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The effects of rigid scapular taping on acromio-humeral distance in healthy shoulders: an observational study 
Authors
Alya.H.Bdaiwi, PhD Research student. Salford University, Health, Sports and Rehabilitation Sciences, Manchester, United Kingdom/ M5 4WT Tel: 0161 295 2017,  HYPERLINK "mailto:a.h.bdaiwi@edu.salford.ac.uk" a.h.bdaiwi@edu.salford.ac.uk
Tanya Anne Mackenzie MSc, PhD Research student.  Salford University, Health, Sports and Rehabilitation Sciences, Manchester, United Kingdom/ M5 4WT.  HYPERLINK "mailto:t.a.mackenzie@edu.salford.ac.uk" t.a.mackenzie@edu.salford.ac.uk
Dr Lee Herrington, PhD. Salford University, School of Sport, Exercise and Physiotherapy, Salford, Manchester, United Kingdom,  HYPERLINK "mailto:l.c.herrington@salford.ac.uk" l.c.herrington@salford.ac.uk
Ian Horlsey PhD. North West Lead Physiotherapist, English Institute of Sport, UK,  HYPERLINK "mailto:Ian.Horsley@eis2win.co.uk" Ian.Horsley@eis2win.co.uk
Ann Cools PT, PhD. Ghent University Dept of Rehabilitation Science and Physiotherapy, Belgium.  HYPERLINK "mailto:AnnCools@UGent.Be" AnnCools@UGent.Be

Source of funding: none
University of Salford Institutional Review Board approval the study. Study number: HSCR12/71

Corresponding author:
Tanya Anne Mackenzie MSc, PhD Research student. Salford University, Health, Sports and Rehabilitation Sciences, Manchester, United Kingdom/ M5 4WT.  HYPERLINK "mailto:t.a.mackenzie@edu.salford.ac.uk" t.a.mackenzie@edu.salford.ac.uk
Abstract
Study Design  A one-group pre-test/post-test repeated measures design. 
Objectives To evaluate the effect of two taping techniques, both separately and combined, on the outcome measures of acromio-humeral distance.
Background Taping to correct scapular position at rest and during motion, as well as to facilitate or inhibit muscle activity around the scapula has been investigated. However, there is very little research done to determine the effects of taping on acromio-humeral distance.
Methods In 20 healthy shoulders, real time ultrasound scanning (RTUS) was used to measure the acromio-humeral distance before and immediately after taping of the scapula. Measurements were collected with the arm in 60� of passive arm abduction.
Results Acromio-humeral distance increased significantly after rigid tape application to the scapula (p <0.003) in healthy shoulders in 60 degrees of passive arm abduction. Although all taping techniques significantly increased the acromio-humeral distance, the �serratus anterior� and combined taping techniques had the greatest effect on the acromio-humeral distance. 
Conclusion Taping techniques applied to the scapula had an immediate effect of increasing the acromio-humeral distance in healthy shoulders in 60 degrees of passive arm abduction. Further studies are needed to establish whether these changes are clinically important and could improve treatment outcomes in individuals with subacromial impingement syndrome.
Key words: acromiohumeral distance, strapping, real time ultrasound.

Abbreviations
AHD �acromion-humeral distance
UT � upper trapezius
SA- serratus anterior
ICC � intraclass correlation
STD � standard deviation
US - ultrasound










Introduction
Interventions aimed at altering scapular position have become fundamental components of shoulder rehabilitation ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"2fcijl3dv0","properties":{"formattedCitation":"{\\rtf \\super 16,25,33\\nosupersub{}}","plainCitation":"16,25,33"},"citationItems":[{"id":649,"uris":["http://zotero.org/users/961722/items/QBZVS86Q"],"uri":["http://zotero.org/users/961722/items/QBZVS86Q"],"itemData":{"id":649,"type":"article-journal","title":"Scapular Muscle Rehabilitation Exercises in Overhead Athletes With Impingement Symptoms Effect of a 6-Week Training Program on Muscle Recruitment and Functional Outcome","container-title":"The American Journal of Sports Medicine","page":"1906-1915","volume":"40","issue":"8","source":"ajs.sagepub.com","abstract":"Background: Previous research has identified some specific exercises to correct scapular muscle balance and onset timing in healthy subjects. However, evidence for their effectiveness in overhead athletes with impingement symptoms has been lacking until now.\nHypothesis: A 6-week exercise program consisting of previously selected exercises is able to improve muscle activation and onset timing during shoulder elevation. This program may also change pain and functionality levels in overhead athletes with mild impingement symptoms.\nStudy Design: Case series; Level of evidence, 4.\nMethods: Forty-seven overhead athletes with mild impingement symptoms (25 men and 22 women) were enrolled in this study. Before and after the 6-week training program, the Shoulder Pain and Disability Index (SPADI) score was individually obtained and maximum voluntary isometric contraction (MVIC) values were determined by surface electromyography. Mean muscle activation levels, muscle ratio data, and muscle onset timing were assessed for the upper (UT), middle (MT), and lower (LT) trapezius and serratus anterior (SA) muscle during arm elevation in the scapular plane.\nResults: Forty participants completed the exercise program. The SPADI scores significantly decreased from 29.86 � 17.03 during initial assessment to 11.7 � 13.78 during postmeasurements (P < .001). The 3 trapezius muscle parts showed increased MVIC values and decreased activation levels during arm elevation, whereas this was not the case for the SA muscle. After the training program, UT/SA significantly decreased, whereas UT/MT and UT/LT did not change (P < .05). No differences in muscle timing between pre- and postmeasurements could be identified. The LT showed significant earlier activation compared with UT ("0.47; P < .001) and MT ("0.49; P < .001). The serratus anterior showed significant earlier activation compared with the UT ("0.74; P < .001), MT ("0.76; P < .001), and LT muscles (F = 0.27; P = .046).\nConclusion: This is the first longitudinal study to demonstrate that previously selected exercises (1) improve pain and function based on SPADI scores, (2) reduce relative trapezius muscle activation, and (3) alter UT/SA ratios. However, they were unable to change the timing of the scapular muscles during arm elevation when compared before and after a 6-week training program in overhead athletes with mild impingement symptoms.","DOI":"10.1177/0363546512453297","ISSN":"0363-5465, 1552-3365","note":"PMID: 22785606","journalAbbreviation":"Am J Sports Med","language":"en","author":[{"family":"Mey","given":"Kristof De"},{"family":"Danneels","given":"Lieven"},{"family":"Cagnie","given":"Barbara"},{"family":"Cools","given":"Ann M."}],"issued":{"date-parts":[["2012",8,1]]},"accessed":{"date-parts":[["2014",3,29]]},"PMID":"22785606"}},{"id":904,"uris":["http://zotero.org/users/961722/items/ZB6BD5BB"],"uri":["http://zotero.org/users/961722/items/ZB6BD5BB"],"itemData":{"id":904,"type":"article-journal","title":"Shoulder Rehabilitation Strategies, Guidelines, and Practice","container-title":"Operative Techniques in Sports Medicine","page":"103-112","volume":"20","issue":"1","source":"ScienceDirect","abstract":"Shoulder rehabilitation can best be understood and implemented as the practical application of biomechanical and muscle activation guidelines to the repaired anatomic structures in order to allow the most complete return to function. The shoulder works as a link in the kinetic chain of joint motions and muscle activations to produce optimum athletic function. Functional shoulder rehabilitation should start with establishment of a stable base of support and muscle facilitation in the trunk and legs, and then proceeds to the scapula and shoulder as healing is achieved and proximal control is gained. The pace of this �flow� of exercises is determined by achievement of the functional goals of each segment in the kinetic chain. In the early rehabilitation stages, the incompletely healed shoulder structures are protected by exercises that are directed towards the proximal segments. As healing proceeds, the weak scapular and shoulder muscles are facilitated in their re-activation by the use of the proximal leg and trunk muscles to re-establish normal coupled activations. Closed chain axial loading exercises form the basis for scapular and glenohumeral functional rehabilitation, as they more closely simulate normal scapula and shoulder positions, proprioceptive input, and muscle activation patterns. In the later rehabilitation stages, glenohumeral control and power production complete the return of function to the shoulder and the kinetic chain. In this integrated approach, glenohumeral emphasis is part of the entire program and is towards the end of rehabilitation, rather than being the entire program and being at the beginning of the program.","DOI":"10.1053/j.otsm.2012.03.012","ISSN":"1060-1872","author":[{"family":"Kibler","given":"W. Ben"},{"family":"McMullen","given":"John"},{"family":"Uhl","given":"Tim"}],"issued":{"date-parts":[["2012",3]]},"accessed":{"date-parts":[["2012",4,30]]}}},{"id":584,"uris":["http://zotero.org/users/961722/items/MQMGZ8ZE"],"uri":["http://zotero.org/users/961722/items/MQMGZ8ZE"],"itemData":{"id":584,"type":"article-journal","title":"Progressive Resistance Exercise in Physical Therapy: A Summary of Systematic Reviews","container-title":"Physical Therapy","page":"1208-1223","volume":"85","issue":"11","source":"EBSCOhost","abstract":"Progressive resistance exercise (PRE) is a method of increasing the ability of muscles to generate force. However, the effectiveness and safety of PRE for clients of physical therapists are not well known. The purpose of this article is to review the evidence on positive and negative effects of PRE as a physical therapy intervention. Electronic databases were searched for systematic reviews on PRE and any relevant randomized trials published after the last available review. The search yielded 18 systematic reviews under major areas of physical therapy: cardiopulmonary, musculoskeletal, neuromuscular, and gerontology. Across conditions, PRE was shown to improve the ability to generate force, with moderate to large effect sizes that may carry over into an improved ability to perform daily activities. Further research is needed to determine the potential negative effects of PRE, how to maximize carryover into everyday activities, and what effect, if any, PRE has on societal participation.","ISSN":"00319023","shortTitle":"Progressive Resistance Exercise in Physical Therapy","journalAbbreviation":"Physical Therapy","author":[{"family":"Taylor","given":"Nicholas F."