinesiotape on Throwing Velocity by Position
Position
Taping
Mean
95% Confidence Interval
Condition
(kph)
Std.
Lower
Upper
Error
Bound
Bound
1*
NT*
121.7
3.8
113.5
130.0
PT*
126.0
5.3
114.6
137.4
KT*
122.8
4.0
114.2
131.4
2*
NT*
119.9
1.8
116.0
123.9
PT*
119.9
2.5
114.4
125.4
KT*
121.5
1.9
117.4
125.7
*1 (Pitchers), *2 (Fielders), NT* (No Tape), PT* (Placebo
Tape), KT* (Kinesiotape)
14
DISCUSSION
Discussion of Results
The primary purpose of this study was to examine the
effect of kinesiotape on throwing velocity as it relates to
athletic performance on three levels. The three variables
were a control with no tape, a placebo tape, and
kinesiotape. Each volunteer subject completed a dynamic
warm up protocol at each session prior to testing. Each
subject completed five trials under each condition; and the
greatest velocity measured under each variable was deemed
optimal throwing velocity for that condition. When
examining the effects of kinesiotape on throwing velocity,
no significant differences were observed within subjects
under three different taping conditions. This is supported
by studies that concurrently examined kinesiotape and its
effect on muscular output and velocity.
A study by Fu, Wong, Pei, et al21 assessed kinesiotape
in a similar measure by examining muscular strength. The
researchers also perceived the subjects under three
different taping conditions: no tape, immediately after
taping, and twelve hours after taping. They found that
15
there were no significant differences observed in muscle
power among the three conditions by evaluation of
concentric quadriceps contractions at 60°/s; eccentric
quadriceps contractions at 60°/s; concentric quadriceps
contractions at 180°/s and eccentric quadriceps
contractions at 180°/s; with testing protocol repeated to
test the hamstrings muscle strength. The study inspected a
similar measure of muscular production, and found no
notable changes within the subjects due to the taping
condition. A concurrent study by
Vithoulka et al,23 assessed kinesiotape efficacy on
quadriceps strength at maximum concentric and eccentric
isokinetic exercise mode in healthy, non-athlete woman. The
researcher tested subjects analogous to the protocol used
in this thesis. Under three different taping conditions: no
tape, placebo tape, and kinesiotape; there was found to be
no significant differences in max concentric torque within
subjects.
A similar study examining kinesiotape’s effect on
muscle contractility was conducted under a similar threecondition design. No tape, Elastikon tape, and kinesiotape
we used to scrutinize grip strength in male subjects. The
researchers also found no significant in strength between
the control and kinesiotape groups.27
16
The results of these studies are important to consider
for athletic trainers’ in future use of the kinesiotape on
our patients or athletes because there is not substantial
evidence-based research to propagate an established
practice of kinesiotape and its techniques.
The goal of this study was to examine the effects of
kinesiotape on throwing velocity. Through successful
testing and statistical analysis, no significant difference
was noted between the three taping conditions. This new
knowledge is meaningful because evidence-based research is
lacking in the dynamic field of kinesiotape. However, more
and more studies are being conducted which examine the
various proposed uses this tape claim to be effective for.
It would be advantageous for future research to examine not
only the effect of kinesiotape on muscular strength as
demonstrated in this thesis, but also for the other
qualities which the tape advertises such as edema
reduction, proprioception, joint stability, and lympodemic
potentials. Forthcoming studies should also adhere to a
randomized, double-blind, controlled study; to maintain the
highest level of quality and the most accurate results for
the prospective of this tape.
17
Conclusions
In conclusion, there is little evidence to support
that the use of kinesiotape increases throwing velocity.
The findings indicate that there are no significant
differences in throwing velocity between any of the three
taping conditions, as well as no significant differences in
throwing velocity for the taping conditions by position.
The kinesiotape conditions threw slower than the placebo
tape condition, but faster than the no tape condition. The
no tape circumstance, overall, threw slower than both the
placebo tape and kinesiotape. Performance tests within
subjects on a larger scale in future studies could provide
more evidence in this area of interest.
