Practical Science on Movement and Pain

Patellar Taping Changes Brain Activity

A study just came out which relates to a previous post I did on kinesiotaping, so I decided to write up a quick summary.

Patellar taping is a common treatment for patellofemoral pain, but the mechanism of action remains unclear. There is some debate about whether the method works due to mechanical effects on patellar alignment, or changes in the brain due to alterations in sensory input. In my previous post I argued in favor of the latter interpretation and this study provides some supporting evidence.

The researchers recruited healthy volunteers and used functional magnetic resonance imaging to monitor their brain activity during knee movement with and without patellar taping.

They found that subjects moving without the tape demonstrated more brain activity in numerous parts of the brain related to motor output. So basically the brain did less work with the tape than without. I guess that’s a good thing.

Previous research has shown that knee taping appears to improve knee coordination in subjects with poor proprioception but not in those with normal proprioception.

Of course none of this means that taping does not work through some other more local mechanism, or that it works at all, but it does give some support to the theory that any potential benefit is achieved through modulating the nervous system.

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7 Responses to Patellar Taping Changes Brain Activity

  1. Llermo says:

    Good article. You may have to consider that the volunteer did well & brain activity was a bit more with taping because with anything introduce to the body that the volunteer’s attention whether conscious or subconscience is toward the knee and forces the volunteer to use tjeir knees properly. You’d get the same result without the tape if the vounteers paid attention to proper knee mechanics.

  2. Tim says:

    “So basically the brain did less work with the tape than without. I guess that’s a good thing.”

    Is it?

    I think this kind of research is fraught with all kinds of problems and issues.

    What this study demonstrates is that when a person has tape -knowingly- applied to their knee, the BOLD response in their brains look different in fMRI in a clinical/laboratory setting.

    Can we really extrapolate any evidence as to the efficacy of this treatment/ intervention from such a study?

    If the healthy volunteers (I assume this means no knee pain) had “more activity in their brains” does this not suggest that this is the “normal”, healthy brain activity associated with the knee movement?

    Following on from this, if there is reduced activity in the brain with taping, could this not be seen as a ‘bad’ thing, ie; reduced compared to ‘normal’.

    Isn’t the above conclusion just as valid? (I don’t think either is ‘correct’ or defensible)

    The skin and brain have a very close relationship indeed, and the post on kinesiotaping on this site is full of some great info and ideas – my issue is with this study and taking any conclusions from changes in fMRI – seems like a real risk of conflating the changes with some kind of benefit.

    What would happen if the tape was applied to another part of the body – distal or proximal, contralaterally to the knee or even another body part altogether?

    With the novel input of tape anywhere on the body, would BOLD brain activity in an fMRI be different?

    The danger I see is another fad taking off with poor epistemology and ‘evidence’ that further enhances the belief in “faulty biomechanics” or “structural problems” as the cause of pain that can be magically corrected with a bit of tape applied to the skin.

    This will not enhance the general understanding of pain in the community, but further degrade it, while leading to reliance on another external agent.

    I think the quote from Lance Armstrong in the Kinesiotaping post is scary:

    “Something better than any laser, wrap, or electric massager…The Tape. It is a special hot-pink athletic tape that came from Japan and seemed to have special powers. Every morning before the stage, they would tape us all up, different parts of our bodies . . . Sometimes we’d be so wrapped up in hot-pink tape that we’d look like dolls, a bunch of broken dolls. But the next day the pain disappeared–it was gone.”

    Look at what he is comparing the tape to – “laser, electric massager, wrap”.

    “A special hot pink tape that came from Japan…” Because the colour and country of origin is important? (it is to enhance a placebo effect one would imagine)

    “seemed to have special powers”

    “the next day the pain was gone”

    A neuroscience based explanation of pain and pain reduction gets drowned out in all of this hype and celebrity endorsement.

    Ahh, but ‘they’ respond, we have neuroscience evidence for kinesiotaping – Callaghan et al 2012: “Effects of Patellar Taping on Brain Activity During Knee Joint Proprioception Tests Using Functional Magnetic Resonance Imaging”

    I’m sounding cranky and ravy in this comment, but I do see a real risk with drawing conclusions from research like this in regards to the treatment of pain (the whole core stability fad started with analogous findings and tens of thousands of Pilates reformers and Real Time Ultrasound machines later…. there are some therapists and manufacturers of Pilates reformers and RTU machines that have increased their net worth – yes I’m sure thousands of patients have benefited, but chronic back pain is no less of a problem now)

    Despite my misgivings with the related research, great post Todd to stimulate discussion and thought. Love the site and look forward to each new post

    Tim

    • Todd Hargrove says:

      Tim,

      Thanks for the comment. I agree with your main points here. Is less brain activity a good thing? When I said “I guess so”, I probably should have put the emphasis on “guess.” You are right that we can’t conclude much from this study.

    • Tim says:

      Kinesiotape is the best fad since the wearing of magnets on the wrist, ankles, neck, or in shoes. I guess some people can’t get rid of the binky.
      All these effect placebos just strengthen support for
      1) always being sincerely positive and encouraging with our patients
      and
      2) giving them a thorough education of what their problem is and how their treatment program will directly benefit the impairment (patient education directly correlates with compliance)

  3. Rod says:

    It’s funny. Alot of people will take the message of taping being useful. I think the nb message is that things are not as they appear. If taping works, how can we approach our movements so that we dont need tape? Its almost a skit from a monty python show.

  4. James Dodd says:

    What would be interesting is to see how brain activity is affected by the placebo effect – and thus challenging all areas of this type of research… how you seen any Todd??

  5. James Dodd says:

    Funny – just seen Tim’s post…..I have tried it out a fair amount on patients….Has it really made a difference…. really not sure?!

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