},{"family":"Dodd","given":"Karen J."},{"family":"Damiano","given":"Diane L."}],"issued":{"date-parts":[["2005",11]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 16,25,33.  This is based on the assumption that altered scapular kinematics can reduce the subacromial space creating inadequate space for clearance of subacromial structures ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"dp4as699r","properties":{"formattedCitation":"{\\rtf \\super 10\\nosupersub{}}","plainCitation":"10"},"citationItems":[{"id":330,"uris":["http://zotero.org/users/961722/items/CZKHEVKR"],"uri":["http://zotero.org/users/961722/items/CZKHEVKR"],"itemData":{"id":330,"type":"article-journal","title":"Effect of abducting and adducting muscle acitivityon glenohumeral translation, scapular kinematics and subacromial space width in vivo","container-title":"Journal of Biomechanics","page":"755-760","volume":"38","author":[{"family":"Graichen","given":"H"},{"family":"Hinterwimme","given":"S"},{"family":"von Eisenhart-Rothe","given":"R"},{"family":"Vogl","given":"T"},{"family":"Englmeie","given":"K H"},{"family":"Eckstein","given":"F"}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 10.  It has been proposed that increased upper trapezius activity and delayed lower trapezius activity leads to a decrease in acromial elevation and posterior scapula tilt ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1tn3hk7epi","properties":{"formattedCitation":"{\\rtf \\super 21,22,31\\nosupersub{}}","plainCitation":"21,22,31"},"citationItems":[{"id":471,"uris":["http://zotero.org/users/961722/items/HEPT89IA"],"uri":["http://zotero.org/users/961722/items/HEPT89IA"],"itemData":{"id":471,"type":"article-journal","title":"Effect of scapular protraction and retraction on isometric shoulder elevation strength","container-title":"Archives of Physical Medicine and Rehabilitation","page":"367-370","volume":"83","issue":"3","source":"ScienceDirect","abstract":"Smith J, Kotajarvi BR, Padgett DJ, Eischen JJ. Effect of scapular protraction and retraction on isometric shoulder elevation strength. Arch Phys Med Rehabil 2002;83:367-70. Objectives: To examine the effect of scapular protraction (SP) and scapular retraction (SR) on isometric shoulder elevation strength measured in the sagittal plane and to test the hypothesis that strength would be significantly reduced when tested in the SP position relative to the neutral resting scapular position (SN). Design: Prospective before-after trial. Setting: Multidisciplinary sports medicine center. Participants: Ten healthy volunteers (5 men, 5 women) ages 26 to 43 years recruited from the Mayo Clinic, Rochester, MN. Interventions: Subjects completed 3 maximal isometric shoulder elevation contractions at 90[deg ] of sagittal plane elevation in the SN, SP, and SR positions. The order of scapular positions was varied to minimize fatigue effects. Mean isometric strength values were compared by using Student t tests. Main Outcome Measures: Isometric shoulder elevation strength for the 3 scapular positions. Results: Isometric strength was significantly lower for the SP position compared with the SN position (8.5 [plusmn] 3.4kg vs 11.1 [plusmn] 4.0kg, P [lt ] .0005) and for the SR position relative to the SN position (7.8 [plusmn] 3.3kg vs 11.1 [plusmn] 4.0kg, P [lt ] .00003). Strength values did not differ between the SP and SR positions (P = .38). Conclusions: Movement of the scapula into a protracted or retracted position results in a statistically significant reduction in isometric shoulder elevation strength as measured in this study. Further research is warranted to examine the relationship between scapular position and shoulder muscle function. [copy ] 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation","DOI":"10.1053/apmr.2002.29666","ISSN":"0003-9993","journalAbbreviation":"Archives of Physical Medicine and Rehabilitation","author":[{"family":"Smith","given":"Jay"},{"family":"Kotajarvi","given":"Brian R."},{"family":"Padgett","given":"Denny J."},{"family":"Eischen","given":"Joe J."}],"issued":{"date-parts":[["2002",3]]},"accessed":{"date-parts":[["2012",9,26]]}}},{"id":301,"uris":["http://zotero.org/users/961722/items/C6SC3TE2"],"uri":["http://zotero.org/users/961722/items/C6SC3TE2"],"itemData":{"id":301,"type":"article-journal","title":"The Association of Scapular Kinematics and Glenohumeral Joint Pathologies","container-title":"Journal of Orthopaedic and Sports Physical Therapy","source":"CrossRef","URL":"http://www.jospt.org/issues/id.2289/article_detail.asp","DOI":"10.2519/jospt.2009.2808","ISSN":"0190-6011","author":[{"family":"Ludewig","given":"Paula M."}],"issued":{"date-parts":[["2009",2]]},"accessed":{"date-parts":[["2012",5,9]]}}},{"id":567,"uris":["http://zotero.org/users/961722/items/KV9DJM3B"],"uri":["http://zotero.org/users/961722/items/KV9DJM3B"],"itemData":{"id":567,"type":"article-journal","title":"Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement","container-title":"Physical Therapy","page":"276-291","volume":"80","issue":"3","source":"EBSCOhost","abstract":"Treatment of patients with impingement symptoms commonly includes exercises intended to restore \"normal\" movement patterns. Evidence that indicates the existence of abnormal patterns in people with shoulder pain is limited. The purpose of this investigation was to analyze glenohumeral and scapulothoracic kinematics and associated scapulothoracic muscle activity in a group of subjects with symptoms of shoulder impingement relative to a group of subjects without symptoms of shoulder impingement matched for occupational exposure to overhead work. Fifty-two subjects were recruited from a population of construction workers with routine exposure to overhead work. Surface electromyographic data were collected from the upper and lower parts of the trapezius muscle and from the serratus anterior muscle. Electromagnetic sensors simultaneously tracked 3-dimensional motion of the trunk, scapula, and humerus during humeral elevation in the scapular plane in 3 handheld load conditions: (1) no load, (2) 2.3-kg load, and (3) 4.6-kg load. An analysis of variance model was used to test for group and load effects for 3 phases of motion (31 degrees - 60 degrees, 61 degrees - 90 degrees, and 91 degrees - 120 degrees). Relative to the group without impingement, the group with impingement showed decreased scapular upward rotation at the end of the first of the 3 phases of interest, increased anterior tipping at the end of the third phase of interest, and increased scapular medial rotation under the load conditions. At the same time, upper and lower trapezius muscle electromyographic activity increased in the group with impingement as compared with the group without impingement in the final 2 phases, although the upper trapezius muscle changes were apparent only during the 4.6-kg load condition. The serratus anterior muscle demonstrated decreased activity in the group with impingement across all loads and phases. Scapular tipping (rotation about a medial to lateral axis) and serratus anterior muscle function are important to consider in the rehabilitation of patients with symptoms of shoulder impingement related to occupational exposure to overhead work. (PTh)","ISSN":"00319023","author":[{"family":"Ludewig","given":"P.M."},{"family":"Cook","given":"T.M."}],"issued":{"date-parts":[["2000",3]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 21,22,31. In addition, decreased serratus anterior activity potentially reduces scapular external and upward rotation during arm elevation ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"uniuffla","properties":{"formattedCitation":"{\\rtf \\super 6\\nosupersub{}}","plainCitation":"6"},"citationItems":[{"id":835,"uris":["http://zotero.org/users/961722/items/WD4H962S"],"uri":["http://zotero.org/users/961722/items/WD4H962S"],"itemData":{"id":835,"type":"article-journal","title":"Scapular Muscle Recruitment Patterns: Trapezius Muscle Latency with and Without Impingement Symptoms","container-title":"The American Journal of Sports Medicine","page":"542-549","volume":"31","issue":"4","source":"ajs.sagepub.com","abstract":"Background: Altered muscle activity in the scapular muscles is commonly believed to be a factor contributing to shoulder impingement syndrome. However, one important measure of the muscular coordination in the scapular muscles, the timing of the temporal recruitment pattern, is undetermined.\nPurpose: To evaluate the timing of trapezius muscle activity in response to an unexpected arm movement in athletes with impingement and in normal control subjects.\nStudy Design: Prospective cohort study.\nMethods: Muscle latency times were measured in all three parts of the trapezius muscle and in the middle deltoid muscle of 39 �overhand athletes� with shoulder impingement and compared with that of 30 overhand athletes with no impingement during a sudden downward falling movement of the arm.\nResults: There were significant differences in the relative muscle latency times between the impingement and the control group subjects. Those with impingement showed a delay in muscle activation of the middle and lower trapezius muscle.