Impacts on clinical practice would be significant if
future research continues to examine all of the stated
claims for kinesiotape. If studies are able to relate an
evidence-base supporting the use of kinesiotape within
rehabilitation practice, more clinicians, and patients,
would benefit greatly from its efficacy. As it relates to
throwing velocity, athletic trainers’ and other
professionals would find this information useful. This
study alone cannot support or deny claims of increased
18
muscular output. However, future studies have the ability
to solidify this tapes effectiveness.
Recommendations
Current literature is still in its infancy as it
relates to kinesiotape. There are very little studies that
examine kinesiotape within an athletic realm. Some studies
inspect how kinesiotape would affect specific muscles
during a unilateral activity under low to moderate
intensity. However, in athletics there are multiple muscles
working at high rate of movement. This is an opportunity
for future studies to examine the multiplanar movements and
how kinesiotape may affect athletes or physically active
people under these specific conditions.
If another study was conducted, a double-blind study
type with more subjects would be preferred. It would also
be advantageous to observe kinesiotapes effects within a
softball populace due to the difference in throwing
mechanics. A future study could also examine this study
with a different taping procedure applied. Activating
different muscle groups compared to this study could yield
different results.
19
REFERENCES
1.
Schoene LM. The Kinesio Taping Method: Here’s a New
Treatment Modality for Podiatry. Sports Podiatry.
2009; 149-156.
2.
O’Sullivan D, Bird SP. Utilization of Kinesio Taping
for Fascia Unloading. Athl Ther Today. 2011; 21: 2127.
3.
Yoshida A, Kahanov L. The Effect of Kinesio Taping on
Lower Trunk Ranges of Motions. Research in Sports
Medicine. 2007; 15: 103-112.
4.
Kahanov L. Kinesio Taping, Part 1: An Overview of Its
Use in Athletes. Athl Ther Today. 2007; 12(3): 17-18.
5.
Bassett KT, Lingman SA, Ellis RF. The Use and
Treatment Efficacy of Kinaesthetic Taping for
Musculoskeletal Conditions; A Systematic Review. NZ J
Physiother. 2010; 28(2): 56-62.
6.
Hendrick CR. The Therapeutic Effects of Kinesio Tape
on a Grade I Lateral Ankle Sprain. [Doctoral
Dissertation]. 2010; 1-54.
7.
Bicici S, Karatas N, Baltaci G. Effect of Athletic
Taping and Kinesiotaping on Measurements of Functional
Performance in Basketball Players With Chronic
Inversion Ankle Sprains. Int J Sports Phys Ther. 2012;
7(2): 154-166.
8.
Witkowski KR. Sticking to Rehab: Though Recently
Popular, Elastic Therapeutic Taping Has Long Been Used
to Provide Pain Relief and Injury Protection and
Prevention. [Web Access]. 2012; 8-12.
9.
Kaya E, Zinnuroglu M, Tugeu I. Kinesio Taping Compared
to Physical Therapy Modalities for the Treatment of
Shoulder Impingement Syndrome. Clin Rheumatol. 2011;
30: 201-207.
20
10.
Aytar A, Ozunlu N, Surenkok O, Baltaci G, Oztop P,
Karatas M. Initial Effects of Kinesio Taping in
Patients with Patellofemoral Pain Syndrome: A
Randomized, Double-Blind Study. Isokinet Exerc Sci.
2011; 19: 135-142.
11.
Kwiatkowska JZ, Labon ER, Skrobot W, Bakula S,
Szamotulska J. Application of Kinesio Taping for
Treatment of Sports Injuries. Research Yearbook. 2007;
13(1): 130-134.
12.
Osterhues DJ. The Use of Kinesio Taping in the
Management of traumatic Patella Dislocation. A Case
Study. Physiother Theory Pract. 2004; 20: 267-270.
13.
Kahanoc L. Kinesio Taping: An Overview of use With
Athletes, Part II. Athl Ther Today. 2007; 12(4): 5-7.
14.
Pope ML, Baker A, Grindstaff TL. Kinesio Taping
Technique for Patellar Tendinopathy. Athletic Training
& Sports Health Care: The Journal for the Practicing
Clinician. 2010; 2(3): 98-99.
15.
Bishop BN. Sports Specific: Products and Treatments to
Assist in Pain Relief and Proper Muscle Activation in
Athletes. [Web Acess]. 2011; 12-15.
16.
