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Taping for whiplash injury?

Whiplash associated disorders (WAD) is a common condition treated in physiotherapy practice, especially in private practice, with approximately 300,000 new cases per annum (CSP, 2005). It is usually due to an acceleration-deceleration mechanism common in road traffic accidents or in certain sports, causing the structures around the spine to become overstretched.http://www.innova-pain.com/wp-content/uploads/2012/12/whiplash.jpgCSP have produced guidelines into the best treatment methods to utilise in our practice. The use of Kinesio taping was not mentioned in the treatment of WAD. However, in the most recent years, there has been increasing evidence of Kinesio taping as an effective treatment method for a number of conditions and pathologies to decrease pain and disability. The use of Kinesio taping in physiotherapy practice has therefore increased in popularity recently.So, as whiplash associated disorders are classified as a soft tissue injury, will Kinesio taping have a similar effect on decreasing pain and disability?

Gonzalez-Iglesias et al (2009) investigated the short-term effects of cervical Kinesio taping on pain and cervical range of motion in patients with acute whiplash injury. They predicted that due to previous evidence suggesting the positive short-term effects of taping on other musculoskeletal conditions e.g. shoulder pain, taping should have a positive effect on WAD also.

The study involved 41 patients who had suffered a WAD II (Quebec Classification) and associated symptoms within 40 days of their injury. They assessed NPRS scores and cervical range of movement without pain in all movements and assigned participants randomly to either receiving taping (with stretch) or a placebo taping application (without stretch).

Results suggested ‘that patients who received Kinesio Taping exhibited statistically significantly greater improvements in neck pain and cervical range of motion both immediately afterwards and at a 24-hour follow-up compared to the placebo group Why did this happen?

  • Tension applied provides neural feedback and reducing the irritation of soft tissue and allowing for increased movement.
  • Pain gate theory facilitating inhibitory pain mechanisms when the tape is applied.
  • Tape providing sensory feedback decreasing fear of movement that patient exhibit following WAD
  • Holds optimal posture by supporting the action of the cervical paraspinal

Improved circulation promoting blood flow and increased healingStrengths 

  • Good supporting evidence of taping in other research
  • Good methodology – random allocation, double-blinded, sample size
  • Indications for future practice

Limitations

  • Although statistically significant the changes were actually very small and did not pass the minimal clinically important difference for pain levels (2 points on NPRS) or range of movement, therefore, the clinical effectiveness should be questioned.
  • Did not investigate longer term effects of taping
  • Does not have a real control group (without any tape) therefore we can’t conclude if results were just due to the passage of time rather than the effectiveness of tape.

Therefore, future research is required to further investigate these findings to get a better understanding of the effect of taping on WAD. For example, it may be of benefit to investigate taping over a longer period of time e.g. longer than 24 hours or look at taping in conjunction with and compared to other treatment modalities.

This research does give physiotherapists another treatment method to consider in terms of the management of whiplash associated disorders in the acute stages, and more importantly, reduces pain for our patients.

 

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