\nConclusion: The results of this study indicate that overhand athletes with impingement symptoms show abnormal muscle recruitment timing in the trapezius muscle. The findings support the theory that impingement of the shoulder may be related to delayed onset of contraction in the middle and lower parts of the trapezius muscle.","ISSN":"0363-5465, 1552-3365","shortTitle":"Scapular Muscle Recruitment Patterns","journalAbbreviation":"Am J Sports Med","language":"en","author":[{"family":"Cools","given":"Ann M"},{"family":"Witvrouw","given":"Erik E"},{"family":"Declercq","given":"Geert A"},{"family":"Danneels","given":"Lieven A"},{"family":"Cambier","given":"Dirk C"}],"issued":{"date-parts":[["2003",7,1]]},"accessed":{"date-parts":[["2012",4,23]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 6. This altered muscular activity and resultant decrease in in acromial elevation, posterior scapula tilt, and scapular upward rotation leading to reduction in AHD is assumed to be a factor in subacromial impingement syndrome  ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1CYQ7Pg8","properties":{"formattedCitation":"{\\rtf \\super 8,12,23,24\\nosupersub{}}","plainCitation":"8,12,23,24"},"citationItems":[{"id":843,"uris":["http://zotero.org/users/961722/items/WJ629FKM"],"uri":["http://zotero.org/users/961722/items/WJ629FKM"],"itemData":{"id":843,"type":"article-journal","title":"Acromio-Humeral Distance Variation Measured by Ultrasonograp... : Clinical Journal of Sport Medicine","container-title":"Clinical Journal of Sport Medicine","page":"197-205","volume":"14","issue":"4","abstract":"Objective: First, to validate an ultrasonographic measure of the acromio-humeral distance (AHD); second, to compare the AHD variation during active abduction in patients with shoulder impingement syndrome (SIS) and healthy subjects; and third, to evaluate the relationship between functional statu...","DOI":"00042752-200407000-00002","shortTitle":"Acromio-Humeral Distance Variation Measured by Ultrasonograp...","author":[{"family":"Desmeules","given":"F"},{"family":"Minville","given":"L"},{"family":"Riederer","given":"B"},{"family":"C�t�","given":"C"},{"family":"Fr�mont","given":"P"}],"issued":{"date-parts":[["2004",7]]},"accessed":{"date-parts":[["2013",6,27]]}}},{"id":822,"uris":["http://zotero.org/users/961722/items/VTNNMBZE"],"uri":["http://zotero.org/users/961722/items/VTNNMBZE"],"itemData":{"id":822,"type":"article-journal","title":"Scapular behavior in shoulder impingement syndrome","container-title":"Archives of Physical Medicine and Rehabilitation","page":"60-69","volume":"83","issue":"1","source":"ScienceDirect","abstract":"H[eacute]bert LJ, Moffet H, McFadyen BJ, Dionne CE. Scapular behavior in shoulder impingement syndrome. Arch Phys Med Rehabil 2002;83;60-9. Objective: To quantify the contribution of each scapular rotation to the scapular total range of motion (ROM) in both shoulders of persons with a unilateral shoulder impingement syndrome (SIS), to compare 3-dimensional (3D) scapular attitudes of their symptomatic and asymptomatic shoulders in flexion and in abduction, and to characterize the scapular behavior of these subjects by classifying them into subgroups based on scapular tilting differences between their symptomatic and asymptomatic shoulders. Design: Comparisons of 3D scapular attitudes, scapular total ROM, and percentage of contributions of each scapular rotation to the scapular total ROM. Setting: A motricity laboratory. Participants: Fifty-one subjects, including 41 with a SIS (29 had an asymptomatic contralateral shoulder) and 10 healthy subjects. Interventions: The 3D scapular attitudes were calculated with the subjects in a standardized seated position; with the arm at rest; or at 70[deg ], 90[deg ], and 110[deg ] of shoulder flexion and abduction. Axial rotation angles were calculated using a fixed set of Cardanic angles. Main Outcome Measures: At 90[deg ] of arm elevation, data from 10 shoulders of healthy subjects were used to set up normative values (99% confidence interval of mean 3D scapular attitudes) to compare with 3D scapular attitudes of symptomatic and asymptomatic shoulders of SIS subjects. We analyzed the scapula behavior of subjects with SIS and classified them into subgroups based on scapular anterior tilting asymmetry. Results: In flexion, almost half of the scapular total ROM was provided by anterior tilting (48.2%-51.3%), whereas in abduction, external rotation (40.3%-42.4%) was the main contributor. Scapular total ROM was higher in abduction than in flexion in all arm positions for both shoulder groups (P [lt ] .01). Also, 3D scapular attitude patterns of both shoulders of SIS subjects were different from those of healthy subjects. At 90[deg ], scapular asymmetry in anterior tilting allowed us to classify SIS subjects with respect to more (lead) or less (lag) scapular tilting in the affected side (P [lt ] .0001) or no difference (P = .11) between the sides (symmetrical). No significant differences (P [gt ] .05), except for a small 2[deg ] difference in transverse rotation during arm flexion at 110[deg ] (P = .002), were observed in 3D scapular attitudes and scapular total ROM between both shoulders of SIS subjects. Patterns of 3D scapular attitudes and scapular total ROM were significantly different between flexion and abduction arm positions (P [lt ] .05). Conclusions: The contribution of rotations and scapular total ROM differed according to the plane of arm elevation in SIS subjects. Group analyses revealed no differences in 3D scapular attitudes between symptomatic and asymptomatic shoulders of subjects with unilateral SIS. This could be caused by the use, in SIS subjects, of inappropriate neuromuscular strategies affecting both shoulders. However, individual analyses revealed scapular asymmetry in the sagittal plane, which suggests that SIS subjects with less anterior tilting in the symptomatic shoulder, as compared with the asymptomatic contralateral one, may be at high risk of developing chronic SIS. This last finding provides scientific evidence to focus rehabilitation protocols toward a restoration of anterior tilting. [copy ] 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation","DOI":"10.1053/apmr.2002.27471","ISSN":"0003-9993","journalAbbreviation":"Archives of Physical Medicine and Rehabilitation","author":[{"family":"Hebert","given":"Luc J."},{"family":"Moffet","given":"H[eacute]l[egrave]ne"},{"family":"McFadyen","given":"Bradford J."},{"family":"Dionne","given":"Clermont E."}],"issued":{"date-parts":[["2002",1]]},"accessed":{"date-parts":[["2012",9,30]]}}},{"id":860,"uris":["http://zotero.org/users/961722/items/WWE6NGAS"],"uri":["http://zotero.org/users/961722/items/WWE6NGAS"],"itemData":{"id":860,"type":"article-journal","title":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects: A randomised controlled trial","container-title":"Manual Therapy","page":"573-577","volume":"18","issue":"6","source":"ScienceDirect","abstract":"The first aim of this study was to investigate whether kinesiotaping (KT) can increase the acromiohumeral distance (AHD) in asymptomatic subjects in the short term. The second aim was to investigate whether the direction of kinesiotaping application influences AHD.\nIn recent years, the use of KT has become increasingly popular for a range of musculoskeletal conditions and for sport injuries. To date, we are unaware of any research investigating the effect of kinesiotaping on AHD. Moreover, it is unknown whether the direction of kinesiotaping application for the shoulder is important.\nForty nine participants were randomly assigned to one of three groups: kinesiotaping group 1 (KT1), kinesiotaping group 2 (KT2) and sham kinesiotaping (KT3). AHD ultrasound measurements at 0� and 60� of shoulder elevation were collected at baseline and immediately after kinesiotape application.\nThe results showed significant improvements in AHD after kinesiotaping, compared with sham taping. The mean difference in AHD between KT1 and KT3 groups was 1.28 mm (95% CI: 0.55, 2.03), and between KT2 and KT3 was 0.98 mm (95% CI: 0.23, 1.74). Comparison of KT1 and KT2 groups, which was performed to identify whether the direction of taping influences the AHD, indicated there were no significant differences.\nKT increases AHD in healthy individuals immediately following application, compared with sham kinesiotape. No differences were found with respect to the direction in which KT was applied.","DOI":"10.1016/j.math.2013.06.002","ISSN":"1356-689X","shortTitle":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects","journalAbbreviation":"Manual Therapy","author":[{"family":"Luque-Suarez","given":"A."},{"family":"Navarro-Ledesma","given":"S."},{"family":"Petocz","given":"P."},{"family":"Hancock","given":"M. J."},{"family":"Hush","given":"J."}],"issued":{"date-parts":[["2013",12]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":498,"uris":["http://zotero.org/users/961722/items/IJXUPC2B"],"uri":["http://zotero.org/users/961722/items/IJXUPC2B"],"itemData":{"id":498,"type":"article-journal","title":"Dynamic In Vivo Glenohumeral Kinematics During Scapular Plane Abduction in Healthy Shoulders","container-title":"Journal of Orthopaedic and Sports Physical Therapy","source":"CrossRef","URL":"http://www.jospt.org/issues/id.2657/article_detail.asp","DOI":"10.2519/jospt.2012.3584","ISSN":"0190-6011","author":[{"family":"Matsuki","given":"Keisuke"}],"issued":{"date-parts":[["2011"]]},"accessed":{"date-parts":[["2012",8,6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 8,12,23,24. Conservative treatment of patients with subacromial impingement syndrome often involves multiple interventions, including: strengthening and stretching exercises, manual therapy techniques, medication,  electrotherapy and taping techniques  ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"UZo9zrFr","properties":{"formattedCitation":"{\\rtf \\super 5,8,11,14,15,20\\nosupersub{}}","plainCitation":"5,8,11,14,15,20"},"citationItems":[{"id":314,"uris":["http://zotero.org/users/961722/items/CIF5QD6Z"],"uri":["http://zotero.org/users/961722/items/CIF5QD6Z"],"itemData":{"id":314,"type":"article-journal","title":"The value of intermittent ultrasound treatment in subacromial impingement syndrome","container-title":"Acta Orthop Traumatol Turc","page":"243-247","volume":"43","issue":"3","source":"www.aott.org.tr","abstract":"Objectives: The role of intermittent ultrasound in the conservative treatment of subacromial impingement syndrome (SIS) has not been clarified. We aimed to evaluate the efficacy of ultrasound treatment in SIS.\nMethods: Thirty-six patients (29 females, 7 males; mean age 51 years; range 40 to 69 years) with type II SIS were randomized to two groups to receive intermittent ultrasound (group 1, n=20) and placebo ultrasound (group 2, n=16) for three weeks (15 sessions). All the patients received the same standard physical therapy and rehabilitation modalities besides ultrasound treatment. Evaluations were made before and three and six weeks after treatment. Functional results were assessed by the Constant score, pain was assessed by a visual analog scale, and range of motion was measured.\nResults: Within-group comparisons showed significant improvements in both groups three and six weeks after treatment (p 0.05). The Constant score improved from 43.7�12.9 to 65.7�7.7 in group 1, and from 43.9�16.4 to 65.3�7.6 in group 2. Pain scores decreased from 5.5 to 2 and from 5 to 1 in group 1 and 2, respectively. Improvements in Constant scores and pain scores were similar in both groups (p>0.05).