Kalter J, Apeldoorn AT, Ostelo RW, Henschke N, Knol
DL, Van Tulder MW. Taping Patients with Clinical Signs
of Subacromial Impingement Syndrome: the Design of a
Randomized Controlled Trail. Musculoskeletal
Disorders. 2011; 12: 1-8.
17.
An H, Miller C, McElveen M, Lynch J. The Effect of
Kinesio Tape on Lower Extremity Functional Movement
Screen Scores. Int J Exerc Sci. 2012; 5(3): 196-204.
18.
Firth BL, Dingley P, Davies ER, Lewis JS, Alexander
CM. The Effect of Kinesiotape on Function, Pain, and
Motoneural Excitability in Healthy People and People
with Achilles Tendinopathy. Clin J Sport Med. 2010;
20: 416-421.
19.
Huang CY, Hsieh TH, Lu SC, Su FC. Effect of the
Kinesio Tape to Muscle Activity and Vertical Jump
Performance in Healthy Inactive People. Biomedical
Engineering Online. 2011; 10: 1-11.
21
20.
Hsu YH, Chen WY, Lin HC, Want WT, Shih YF. The Effects
of Taping on Scapular Kinematics and Muscle
Performance in Baseball Players with Shoulder
Impingement Syndrome. J Electromyogr Kinesiol. 2009;
19: 1092-1099.
21.
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.
2008; 11: 198-201.
22.
Lee JH, Yoo WG, Lee KS. Effects of Head-Neck Rotation
and Kinesio taping of the Flexor Muscles on DominantHand Grip Strength. J Phys Ther Sci. 2010; 22: 285298.
23.
Vithoulka I, Beneka A, Malliou P, Aggelousis N,
Karatsolis K, Diamantopoulos K. The Effects of
Kinesio-Taping on Quadriceps Strength During
Isokinetic Exercise in Healthy Non Athlete Women.
Isokinet Exerc Sci. 2010; 18: 1-6.
24.
Schneider M, Rhea M, Bay C. The Effect of Kinesio Tex
Tape on Muscular Strength of the Forearm Extensors on
Collegiate Tennis Athletes. [Web Based Study]. 1-9.
25.
Aktas G, Baltaci G. Does Kinesiotape Increase Knee
Muscles Strength and Functional Performance? Isokinet
Exerc Sci. 2011; 19: 149-155.
26.
Carter A, Kaminski T, Douex A, Knight C, Richards J.
Effects of High Volume Upper Extremity Plyometric
Training on Throwing Velocity and Functional Strength
ratios of the Shoulder Rotators in Collegiate baseball
Players. J Strength Cond Res. 2007; 20(1): 208-215.
27.
Baker C, Laiderman B, Paunicka E, Simpson R, Weaver R.
The Effect of tape on Fascial Planes on Muscle
Contraction. [Web Based Study]. 2011; 1-9.
22
APPENDICES
23
APPENDIX A
Review of Literature
24
REVIEW OF LITERATURE
Kinesiotape has been the subject of a lot controversy
within the medical field in recent years. Its popularity
has increased with the explosion of its prevalence of usage
within the sports medicine and physical therapy fields. The
proposed study will examine how kinesiotape will affect the
velocity of a throw or overhead movement in athletes
involved in such sports. Though research examining the
effectiveness of kinesiotape is in its infancy in terms of
publication, there still is a need to observe whether this
new technology is clinically useful in the athletic
training realm.
The purpose of this review is to examine published
literature evaluating the relationship between kinesiotape
and throwing velocity. The information obtained within this
study can aid clinicians in their practical decision
making; in regards to using this tool within their
practice. This will be accomplished using the following
sections: kinesiotape basics, defining muscular strength,
biomechanics of the throwing motion, effects of kinesiotape
on muscular strength, and effects of kinesiotape on
25
proprioception, endurance, and swelling or lymphatic
drainage.
Kinesiotape Basics
The researcher in this article examined the original
research of Dr. Kenzo Kase, known as the original pioneer
of kinesiotape. The investigator detailed the various
techniques outlined and also explained, in detail, the
purposes for applying this type of tape. She also theorized
the potential uses of this modality within the field of
podiatry.1
In a study by Kahanoc, a more in depth examination was
performed examining the use of kinesiotape with athletes.
The researcher concluded that kinesiotape is considered a
safe technique with limited associated side effects to
athletes. However, using this technique takes significant
practice and certification with kinesiotape in order to be
performed for optimal outcome for patients.2
In a concurrent systematic review by Kahanov, the
study examined the use of kinesiotape within the athletic
realm. The researcher detailed the proposed effects that
this method can have upon athletes who are competing at
multiple levels and its effectiveness within a
26
rehabilitation program. The examiner concludes that
kinesiotape can be very effective in athletes and sports
medicine although further research is warranted.3
Effects on Muscular Strength on Velocity
The examination of muscular strength in relation to
kinesiotape intervention has begun to increase in frequency
in peer reviewed journals. With this rise in popularity and
evidence based effects of the tape, researchers should now
begin to focus their energies to determining if kinesiotape
is as effective in terms of velocity as it is with others.
Using specific techniques, the utilization of this method
could potentially have a great effect on a vast population.
A systematic review was performed, using a critique of
all randomized controlled trials within the EBSCO Database,
where kinesiotape and its effects were put under scrutiny.
Out of the three published studies that met the inclusion
criteria, two of them exhibited a high methodological
quality status with the other one receiving a score of
“limited” using the 11-item PEDro scale. According to the
research none of the literature showed clinical
significance (p<0.05) in relation to the use of
kinesiotaping.4
27
In an article by Firth, Davies, Lewis, and Alexander6,
the researcher examined kinesiotaping’s effect on hop
distance, pain, and motoneural excitability in both a
healthy population and a population with achilles
tendinopathy. Twenty-six healthy and twenty-nine subjects
with achilles tendinopathy were used for this withinsubject study. Results found no changes in hop distance
when tape was applied and no changes in reported pain. The
Hoffman (H) reflex amplitude of the lateral soleus and
middle gastrocnemius increased in healthy people after the
tape was removed, as collected using electromyographical
activity measurements by utilization of surface electrodes.
There was no change in activity in subjects with Achilles
tendinopathy.5
In another report6, the authors detailed the initial
effects of kinesiotape on strength, joint position sense
and balance in patients with patellofemoral pain syndrome.
Using a randomized double-blind study methodology, twentytwo subjects were separated into two groups: kinesiotape,
and placebo kinesiotape. Forty-five minutes after
application, positive significant differences were noted in
muscle strength, joint position sense, static and dynamic
balance, and pain intensity showing statistical increase in
the kinesiotape groups.6
28
An additional report7 attempted to determine the
effectiveness of kinesiotape in relation to muscle activity
and vertical jump height performance. This study utilized
thirty-one healthy adults which were divided into four
groups: two elastic tapes, kinesiotape, and an MPlacebo (3M
Micropore) tape. Results showed kinesiotape increased
ground reaction forces, and EMG activity in the medial
gastrocnemius. Height of jump, however, remained constant
for all the groups18. This shows positive results in favor
of kinesiotapes effect on muscular strength.
Fu, Wong, Pei, et al8 examined the effects of
kinesiotape on muscular strength in athletes. This pilot
study divided subjects into three conditions: no taping,
immediately after taping, and twelve hours after taping.
Results showed no significant difference in muscle power
among the three conditions by evaluation of concentric
quadriceps contractions at 60°/s; eccentric quadriceps
contractions at 60°/s; concentric quadriceps contractions
at 180°/s and eccentric quadriceps contractions at 180°/s;
with testing protocol repeated to test the hamstrings
muscle strength.
Additionally researchers9 examined the effect of
kinesiotape on head-neck rotation and flexor muscle group
dominant hand grip strength. Forty subjects (20 men,
29
20women) were tested and the results found that grip
strength increased in the dominant hand after application
of kinesiotape when compared to that of the no tape
condition.