\nConclusion: Our findings suggest that intermittent ultrasound added to conservative treatment of SIS do not provide an additional benefit to the patients.","DOI":"10.3944/aott.v43i3.3869","ISSN":"1017-995x","language":"tr","author":[{"family":"Celik","given":"Derya"},{"family":"Atalar","given":"Ata Can"},{"family":"Sahinkaya","given":"Sabahattin"},{"family":"Demirhan","given":"Mehmet"}],"issued":{"date-parts":[["2004",7,23]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":843,"uris":["http://zotero.org/users/961722/items/WJ629FKM"],"uri":["http://zotero.org/users/961722/items/WJ629FKM"],"itemData":{"id":843,"type":"article-journal","title":"Acromio-Humeral Distance Variation Measured by Ultrasonograp... : Clinical Journal of Sport Medicine","container-title":"Clinical Journal of Sport Medicine","page":"197-205","volume":"14","issue":"4","abstract":"Objective: First, to validate an ultrasonographic measure of the acromio-humeral distance (AHD); second, to compare the AHD variation during active abduction in patients with shoulder impingement syndrome (SIS) and healthy subjects; and third, to evaluate the relationship between functional statu...","DOI":"00042752-200407000-00002","shortTitle":"Acromio-Humeral Distance Variation Measured by Ultrasonograp...","author":[{"family":"Desmeules","given":"F"},{"family":"Minville","given":"L"},{"family":"Riederer","given":"B"},{"family":"C�t�","given":"C"},{"family":"Fr�mont","given":"P"}],"issued":{"date-parts":[["2004",7]]},"accessed":{"date-parts":[["2013",6,27]]}}},{"id":802,"uris":["http://zotero.org/users/961722/items/V8FZJMTU"],"uri":["http://zotero.org/users/961722/items/V8FZJMTU"],"itemData":{"id":802,"type":"chapter","title":"Physiotherapy interventions for shoulder pain","container-title":"Cochrane Database of Systematic Reviews","publisher":"John Wiley & Sons, Ltd","source":"Wiley Online Library","abstract":"Background\nBackground\n\nThe prevalence of shoulder disorders has been reported to range from seven to 36% of the population (Lundberg 1969) accounting for 1.2% of all General Practitioner encounters in Australia (Bridges Webb 1992). Substantial disability and significant morbidity can result from shoulder disorders. While many treatments have been employed in the treatment of shoulder disorders, few have been proven in randomised controlled trials. Physiotherapy is often the first line of management for shoulder pain and to date its efficacy has not been established. This review is one in a series of reviews of varying interventions for shoulder disorders, updated from an earlier Cochrane review of all interventions for shoulder disorder.\n\nObjectives\nObjectives\n\nTo determine the efficacy of physiotherapy interventions for disorders resulting in pain, stiffness and/or disability of the shoulder.\n\nSearch methods\nSearch methods\n\nMEDLINE, EMBASE, the Cochrane Clinical Trials Regiter and CINAHL were searched 1966 to June 2002. The Cochrane Musculoskeletal Review Group's search strategy was used and key words gained from previous reviews and all relevant articles were used as text terms in the search.\n\nSelection criteria\nSelection criteria\n\nEach identified study was assessed for possible inclusion by two independent reviewers. The determinants for inclusion were that the trial be of an intervention generally delivered by a physiotherapist, that treatment allocation was randomised; and that the study population be suffering from a shoulder disorder, excluding trauma and systemic inflammatory diseases such as rheumatoid arthritis.\n\nData collection and analysis\nData collection and analysis\n\nThe methodological quality of the included trials was assessed by two independent reviewers according to a list of predetermined criteria, which were based on the PEDro scale specifically designed for the assessment of validity of trials of physiotherapy interventions. Outcome data was extracted and entered into Revman 4.1. Means and standard deviations for continuous outcomes and number of events for binary outcomes were extracted where available from the published reports. All standard errors of the mean were converted to standard deviation. For trials where the required data was not reported or not able to be calculated, further details were requested from first authors. If no further details were provided, the trial was included in the review and fully described, but not included in the meta-analysis. Results were presented for each diagnostic sub group (rotator cuff disease, adhesive capsulitis, anterior instability etc) and, where possible, combined in meta-analysis to give a treatment effect across all trials.\n\nMain results\nMain results\n\nTwenty six trials met inclusion criteria. Methodological quality was variable and trial populations were generally small (median sample size = 48, range 14 to 180). Exercise was demonstrated to be effective in terms of short term recovery in rotator cuff disease (RR 7.74 (1.97, 30.32), and longer term benefit with respect to function (RR 2.45 (1.24, 4.86). Combining mobilisation with exercise resulted in additional benefit when compared to exercise alone for rotator cuff disease. Laser therapy was demonstrated to be more effective than placebo for adhesive capsulitis (RR 8, 95%CI 2.11 to 30.34) but not for supraspinatus tendinitis (RR 2, 95%CI 0.98 to 4.09). Both ultrasound and pulsed electromagnetic field therapy resulted in improvement compared to placebo in pain in calcific tendinitis (RR 1.81 (1.26, 2.60) and RR 19 (1.16, 12.43) respectively). There is no evidence of the effect of ultrasound in shoulder pain (mixed diagnosis), adhesive capsulitis or rotator cuff tendinitis. When compared to exercises, ultrasound is of no additional benefit over and above exercise alone. There is some evidence that for rotator cuff disease, corticosteroid injections are superior to physiotherapy and no evidence that physiotherapy alone is of benefit for adhesive capsulitis\n\nAuthors' conclusions\nAuthors' conclusions\n\nThe small sample sizes, variable methodological quality and heterogeneity in terms of population studied, physiotherapy intervention employed and length of follow up of randomised controlled trials of physiotherapy interventions results in little overall evidence to guide treatment. There is evidence to support the use of some interventions in specific and circumscribed cases. There is a need for trials of physiotherapy interventions for specific clinical conditions associated with shoulder pain, for shoulder pain where combinations of physiotherapy interventions, as well as, physiotherapy interventions as an adjunct to other, non physiotherapy interventions are compared. This is more reflective of current clinical practice. Trials should be adequately powered and address key methodological criteria such as allocation concealment and blinding of outcome assessor.","URL":"http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004258/abstract","ISBN":"1465-1858","language":"en","author":[{"family":"Green","given":"Sally"},{"family":"Buchbinder","given":"Rachelle"},{"family":"Hetrick","given":"Sarah E"}],"issued":{"date-parts":[["1996"]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":736,"uris":["http://zotero.org/users/961722/items/T7HNXC73"],"uri":["http://zotero.org/users/961722/items/T7HNXC73"],"itemData":{"id":736,"type":"article-journal","title":"The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome","container-title":"Journal of Electromyography and Kinesiology","page":"1092-1099","volume":"19","issue":"6","source":"CrossRef","DOI":"10.1016/j.jelekin.2008.11.003","ISSN":"10506411","author":[{"family":"Hsu","given":"Yin-Hsin"},{"family":"Chen","given":"Wen-Yin"},{"family":"Lin","given":"Hsiu-Chen"},{"family":"Wang","given":"Wendy T.J."},{"family":"Shih","given":"Yi-Fen"}],"issued":{"date-parts":[["2009",12]]},"accessed":{"date-parts":[["2012",5,9]]}}},{"id":4,"uris":["http://zotero.org/users/961722/items/23X6IWRR"],"uri":["http://zotero.org/users/961722/items/23X6IWRR"],"itemData":{"id":4,"type":"article-journal","title":"Taping patients with clinical signs of subacromial impingement syndrome: the design of a randomized controlled trial","container-title":"BMC Musculoskeletal Disorders","page":"188","volume":"12","source":"PubMed Central","abstract":"Background\nShoulder problems are a common complaint of the musculoskeletal system. Physical therapists treat these patients with different modalities such as exercise, massage, and shoulder taping. Although different techniques have been described, the effectiveness of taping has not yet been established. The aim of this study is to assess the effectiveness and cost-effectiveness of usual physical therapy care in combination with a particular tape technique for subacromial impingement syndrome of the shoulder compared to usual physical therapy care without this tape technique in a primary healthcare setting.\n\nMethods and design\nAn economic evaluation alongside a randomized controlled trial will be conducted. A sample of 140 patients between 18 and 65 years of age with a diagnosis of subacromial impingement syndrome (SAIS) as assessed by physical therapists will be recruited. Eligible patients will be randomized to either the intervention group (usual care in combination with the particular tape technique) or the control group (usual care without this tape technique). In both groups, usual care will consist of individualized physical therapy care. The primary outcomes will be shoulder-specific function (the Simple Shoulder Test) and pain severity (11-point numerical rating scale). The economic evaluation will be performed using a societal perspective. All relevant costs will be registered using cost diaries. Utilities (Quality Adjusted Life Years) will be measured using the EuroQol. The data will be collected at baseline, and 4, 12, and 26 weeks follow-up.\n\nDiscussion\nThis pragmatic study will provide information about the effectiveness and cost-effectiveness of taping in patients presenting with clinical signs of SAIS.