In a study by Vithoulka et al, the effect of
kinesiotape on quadriceps strength at maximum concentric
and eccentric isokinetic exercise mode in healthy nonathlete woman, using three different taping groups: no
tape, placebo tape, kinesiotape; results showed that there
were no significant differences in max concentric torque
between the three groups, but there was a significant
difference in max eccentric torque during the concentric
and eccentric modes of the quadriceps muscle group with the
kinesiotape.10
Further research was conducted observing the
kinesiotape in healthy colligate tennis athletes could
decrease fatigue by maintaining strength in the forearm
extensor group. Using fourteen Division I tennis athletes,
results showed that grip strength was increased in the
kinesiotape group as compared to the control group.11
An additional report examined the influence of taping
with a flexible tape (kinesiotape) on performance and its
effect on the impulse in a stretch-shortening cycle
movement. Twenty-three subjects were broken up into
30
kinesiotape and no tape groups. The results showed no
significant difference in the jumping performance of the
intervention group as compared to the control group.12
Yet another study was launched to view the effects of
kinesiotaping on muscle contractility when compared to no
tape and Elastikon taping applications on grip strength.
Results showed significant differences between the
Elastikon and kinesiotape groups in male subjects in that
the Elastikon actually decreased performance. There was no
reported significant difference in strength between the
control and kinesiotape groups.13
The purpose of the following study was to investigate
if kinesiotaping has an influence on the motor nerve
conduction velocity. Seventeen healthy subjects were tested
for this study. Results showed no significant differences
between the kinesiotape and control groups with respect to
latency, amplitude, and motor nerve conduction.14
Another study was conducted in order to test
kinesiotape on bioelectrical activity of the vastus
medialis muscle in the quadriceps muscle group. Twentyseven healthy persons were tested and twenty-four hours
after kinesiotaping revealed significantly increased
recruitment of muscle’s motor units (peak torque). After
31
seventy-two hours after taping there was significantly
increased bioelectric activity.15
The researchers16 in this study examined how taping
influenced electromyographic activity in the scapular
rotators in healthy shoulders. The movement, direction, and
tape were all randomized. Results showed no significant
difference between the taping groups as it relates to
scapular muscle activity.
Looking at the immediate effects of applied
kinesiotaping to the forearm in maximal grip strength and
force sense of healthy colligate athletes, twenty-one
healthy athletes were used as subjects. Results showed no
significant differences in maximal strength of grip between
the three conditions: kinesiotape, placebo tape, no tape.17
In summary, the effect of kinesiotape on muscular
strength is becoming more prevalent in current research.
With the results showing the positive correlation between
specific taping methods and other benefits of the tape,
this aspect of the interventions potential must be
explored. It would not only be clinically relevant, it
would also open the doors to further research on possible
other tapings or prophylactic methods for performance
enhancement.
32
Effects on Proprioception, Endurance, Swelling
When examining effects of kinesiotape on proprioception,
endurance, and swelling; the researchers of the following
article studied the effect of fascia unload when
kinesiotape was applied. The examiners performed a
systematic review of kinesiotape and its effects on
muscular events related to fascia injury. Through their
research they found that this technique helps lower pain
levels and increases range of motion, however there is
inconclusive research related to its muscle power effect
through fascia unloading.18
Additionally, examiners conducted research on
kinesiotape and its effect on lower trunk ranges of motion.
They studied thirty healthy individuals with no history of
lower trunk or back issues and performed range of motion
measurements pre-taping and post-taping. They concluded
that trunk flexion was significantly improved as compared
to the non tape group, with lateral flexion or extension
showing now noteworthy improvement.19
More research was performed looking at the therapeutic
effects of kinesiotape on Grade I lateral ankle sprains.
Using twenty-five high school aged students who suffered
grade I lateral ankle sprains. Using a control group who
33
used ASO tape, results found no significant difference
between the two groups for pain or when performing single
leg hop for distance, box drills or the Illinois test. Yet,
the ASO group showed they could perform more squats than
the kinesiotape group at four and eight weeks.20
This study looked at the effects of different types of
taping on functional performance in athletes with chronic
inversion sprains of the ankle. Using a crossover study
design method, fifteen athletes were used and split into
kinesiotape; athletic tape, placebo, and no tape. There
were no significant differences among the groups for SEBT.
Kinesiotape and athletic tape yielded faster performance
times in single limb hurdle as compared to the other
groups. However, there was lower performance in the heel
raise and vertical jump tests from the groups who had the
tape.21
When examining shoulder pain, multiple techniques were
used that including kinesiotape. The researcher also
examined the clinical application and outcomes. Using
supporting evidential research, she concluded that it could
be a viable treatment adjunct.22
In an additional study looking to determine and
compare the efficacy of kinesiotape and physical therapy
modalities in patients with shoulder impingement. Using a
34
DASH (Disability of the Arm, Shoulder, and Hand) as a
subjective measurement, along with a visual analog scale,
scores significantly decreased in both treatment groups as
compared to baseline levels. The kinesiotape group scores
significantly decreased with night, rest, and movement10.
Supplementary research examined the effect of kinesiotape
on calf injury prevention in triathletes during
competition.23
This pilot study observed the subjective perception of
local pain after competition. It was observed that none of
the athletes suffered contractures or cramps in the calves
and pain was no more than a 2 on the CR10 scale in subjects
with kinesiotape12. Further examinations looked to determine
how kinesiotape can be effective in the field of athletics
and sports medicine. Using clinical observations, the
researcher found that after kinesiotape application,
injured athletes had decreased pain levels, as well as
decreased visible edema, as well as no visible allergic
reactions.24
In a case report examining the use of kinesiotaping in
the management of traumatic patella dislocations, the
researcher found that the use of kinesiotape could be
beneficial to decrease pain, and enhanced quadriceps
35
activity and weight bearing stability during functional
activities.25
Another study observed how kinesiotaping affected
patients with patellar tendinopathy. Using a U-strip
technique the researcher determined that the use of the
tape could be beneficial due to the fact that the final
position of the tape does not restrict range of motion.26
In this additional article describing how kinesiotape
can be used to aid in pain relief and also allow proper
muscle activation in an athletic population, the
researchers found that its biggest aid was in the ability
of the tape to act as a constant treatment that the athlete
can wear between treatments and still receiving an
advantage.27
Additional research examined the effect of elastic
taping on kinematics, muscle activity, and strength of the
scapular region in baseball players with shoulder
impingement. Seventeen baseball players were tested.
All
subjects received kinesiotape and the placebo tape. Results
showed that kinesiotaping significantly increase scapular
posterior tilt at 30° and 60° during arm raising and
increased the lower trapezius muscle activity in the arm
lowering phase in comparison to the placebo tape.28
36
Supplementary research examined the signs of
subacromial impingement syndrome and the effect of taping
these patients. Using a randomized controlled study
methodology, One hundred and forty patients were assessed
as subjects. The results indicated that taping patients
with this condition improved outcomes on pain relief and
functional improvement.29
Throwing Velocity
There are multiple ways in which throwing velocity can
be assessed. Freeston and Rooney30 detailed a method which
involved the incorporation of a radar gun measuring
velocity as a percentage of the individual’s maximal
throwing velocity, rather than expressing the number of
throws at a set distance or percentage of perceived maximal
exertion.
Marques et al determined throwing velocity by the use
of a Doppler radar gun which was located behind a target
with intraclass correlation coefficient for throwing
velocity at 0.95 (95% confidence interval: 0.91-0.96) and
coefficient of variation of 3.5%.31
37
For the purposes of this study we will examine
throwing velocity as detailed by Carter et al as detailed
in the methods section.
In summary, current evidence based research relating
to kinesiotape’s wide range of use is lacking. While other
aspects such as edema control, lymphatic drainage, and pain
have become more relevant; studies involving muscular
strength are still in their infancy. It is imperative that
testing procedures are performed on any and all
characteristics of this modality. The evidence based
outcomes of a study such as this could help add another
tool which practicing clinicians may be able to employ
within an ever dynamic field.
38
APPENDIX B
The Problem
39
STATEMENT OF THE PROBLEM
The purpose of the study is to examine the effect of
kinesiotape on throwing velocity.
It is important to
examine this intervention because kinesiotape has become
very popular within the medical community but there is
still little current research in regards to its effect on
throwing velocity or muscular strength.
We already are
aware of the positive effects of this tape on lymphatic
drainage, edema control, and myofascial symptoms; yet, if
it is possible to definitively state whether kinesiotape
will increase this variant of muscular strength, we can
possibly relate it to other joints within the body and the
specific demands of a therapeutic rehabilitation program. I
also believe that this study could clarify exactly what the
kinesiotape’s role in relation to the human anatomy and the
effects on any power production systems within the body.