\n\nTrial registration\nTrial registration number: NTR2575","DOI":"10.1186/1471-2474-12-188","ISSN":"1471-2474","note":"PMID: 21849055\nPMCID: PMC3173405","shortTitle":"Taping patients with clinical signs of subacromial impingement syndrome","journalAbbreviation":"BMC Musculoskelet Disord","author":[{"family":"Kalter","given":"Joeri"},{"family":"Apeldoorn","given":"Adri T"},{"family":"Ostelo","given":"Raymond W"},{"family":"Henschke","given":"Nicholas"},{"family":"Knol","given":"Dirk L"},{"family":"van Tulder","given":"Maurits W"}],"issued":{"date-parts":[["2011",8,17]]},"accessed":{"date-parts":[["2014",3,29]]},"PMID":"21849055","PMCID":"PMC3173405"}},{"id":62,"uris":["http://zotero.org/users/961722/items/3XHKTA39"],"uri":["http://zotero.org/users/961722/items/3XHKTA39"],"itemData":{"id":62,"type":"article-journal","title":"Prevalence and incidence of adults consulting for shoulder conditions in UK primary care; patterns of diagnosis and referral","container-title":"Rheumatology","page":"215-221","volume":"45","issue":"2","source":"rheumatology.oxfordjournals.org","abstract":"Objectives. To estimate the national prevalence and incidence of adults consulting for a shoulder condition and to investigate patterns of diagnosis, treatment, consultation and referral 3 yr after initial presentation.\nMethods. Prevalence and incidence rates were estimated for 658469 patients aged 18 and over in the year 2000 using a primary care database, the IMS Disease Analyzer�Mediplus UK. A cohort of 9215 incident cases was followed-up prospectively for 3 yr beyond the initial consultation.\nResults. The annual prevalence and incidence of people consulting for a shoulder condition was 2.36% [95% confidence interval (CI) 2.32�2.40%] and 1.47% (95% CI 1.44�1.50%), respectively. Prevalence increased linearly with age whilst incidence peaked at around 50 yr then remained static at around 2%. Around half of the incident cases consulted once only, while 13.6% were still consulting with a shoulder problem during the third year of follow-up. During the 3 yr following initial presentation, 22.4% of patients were referred to secondary care, 30.8% were prescribed non-steroidal anti-inflammatory drugs and 10.6% were given an injection by their general practitioner (GP). GPs tended to use a limited number of generalized codes when recording a diagnosis; just five of 426 possible Read codes relating to shoulder conditions accounted for 74.6% of the diagnoses of new cases recorded by GPs.\nConclusions. The prevalence of people consulting for shoulder problems in primary care is substantially lower than community-based estimates of shoulder pain. Most referrals occur within 3 months of initial presentation, but only a minority of patients are referred to orthopaedic specialists or rheumatologists. GPs may lack confidence in applying precise diagnoses to shoulder conditions.","DOI":"10.1093/rheumatology/kei139","ISSN":"1462-0324, 1462-0332","note":"PMID: 16263781","journalAbbreviation":"Rheumatology","language":"en","author":[{"family":"Linsell","given":"L."},{"family":"Dawson","given":"J."},{"family":"Zondervan","given":"K."},{"family":"Rose","given":"P."},{"family":"Randall","given":"T."},{"family":"Fitzpatrick","given":"R."},{"family":"Carr","given":"A."}],"issued":{"date-parts":[["2006",2,1]]},"accessed":{"date-parts":[["2014",3,29]]},"PMID":"16263781"}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 5,8,11,14,15,20. When using taping techniques, researchers have demonstrated that taping effectively improved joint stability by biomechanically creating realignment of the glenohumeral joint and scapula, with resultant increase in shoulder range of motion and reduced pain in the shoulder  ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1b4i00k0mm","properties":{"formattedCitation":"{\\rtf \\super 3,13,18,29,34,37\\nosupersub{}}","plainCitation":"3,13,18,29,34,37"},"citationItems":[{"id":908,"uris":["http://zotero.org/users/961722/items/ZDFNDWQ5"],"uri":["http://zotero.org/users/961722/items/ZDFNDWQ5"],"itemData":{"id":908,"type":"article-journal","title":"Subacromial impingement syndrome: The role of posture and muscle imbalance","container-title":"Journal of Shoulder and Elbow Surgery","page":"385-392","volume":"14","issue":"4","source":"ScienceDirect","abstract":"Changes in upper body posture, colloquially termed forward head posture (FHP), are considered to be an etiologic factor in the pathogenesis of subacromial impingement syndrome (SIS). The literature suggests that postural deviations associated with FHP follow distinct patterns involving an increase in the thoracic kyphosis angle and a downwardly rotated, anteriorly tilted, and protracted scapula, which in turn leads to increased compression in the subacromial space. These postural changes are thought to occur concurrently with an imbalance of the musculature, and conservative rehabilitation commonly involves addressing both posture and muscle imbalance. There is a paucity of evidence supporting the hypothesis that posture and muscle imbalance are involved in the etiology of SIS. The purpose of this study was to investigate whether FHP was associated with an increased thoracic kyphosis, an altered position of the scapula; and a reduction in glenohumeral elevation range. Selected sagittal and frontal plane postural measurements were made in 60 asymptomatic subjects and 60 subjects with SIS. The findings suggested that upper body posture does not follow the set patterns described in the literature, and further research is required to determine whether upper body and scapular posture and muscle imbalance are involved in the pathogenesis of SIS.","DOI":"10.1016/j.jse.2004.08.007","ISSN":"1058-2746","shortTitle":"Subacromial impingement syndrome","author":[{"family":"Lewis","given":"Jeremy S."},{"family":"Green","given":"Ann"},{"family":"Wright","given":"Christine"}],"issued":{"date-parts":[["2005",7]]}}},{"id":119,"uris":["http://zotero.org/users/961722/items/65S9KRIB"],"uri":["http://zotero.org/users/961722/items/65S9KRIB"],"itemData":{"id":119,"type":"article-journal","title":"Scapular Taping in the Treatment of Anterior Shoulder Impingement","container-title":"Physical Therapy","page":"803-812","volume":"75","issue":"9","source":"ptjournal.apta.org","ISSN":"0031-9023, 1538-6724","journalAbbreviation":"Physical Therapy","language":"en","author":[{"family":"Host","given":"Helen H."}],"issued":{"date-parts":[["1995",9,1]]},"accessed":{"date-parts":[["2012",8,23]]}}},{"id":503,"uris":["http://zotero.org/users/961722/items/ITEPHPBP"],"uri":["http://zotero.org/users/961722/items/ITEPHPBP"],"itemData":{"id":503,"type":"article-journal","title":"Effects of Taping on Pain and Function in Patellofemoral Pain Syndrome: A Randomized Controlled Trial","container-title":"Journal of Orthopaedic & Sports Physical Therapy","page":"504-510","volume":"34","issue":"9","source":"CrossRef","DOI":"10.2519/jospt.2004.34.9.504","ISSN":"0190-6011, 1938-1344","shortTitle":"Effects of Taping on Pain and Function in Patellofemoral Pain Syndrome","language":"en","author":[{"family":"Whittingham","given":"Martin"},{"family":"Palmer","given":"Shea"},{"family":"Macmillan","given":"Fiona"}],"issued":{"date-parts":[["2004",9]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":248,"uris":["http://zotero.org/users/961722/items/AGVIMSAN"],"uri":["http://zotero.org/users/961722/items/AGVIMSAN"],"itemData":{"id":248,"type":"article-journal","title":"Scapular taping alters kinematics in asymptomatic subjects","container-title":"Journal of Electromyography and Kinesiology","page":"326-333","volume":"23","issue":"2","source":"ScienceDirect","abstract":"Scapular taping is frequently used in the management of shoulder pain and as a part of injury prevention strategies in sports. It is believed to alter scapular kinematics and restore normal motion. However, there is little evidence to support its use. The aim of the study was to investigate the effect of shoulder taping on the scapular kinematics of asymptomatic subjects.\nThirteen asymptomatic subjects performed elevations in the sagittal and scapular planes with no tape and after the application of tape. A motion tracking system and a scapula locator method were used to measure the shoulder movement. Co-ordinate frames were defined for the thorax, humerus and scapula and Euler angles were used to calculate joints rotations.\nScapular taping increased the scapular external and upward rotations and posterior tilt in elevations in the sagittal plane (p < 0.001). In the scapular plane, taping increased scapular external rotation (p < 0.05).\nTaping affects scapulothoracic kinematics in asymptomatic subjects. The effect may be different for different planes of movement. The findings have implications on the use of taping as a preventive measure in high-risk groups. Further work is needed to assess the effect of taping on symptomatic populations.","DOI":"10.1016/j.jelekin.2012.11.005","ISSN":"1050-6411","journalAbbreviation":"Journal of Electromyography and Kinesiology","author":[{"family":"Shaheen","given":"Aliah F."},{"family":"Villa","given":"Coralie"},{"family":"Lee","given":"Yen-Ni"},{"family":"Bull","given":"Anthony M. J."},{"family":"Alexander","given":"Caroline M."}],"issued":{"date-parts":[["2013",4]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":497,"uris":["http://zotero.org/users/961722/items/IIWSX7GF"],"uri":["http://zotero.org/users/961722/items/IIWSX7GF"],"itemData":{"id":497,"type":"article-journal","title":"The Clinical Efficacy of Kinesio Tape for Shoulder Pain: A Randomized, Double-Blinded, Clinical Trial","container-title":"Journal of Orthopaedic & Sports Physical Therapy","page":"389-395","volume":"38","issue":"7","source":"CrossRef","DOI":"10.2519/jospt.2008.2791","ISSN":"0190-6011, 1938-1344","shortTitle":"The Clinical Efficacy of Kinesio Tape for Shoulder Pain","language":"en","author":[{"family":"Thelen","given":"Mark D."},{"family":"Dauber","given":"James A."},{"family":"Stoneman","given":"Paul D."}],"issued":{"date-parts":[["2008",7]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":469,"uris":["http://zotero.org/users/961722/items/HDUFCSIP"],"uri":["http://zotero.org/users/961722/items/HDUFCSIP"],"itemData":{"id":469,"type":"article-journal","title":"The role of physiotherapy in the prevention and treatment of osteoporosis","container-title":"Manual Therapy","page":"198-213","volume":"5","issue":"4","source":"ScienceDirect","abstract":"Osteoporosis is an increasing public health problem that causes loss of life and reduced quality of life in sufferers. Strategies to improve bone density and reduce the likelihood of falls are important in the prevention of osteoporosis. Physiotherapists have a role to play in this condition through exercise prescription, therapeutic modalities, specific techniques and education. Appropriate treatment goals can be established following a thorough assessment of signs and symptoms, risk factors for osteoporosis and functional status. Levels of bone density measured from dual energy X-ray absorptiometry can help guide patient management. Since the aim is to maximize peak bone mass in children and adolescents, participation in a variety of high-impact activities should be encouraged. In the middle adult years, small increases in bone mass may be achieved by structured weight-training and weight-bearing exercise. In the older adult years, particularly if osteopenia or osteoporosis is present, the aim is to conserve bone mass, reduce the risk of falls, promote extended posture, reduce pain, and improve mobility and function.","DOI":"10.1054/math.2000.0369","ISSN":"1356-689X","journalAbbreviation":"Manual Therapy","author":[{"family":"Bennell","given":"Kim"},{"family":"Khan","given":"Karim"},{"family":"McKay","given":"Heather"}],"issued":{"date-parts":[["2000",11]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 3,13,18,29,34,37. The underlying mechanism responsible for the effect of taping is not fully understood. It is postulated that taping enhances muscle force production by altering the length-tension relationship of muscles ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"250o13u9mn","properties":{"formattedCitation":"{\\rtf \\super 13,26\\nosupersub{}}","plainCitation":"13,26"},"citationItems":[{"id":119,"uris":["http://zotero.org/users/961722/items/65S9KRIB"],"uri":["http://zotero.org/users/961722/items/65S9KRIB"],"itemData":{"id":119,"type":"article-journal","title":"Scapular Taping in the Treatment of Anterior Shoulder Impingement","container-title":"Physical Therapy","page":"803-812","volume":"75","issue":"9","source":"ptjournal.apta.org","ISSN":"0031-9023, 1538-6724","journalAbbreviation":"Physical Therapy","language":"en","author":[{"family":"Host","given":"Helen H."}],"issued":{"date-parts":[["1995",9,1]]},"accessed":{"date-parts":[["2012",8,23]]}}},{"id":99,"uris":["http://zotero.org/users/961722/items/5BGZS43W"],"uri":["http://zotero.org/users/961722/items/5BGZS43W"],"itemData":{"id":99,"type":"article-journal","title":"Manual landmark identification and tracking during the medial rotation test of the shoulder: An accuracy study using three-dimensional ultrasound and motion analysis measures","container-title":"Manual Therapy","page":"529-535","volume":"13","issue":"6","source":"ScienceDirect","abstract":"Palpation of movement is a common clinical tool for assessment of movement in patients with musculoskeletal symptoms. The purpose of this study was to measure the accuracy of palpation of shoulder girdle translation during the medial rotation test (MRT) of the shoulder. The translation of the gleno-humeral and scapulo-thoracic joints was measured using both three-dimensional ultrasound and palpation in order to determine the accuracy of translation tracking during the MRT of the shoulder. Two movements of 11 normal subjects (mean age 24 (SD=4), range 19�47 years) were measured. The agreement between measures was good for scapulo-thoracic translation (r=0.83). Gleno-humeral translation was systematically under estimated (p=0.03) although moderate correlation was found (r=0.65). These results indicate that translation of the measured joints can be tracked by palpation and further tests of the efficacy of palpation tracking during musculoskeletal assessment may be warranted.","DOI":"10.1016/j.math.2007.07.009","ISSN":"1356-689X","shortTitle":"Manual landmark identification and tracking during the medial rotation test of the shoulder","journalAbbreviation":"Manual Therapy","author":[{"family":"Morrissey","given":"D."},{"family":"Morrissey","given":"M. C."},{"family":"Driver","given":"W."},{"family":"King","given":"J. B."},{"family":"Woledge","given":"R. C."}],"issued":{"date-parts":[["2008",12]]},"accessed":{"date-parts":[["2014",3,28]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 13,26. Another view is that taping works by offering constant proprioceptive feedback during dynamic movements ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1CtOjRuT","properties":{"formattedCitation":"{\\rtf \\super 1,2\\nosupersub{}}","plainCitation":"1,2"},"citationItems":[{"id":2585,"uris":["http://zotero.org/users/961722/items/W7MFPGS3"],"uri":["http://zotero.org/users/961722/items/W7MFPGS3"],"itemData":{"id":2585,"type":"article-journal","title":"The effect of scapula taping on electromyographic activity and musical performance in professional violinists","container-title":"Australian Journal of Physiotherapy","page":"197-203","volume":"48","issue":"3","source":"ScienceDirect","abstract":"Taping the scapula has been suggested as a method of improving both scapula position and muscular efficiency of the shoulder girdle. These factors have been linked to neck and arm problems in violinists. The purpose of this study was to evaluate the effects of taping the scapulae of violinists into a position that prevented excessive elevation and protraction whilst playing. Eight professional violinists played three different musical excerpts with and without scapula taping applied in random order. Electromyographic activity was recorded from the upper trapezii, the scapula retractors and the right sternocleidomastoid muscles. Performances were recorded onto videotape and audiocassette, and self-report data collected for later analysis. Compared with the control condition, scapula taping increased electromyographic activity in the left upper trapezius muscle during playing by 49% as an overall effect, with a 60% increase in the most physically demanding piece played. Lower music quality was detected in the same piece by raters blinded to performance conditions. Taping also had significant negative effects on subjects� reports of concentration and comfort. Short-term application of scapula taping did not enhance selected scapula stabilising muscles during playing and was not well tolerated by professional violinists.","DOI":"10.1016/S0004-9514(14)60224-5","ISSN":"0004-9514","journalAbbreviation":"Australian Journal of Physiotherapy","author":[{"family":"Ackermann","given":"Bronwen"},{"family":"Adams","given":"Roger"},{"family":"Marshall","given":"Elfreda"}],"issued":{"date-parts":[["2002"]]},"accessed":{"date-parts":[["2014",11,21]]}}},{"id":913,"uris":["http://zotero.org/users/961722/items/ZHKG5ENV"],"uri":["http://zotero.org/users/961722/items/ZHKG5ENV"],"itemData":{"id":913,"type":"article-journal","title":"Does tape facilitate or inhibit the lower fibres of trapezius?","container-title":"Manual Therapy","page":"37-41","volume":"8","issue":"1","source":"ScienceDirect","abstract":"The application of tape to the skin overlying the lower fibres of trapezius is generally thought to facilitate this muscle. However, this facilitation has not been thoroughly investigated. In this study, the effect of tape upon trapezius motoneurone pool excitability was assessed using the trapezius H reflex. The amplitude of the H reflex was measured across four conditions: before tape application, with Endura Fix tape, with the addition of Endura Sports tape and finally with the tape removed. Instead of the expected facilitation of lower trapezius, this tape inhibited lower trapezius activity. On average, the application of Endura Fix tape inhibited trapezius by 4%. The application of Endura Sports tape overlaying the Endura Fix tape inhibited trapezius on average by 22%. This inhibition did not last once the tape was removed. This suggests that any change in shoulder girdle symptoms or movement, which occurs with the application of this particular tape is not explicable on the basis of the facilitation of the lower fibres of trapezius.","DOI":"10.1054/math.2002.0485","ISSN":"1356-689X","journalAbbreviation":"Manual Therapy","author":[{"family":"Alexander","given":"C. M"},{"family":"Stynes","given":"S"},{"family":"Thomas","given":"A"},{"family":"Lewis","given":"J"},{"family":"Harrison","given":"P. J"}],"issued":{"date-parts":[["2003",2]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 1,2. It is also possible that rigid taping passively repositions the scapula. Further debate exists as to which taping techniques are best suited to particular shoulder conditions. Considerable literature exists  ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Tfhfmohl","properties":{"formattedCitation":"{\\rtf \\super 1,2,14,19,27\\uc0\\u8211{}30,34\\nosupersub{}}","plainCitation":"1,2,14,19,27�30,34"},"citationItems":[{"id":2585,"uris":["http://zotero.org/users/961722/items/W7MFPGS3"],"uri":["http://zotero.org/users/961722/items/W7MFPGS3"],"itemData":{"id":2585,"type":"article-journal","title":"The effect of scapula taping on electromyographic activity and musical performance in professional violinists","container-title":"Australian Journal of Physiotherapy","page":"197-203","volume":"48","issue":"3","source":"ScienceDirect","abstract":"Taping the scapula has been suggested as a method of improving both scapula position and muscular efficiency of the shoulder girdle. These factors have been linked to neck and arm problems in violinists. The purpose of this study was to evaluate the effects of taping the scapulae of violinists into a position that prevented excessive elevation and protraction whilst playing. Eight professional violinists played three different musical excerpts with and without scapula taping applied in random order. Electromyographic activity was recorded from the upper trapezii, the scapula retractors and the right sternocleidomastoid muscles. Performances were recorded onto videotape and audiocassette, and self-report data collected for later analysis. Compared with the control condition, scapula taping increased electromyographic activity in the left upper trapezius muscle during playing by 49% as an overall effect, with a 60% increase in the most physically demanding piece played. Lower music quality was detected in the same piece by raters blinded to performance conditions. Taping also had significant negative effects on subjects� reports of concentration and comfort. Short-term application of scapula taping did not enhance selected scapula stabilising muscles