Definition of Terms
The following definitions of terms will be defined for
this study:
1)
Kinesiotape – a special type of tape manufactured with
a special weave and viscosity that allows ventilation
40
and water resistance, with more expanded elasticity
and a minimization of skin discomfort.18
2)
Throwing Velocity- mainly contributed by internal
rotation of the shoulder and elbow external rotation;
in addition maximal pelvis, trunk rotation and flexion
correlate positively with ball release velocity.36
Basic Assumptions
The following are basic assumptions of this study:
1)
The subjects will be honest when they complete their
demographic sheets.
2)
The subjects will perform to the best of their ability
during testing sessions.
3)
All taping procedures will be applied with a high
degree of consistency.
Limitations of the Study
The following are possible limitations of the study:
1)
The validity of kinesiotape and specific techniques to
increase muscular performance has yet to be
definitively determined.
2)
The velocity of the throws from the subjects will
differ based upon many variables.
41
Delimitations of the Study
The following are possible delimitations of the study:
1)
The subjects will be California University of
Pennsylvania Division II male and female varsity
athletes.
Significance of the Study
The significance of this study will be multi-tiered.
First, if any positive correlation can be made, the
implications with the use of kinesiotape in athletics can
be expanded to beyond baseball and softball. Secondly,
within the rehabilitation realm, this intervention can be
used to increase muscular strength or velocity in those
involved in injury recovery.
42
APPENDIX C
Additional Methods
43
APPENDIX C1
IRB APPROVAL: CALIFORNIA UNIVERSITY OF PENNSYLVANIA
44
From : instreviewboard
Subject : IRB approval for proposal # 12-042
Institutional Review Board
California University of Pennsylvania
Morgan Hall, Room 310
250 University Avenue
California, PA 15419
instreviewboard@calu.edu
Robert Skwarecki, Ph.D., CCC-SLP,Chair
Dear Erin Podroskey and Ryan Davis:
Please consider this email as official notification that your proposal titled
"The Acute Effects of Kinesiotape on Throwing Accuracy in Overhead
Sport Athletes” & "The Acute Effects of Kinesiotape on Throwing Velocity"
(Proposal #12-042) has been approved by the California University of
Pennsylvania Institutional Review Board as submitted.
The effective date of the approval is 3-1-2013 and the expiration date is 228-2014. These dates must appear on the consent form.
Please note that Federal Policy requires that you notify the IRB promptly
regarding any of the following:
(1) Any additions or changes in procedures you might wish for
your study (additions or changes must be approved by the IRB
before they are implemented)
(2) Any events that affect the safety or well-being of subjects
(3) Any modifications of your study or other responses that are
necessitated by any events reported in (2).
(4) To continue your research beyond the approval expiration date
of 2-28-2014 you must file additional information to be
considered for continuing review. Please contact
instreviewboard@calu.edu
Please notify the Board when data collection is complete.
Regards,
Robert Skwarecki, Ph.D., CCC-SLP
Chair, Institutional Review Board
45
APPENDIX C2
Individual Data Collection Sheet
46
Subject Number______________________
Gender_______________________________
Position______________________ ______
Taping Condition_______________________
Training Session Number__________________________
Throwing
Condition
Accuracy
(CM)
Velocity
(KPH)
Comments:
Notes:
Warm
5
Warm
Throw
Up
Up
1
Complete
Throws
Complete
Throw
2
Throw
3
Throw
4
Throw
5
47
APPENDIX C3
Taping Protocol
48
Figure 1. Pectoralis Major Inhibition Taping
Figure 2. Rhomboid Major Facilitation Taping
49
APPENDIX C4
Spec Sheet for Radar Gun
50
Figure 3. Radar Gun Specifications.
51
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Bassett KT, Lingman SA, Ellis RF. The Use and
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Firth BL, Dingley P, Davies ER, Lewis JS, Alexander
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6.
Aytar A, Ozunlu N, Surenkok O, Baltaci G, Oztop P,
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Huang CY, Hsieh TH, Lu SC, Su FC. Effect of the
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8.
Fu TC, Wong AM, Pei YC, Wu KP, Chou SW, Lin YC. Effect
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2008; 11: 198-201.
9.
Lee JH, Yoo WG, Lee KS. Effects of Head-Neck Rotation
and Kinesio taping of the Flexor Muscles on DominantHand Grip Strength. J Phys Ther Sci. 2010; 22: 285298.
52
10.