during playing and was not well tolerated by professional violinists.","DOI":"10.1016/S0004-9514(14)60224-5","ISSN":"0004-9514","journalAbbreviation":"Australian Journal of Physiotherapy","author":[{"family":"Ackermann","given":"Bronwen"},{"family":"Adams","given":"Roger"},{"family":"Marshall","given":"Elfreda"}],"issued":{"date-parts":[["2002"]]},"accessed":{"date-parts":[["2014",11,21]]}}},{"id":913,"uris":["http://zotero.org/users/961722/items/ZHKG5ENV"],"uri":["http://zotero.org/users/961722/items/ZHKG5ENV"],"itemData":{"id":913,"type":"article-journal","title":"Does tape facilitate or inhibit the lower fibres of trapezius?","container-title":"Manual Therapy","page":"37-41","volume":"8","issue":"1","source":"ScienceDirect","abstract":"The application of tape to the skin overlying the lower fibres of trapezius is generally thought to facilitate this muscle. However, this facilitation has not been thoroughly investigated. In this study, the effect of tape upon trapezius motoneurone pool excitability was assessed using the trapezius H reflex. The amplitude of the H reflex was measured across four conditions: before tape application, with Endura Fix tape, with the addition of Endura Sports tape and finally with the tape removed. Instead of the expected facilitation of lower trapezius, this tape inhibited lower trapezius activity. On average, the application of Endura Fix tape inhibited trapezius by 4%. The application of Endura Sports tape overlaying the Endura Fix tape inhibited trapezius on average by 22%. This inhibition did not last once the tape was removed. This suggests that any change in shoulder girdle symptoms or movement, which occurs with the application of this particular tape is not explicable on the basis of the facilitation of the lower fibres of trapezius.","DOI":"10.1054/math.2002.0485","ISSN":"1356-689X","journalAbbreviation":"Manual Therapy","author":[{"family":"Alexander","given":"C. M"},{"family":"Stynes","given":"S"},{"family":"Thomas","given":"A"},{"family":"Lewis","given":"J"},{"family":"Harrison","given":"P. J"}],"issued":{"date-parts":[["2003",2]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":736,"uris":["http://zotero.org/users/961722/items/T7HNXC73"],"uri":["http://zotero.org/users/961722/items/T7HNXC73"],"itemData":{"id":736,"type":"article-journal","title":"The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome","container-title":"Journal of Electromyography and Kinesiology","page":"1092-1099","volume":"19","issue":"6","source":"CrossRef","DOI":"10.1016/j.jelekin.2008.11.003","ISSN":"10506411","author":[{"family":"Hsu","given":"Yin-Hsin"},{"family":"Chen","given":"Wen-Yin"},{"family":"Lin","given":"Hsiu-Chen"},{"family":"Wang","given":"Wendy T.J."},{"family":"Shih","given":"Yi-Fen"}],"issued":{"date-parts":[["2009",12]]},"accessed":{"date-parts":[["2012",5,9]]}}},{"id":602,"uris":["http://zotero.org/users/961722/items/NMCUW773"],"uri":["http://zotero.org/users/961722/items/NMCUW773"],"itemData":{"id":602,"type":"article-journal","title":"The effects of scapular taping on electromyographic muscle activity and proprioception feedback in healthy shoulders","container-title":"Journal of Orthopaedic Research","page":"53-57","volume":"29","issue":"1","source":"Wiley Online Library","abstract":"We investigated the effects of scapular tape on the electromyographic (EMG) activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), anterior deltoid (AD), and shoulder proprioception in 12 healthy shoulders. Participants were blindfolded and required to complete a target end/mid range position with the hand. They performed six trials under two experimental conditions; no tape and therapeutic tape. EMG activity was measured by surface electrodes, and proprioception was measured by the FASTRAK electromagnetic motion tracking system. Two-way repeated measures ANOVA showed that UT and AD activities decreased 2.65% (p	 =	 0.001), and SA muscular activities increased 1.9% (p	 =	 0.015) in the taping condition. The proprioceptive feedback magnitude was significantly lower in the taping condition than in the no taping condition (11.9�, p	 <	 0.005). Additionally, correlation coefficients were higher than 0.5 between muscle activity and proprioceptive feedback with the taping condition; UT and magnitude in the mid range task (R	 =	 0.516); LT and magnitude in the end range task (R	 =	 "0.524); and SA and magnitude in the mid range task (R	 =	 "0.576). The results suggest that scapular tape affects the muscle activity of UT, AD, and SA, and that the effects are related to proprioception feedback. These results implicate that the mechanisms by which scapular taping induces effects can be explained by neuromuscular control and proprioceptive feedback factors. � 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:53�57, 2011","DOI":"10.1002/jor.21146","ISSN":"1554-527X","journalAbbreviation":"J. Orthop. Res.","language":"en","author":[{"family":"Lin","given":"Jiu-jenq"},{"family":"Hung","given":"Cheng-Ju"},{"family":"Yang","given":"Pey-Lin"}],"issued":{"date-parts":[["2011",1,1]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":63,"uris":["http://zotero.org/users/961722/items/3Z2H3F6H"],"uri":["http://zotero.org/users/961722/items/3Z2H3F6H"],"itemData":{"id":63,"type":"article-journal","title":"Validity and Reproducibility of the Measurements Obtained Using the Flexicurve Instrument to Evaluate the Angles of Thoracic and Lumbar Curvatures of the Spine in the Sagittal Plane","container-title":"Rehabilitation Research and Practice","page":"1-9","volume":"2012","source":"CrossRef","DOI":"10.1155/2012/186156","ISSN":"2090-2867, 2090-2875","author":[{"family":"de Oliveira","given":"Tatiana Scheeren"},{"family":"Candotti","given":"Cl�udia Tarrag�"},{"family":"La Torre","given":"Marcelo"},{"family":"Pelinson","given":"Patricia Paula Tonin"},{"family":"Furlanetto","given":"T�ssia Silveira"},{"family":"Kutchak","given":"Fernanda Machado"},{"family":"Loss","given":"Jefferson Fagundes"}],"issued":{"date-parts":[["2012"]]},"accessed":{"date-parts":[["2013",2,21]]}}},{"id":547,"uris":["http://zotero.org/users/961722/items/KCAZP79A"],"uri":["http://zotero.org/users/961722/items/KCAZP79A"],"itemData":{"id":547,"type":"article-journal","title":"The Effects of Scapular Taping on the Surface Electromyographic Signal Amplitude of Shoulder Girdle Muscles During Upper Extremity Elevation in Individuals With Suspected Shoulder Impingement Syndrome","container-title":"Journal of Orthopaedic & Sports Physical Therapy","page":"694-702","volume":"37","issue":"11","source":"CrossRef","DOI":"10.2519/jospt.2007.2467","ISSN":"0190-6011, 1938-1344","language":"en","author":[{"family":"Selkowitz","given":"David M."},{"family":"Chaney","given":"Casey"},{"family":"Stuckey","given":"Sandra J."},{"family":"Vlad","given":"Georgeanne"}],"issued":{"date-parts":[["2007",11]]},"accessed":{"date-parts":[["2014",3,28]]}}},{"id":248,"uris":["http://zotero.org/users/961722/items/AGVIMSAN"],"uri":["http://zotero.org/users/961722/items/AGVIMSAN"],"itemData":{"id":248,"type":"article-journal","title":"Scapular taping alters kinematics in asymptomatic subjects","container-title":"Journal of Electromyography and Kinesiology","page":"326-333","volume":"23","issue":"2","source":"ScienceDirect","abstract":"Scapular taping is frequently used in the management of shoulder pain and as a part of injury prevention strategies in sports. It is believed to alter scapular kinematics and restore normal motion. However, there is little evidence to support its use. The aim of the study was to investigate the effect of shoulder taping on the scapular kinematics of asymptomatic subjects.\nThirteen asymptomatic subjects performed elevations in the sagittal and scapular planes with no tape and after the application of tape. A motion tracking system and a scapula locator method were used to measure the shoulder movement. Co-ordinate frames were defined for the thorax, humerus and scapula and Euler angles were used to calculate joints rotations.\nScapular taping increased the scapular external and upward rotations and posterior tilt in elevations in the sagittal plane (p < 0.001). In the scapular plane, taping increased scapular external rotation (p < 0.05).\nTaping affects scapulothoracic kinematics in asymptomatic subjects. The effect may be different for different planes of movement. The findings have implications on the use of taping as a preventive measure in high-risk groups. Further work is needed to assess the effect of taping on symptomatic populations.","DOI":"10.1016/j.jelekin.2012.11.005","ISSN":"1050-6411","journalAbbreviation":"Journal of Electromyography and Kinesiology","author":[{"family":"Shaheen","given":"Aliah F."},{"family":"Villa","given":"Coralie"},{"family":"Lee","given":"Yen-Ni"},{"family":"Bull","given":"Anthony M. J."},{"family":"Alexander","given":"Caroline M."}],"issued":{"date-parts":[["2013",4]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":641,"uris":["http://zotero.org/users/961722/items/Q45U4BEM"],"uri":["http://zotero.org/users/961722/items/Q45U4BEM"],"itemData":{"id":641,"type":"article-journal","title":"Clinical effectiveness of kinesiological taping on pain and pain-free shoulder range of motion in patients with shoulder impingement syndrome: a randomised, double blinded, placebo-controlled trial","container-title":"International Journal of Sports Physical Therapy","page":"800-810","volume":"8","issue":"6","source":"PubMed Central","abstract":"Background:\nKinesiological taping (KT) is commonly used to improve symptoms associated with musculoskeletal disorders. However, review of the literature revealed minimal evidence to support the use of KT in treatment of shoulder disorders and controversy exists regarding the effect of KT in patients with shoulder impingement syndrome (SIS).\n\nObjective:\nThe purpose of this study was to investigate the effect of KT on pain intensity during movement, pain experienced during the night (nocturnal pain), and pain free shoulder range of motion (ROM) immediately after taping, after three days and after one week, in patients with SIS.\n\nDesign:\nRandomized, Double blinded, Placebo controlled design.\n\nParticipants:\nA total of 30 patients with SIS participated in this study. Patients were assigned randomly to a control (N = 15) and an experimental group (N = 15).