Vithoulka I, Beneka A, Malliou P, Aggelousis N,
Karatsolis K, Diamantopoulos K. The Effects of
Kinesio-Taping on Quadriceps Strength During
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Isokinet Exerc Sci. 2010; 18: 1-6.
11.
Schneider M, Rhea M, Bay C. The Effect of Kinesio Tex
Tape on Muscular Strength of the Forearm Extensors on
Collegiate Tennis Athletes. [Web Based Study]. 1-9.
12.
Kummel J, Mauz D, Blab F, Vieten M. Effect of Kinesio
Taping on Performance in Counter-Movement Jump.
Biomechanics in Sports. 2011; 29: 605-607.
13.
Baker C, Laiderman B, Paunicka E, Simpson R, Weaver R.
The Effect of tape on Fascial Planes on Muscle
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14.
Lee MH, Lee CR, Park JS, et al. Influence of Kinesio
Taping on the Motor Neuron Conduction Velocity. J Phys
Ther Sci. 2011; 23: 313-315.
15.
Slupik A, Dwornik M, Bialoszewski D, Zych E. Effect of
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2007; 6(6): 644-651.
16.
Cools AM, Witvrouw EE, Danneels LA, Cambier DC. Does
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in the Scapular Rotators in Health Shoulders. Manual
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17.
Chang HY, Chou KY, Lin JJ, Lin CF, Wang CH. Immediate
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18.
O’Sullivan D, Bird SP. Utilization of Kinesio Taping
for Fascia Unloading. Athl Ther Today. 2011; 21: 2127.
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Yoshida A, Kahanov L. The Effect of Kinesio Taping on
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53
20.
Hendrick CR. The Therapeutic Effects of Kinesio Tape
on a Grade I Lateral Ankle Sprain. [Doctoral
Dissertation]. 2010; 1-54.
21.
Bicici S, Karatas N, Baltaci G. Effect of Athletic
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Inversion Ankle Sprains. Int J Sports Phys Ther. 2012;
7(2): 154-166.
22.
Witkowski KR. Sticking to Rehab: Though Recently
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to Provide Pain Relief and Injury Protection and
Prevention. [Web Access]. 2012; 8-12.
23.
Kaya E, Zinnuroglu M, Tugeu I. Kinesio Taping Compared
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25.
Osterhues DJ. The Use of Kinesio Taping in the
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26.
Pope ML, Baker A, Grindstaff TL. Kinesio Taping
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Bishop BN. Sports Specific: Products and Treatments to
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55
ABSTRACT
TITLE:
THE ACUTE EFFECTS OF KINESIOTAPE ON THROWING
VELOCITY IN COLLEGIATE BASEBALL ATHLETES
RESEARCHER:
Ryan F. Davis, ATC, PES
ADVISOR:
Thomas F. West, PhD, ATC
PURPOSE:
To determine the acute efficacy of
kinesiotape on throwing velocity.
METHODS:
Sixteen volunteer subjects were asked to
make five successive throws under three
different taping conditions; no tape,
placebo tape (Elaskiton®), and kinesiotape
(Kinesio® Tex Gold™). The velocity for each
throw was measured by a radar gun and
recorded. The highest speed, measured in
kilometers per hour (kph), was deemed
optimal throwing velocity under the specific
condition.
FINDINGS:
The primary purpose of this study was to
examine the effect of kinesiotape on
throwing velocity as it relates to athletic
performance on three levels. The three
variables were a control with no tape, a
placebo tape, and kinesiotape. Sixteen male
subjects volunteered to be a part of this
study. Each informed subject completed a
dynamic warm up protocol at each session
prior to testing. Each subject completed
five trails under each condition; and the
greatest velocity measured under each
variable was deemed optimal throwing
velocity for that condition. There was no
significant effect found (F(2,28) = .64 , p
> .05). No significant difference exists
among no tape (m = 120.88, se = 2.13),
placebo tape (m = 123.01, se = 2.94), and
kinesiotape (m = 122.21, se = 2.23) means.
CONCLUSION:
After reviewing the results of this study it
is concluded that kinesiotape does not have
a significant effect on throwing velocity.
Testing specific claims of this tape still
56
remain in their infancy; however, this leads
to a large opportunity for future evidencebased research to examine not only the
muscular output assertions, but also the
many other therapeutic goals this tape has
been used for.