\n\nMethods:\nThe patients in the experimental group received a standardized therapeutic KT. The standardized, placebo neutral KT was applied for control group. KT was applied two times with a three day interval, remaining on during the 3 day interval. Both groups followed the same procedures. Pain free active ROM during shoulder abduction, flexion, and elevation in the scapular plane was measured. Visual analogue scale (VAS) for pain intensity during movement or nocturnal pain and was assessed at baseline, immediately after KT, after three days, and one week after KT.\n\nResults:\nThe result of repeated measures ANOVA showed a significant change in pain level during movement, nocturnal pain, and pain free ROM (p = 0.000) after KT in the experimental group. In the ANCOVA, controlling for pre test scores, change in pain level at movement (p = 0.009) and nocturnal pain (p = 0.04) immediately after KT was significantly greater in the experimental group than in control group. There was no significant difference in ROM measures (p > 0.05) between groups immediately after KT. No significant differences were found between the two groups in the after one week measurements of pain intensity and shoulder ROM.\n\nConclusion:\nThe KT produces an immediate improvement in the pain intensity at movement and nocturnal pain in patients with SIS.\n\nLevel of Evidence:\n1","ISSN":"2159-2896","note":"PMID: 24377066\nPMCID: PMC3867073","shortTitle":"CLINICAL EFFECTIVENESS OF KINESIOLOGICAL TAPING ON PAIN AND PAIN-FREE SHOULDER RANGE OF MOTION IN PATIENTS WITH SHOULDER IMPINGEMENT SYNDROME","journalAbbreviation":"Int J Sports Phys Ther","author":[{"family":"Shakeri","given":"Hassan"},{"family":"Keshavarz","given":"Roshanak"},{"family":"Arab","given":"Amir Massoud"},{"family":"Ebrahimi","given":"Ismaeil"}],"issued":{"date-parts":[["2013",12]]},"accessed":{"date-parts":[["2014",3,29]]},"PMID":"24377066","PMCID":"PMC3867073"}},{"id":497,"uris":["http://zotero.org/users/961722/items/IIWSX7GF"],"uri":["http://zotero.org/users/961722/items/IIWSX7GF"],"itemData":{"id":497,"type":"article-journal","title":"The Clinical Efficacy of Kinesio Tape for Shoulder Pain: A Randomized, Double-Blinded, Clinical Trial","container-title":"Journal of Orthopaedic & Sports Physical Therapy","page":"389-395","volume":"38","issue":"7","source":"CrossRef","DOI":"10.2519/jospt.2008.2791","ISSN":"0190-6011, 1938-1344","shortTitle":"The Clinical Efficacy of Kinesio Tape for Shoulder Pain","language":"en","author":[{"family":"Thelen","given":"Mark D."},{"family":"Dauber","given":"James A."},{"family":"Stoneman","given":"Paul D."}],"issued":{"date-parts":[["2008",7]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 1,2,14,19,27�30,34 related to a variety of taping techniques frequently used in clinical practice and considered to improve symptoms in various shoulder conditions. However, there has been little research undertaken to determine the effect of taping on the acromio-humeral distance (AHD). A previous study investigated the effect of taping on AHD: this study conducted by Luque-Saurez et al., (2013), investigated the effectiveness of kinesiotaping. The results demonstrate that there was an increase in acromio-humeral distance immediately after the application of kinesiotaping in healthy participants.

The subacromial space can be evaluated by measuring acromio-humeral distance (AHD) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"2cvn4s4740","properties":{"formattedCitation":"{\\rtf \\super 23\\nosupersub{}}","plainCitation":"23"},"citationItems":[{"id":860,"uris":["http://zotero.org/users/961722/items/WWE6NGAS"],"uri":["http://zotero.org/users/961722/items/WWE6NGAS"],"itemData":{"id":860,"type":"article-journal","title":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects: A randomised controlled trial","container-title":"Manual Therapy","page":"573-577","volume":"18","issue":"6","source":"ScienceDirect","abstract":"The first aim of this study was to investigate whether kinesiotaping (KT) can increase the acromiohumeral distance (AHD) in asymptomatic subjects in the short term. The second aim was to investigate whether the direction of kinesiotaping application influences AHD.\nIn recent years, the use of KT has become increasingly popular for a range of musculoskeletal conditions and for sport injuries. To date, we are unaware of any research investigating the effect of kinesiotaping on AHD. Moreover, it is unknown whether the direction of kinesiotaping application for the shoulder is important.\nForty nine participants were randomly assigned to one of three groups: kinesiotaping group 1 (KT1), kinesiotaping group 2 (KT2) and sham kinesiotaping (KT3). AHD ultrasound measurements at 0� and 60� of shoulder elevation were collected at baseline and immediately after kinesiotape application.\nThe results showed significant improvements in AHD after kinesiotaping, compared with sham taping. The mean difference in AHD between KT1 and KT3 groups was 1.28 mm (95% CI: 0.55, 2.03), and between KT2 and KT3 was 0.98 mm (95% CI: 0.23, 1.74). Comparison of KT1 and KT2 groups, which was performed to identify whether the direction of taping influences the AHD, indicated there were no significant differences.\nKT increases AHD in healthy individuals immediately following application, compared with sham kinesiotape. No differences were found with respect to the direction in which KT was applied.","DOI":"10.1016/j.math.2013.06.002","ISSN":"1356-689X","shortTitle":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects","journalAbbreviation":"Manual Therapy","author":[{"family":"Luque-Suarez","given":"A."},{"family":"Navarro-Ledesma","given":"S."},{"family":"Petocz","given":"P."},{"family":"Hancock","given":"M. J."},{"family":"Hush","given":"J."}],"issued":{"date-parts":[["2013",12]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 23,  a two-dimensional linear measure of the smallest distance between the under surface of the acromion and the most anterior part of the humerus ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"p7rvtSoH","properties":{"formattedCitation":"{\\rtf \\super 8,12,36\\nosupersub{}}","plainCitation":"8,12,36"},"citationItems":[{"id":822,"uris":["http://zotero.org/users/961722/items/VTNNMBZE"],"uri":["http://zotero.org/users/961722/items/VTNNMBZE"],"itemData":{"id":822,"type":"article-journal","title":"Scapular behavior in shoulder impingement syndrome","container-title":"Archives of Physical Medicine and Rehabilitation","page":"60-69","volume":"83","issue":"1","source":"ScienceDirect","abstract":"H[eacute]bert LJ, Moffet H, McFadyen BJ, Dionne CE. Scapular behavior in shoulder impingement syndrome. Arch Phys Med Rehabil 2002;83;60-9. Objective: To quantify the contribution of each scapular rotation to the scapular total range of motion (ROM) in both shoulders of persons with a unilateral shoulder impingement syndrome (SIS), to compare 3-dimensional (3D) scapular attitudes of their symptomatic and asymptomatic shoulders in flexion and in abduction, and to characterize the scapular behavior of these subjects by classifying them into subgroups based on scapular tilting differences between their symptomatic and asymptomatic shoulders. Design: Comparisons of 3D scapular attitudes, scapular total ROM, and percentage of contributions of each scapular rotation to the scapular total ROM. Setting: A motricity laboratory. Participants: Fifty-one subjects, including 41 with a SIS (29 had an asymptomatic contralateral shoulder) and 10 healthy subjects. Interventions: The 3D scapular attitudes were calculated with the subjects in a standardized seated position; with the arm at rest; or at 70[deg ], 90[deg ], and 110[deg ] of shoulder flexion and abduction. Axial rotation angles were calculated using a fixed set of Cardanic angles. Main Outcome Measures: At 90[deg ] of arm elevation, data from 10 shoulders of healthy subjects were used to set up normative values (99% confidence interval of mean 3D scapular attitudes) to compare with 3D scapular attitudes of symptomatic and asymptomatic shoulders of SIS subjects. We analyzed the scapula behavior of subjects with SIS and classified them into subgroups based on scapular anterior tilting asymmetry. Results: In flexion, almost half of the scapular total ROM was provided by anterior tilting (48.2%-51.3%), whereas in abduction, external rotation (40.3%-42.4%) was the main contributor. Scapular total ROM was higher in abduction than in flexion in all arm positions for both shoulder groups (P [lt ] .01). Also, 3D scapular attitude patterns of both shoulders of SIS subjects were different from those of healthy subjects. At 90[deg ], scapular asymmetry in anterior tilting allowed us to classify SIS subjects with respect to more (lead) or less (lag) scapular tilting in the affected side (P [lt ] .0001) or no difference (P = .11) between the sides (symmetrical). No significant differences (P [gt ] .05), except for a small 2[deg ] difference in transverse rotation during arm flexion at 110[deg ] (P = .002), were observed in 3D scapular attitudes and scapular total ROM between both shoulders of SIS subjects. Patterns of 3D scapular attitudes and scapular total ROM were significantly different between flexion and abduction arm positions (P [lt ] .05). Conclusions: The contribution of rotations and scapular total ROM differed according to the plane of arm elevation in SIS subjects. Group analyses revealed no differences in 3D scapular attitudes between symptomatic and asymptomatic shoulders of subjects with unilateral SIS. This could be caused by the use, in SIS subjects, of inappropriate neuromuscular strategies affecting both shoulders. However, individual analyses revealed scapular asymmetry in the sagittal plane, which suggests that SIS subjects with less anterior tilting in the symptomatic shoulder, as compared with the asymptomatic contralateral one, may be at high risk of developing chronic SIS. This last finding provides scientific evidence to focus rehabilitation protocols toward a restoration of anterior tilting. [copy ] 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation","DOI":"10.1053/apmr.2002.27471","ISSN":"0003-9993","journalAbbreviation":"Archives of Physical Medicine and Rehabilitation","author":[{"family":"Hebert","given":"Luc J."},{"family":"Moffet","given":"H[eacute]l[egrave]ne"},{"family":"McFadyen","given":"Bradford J."},{"family":"Dionne","given":"Clermont E."}],"issued":{"date-parts":[["2002",1]]},"accessed":{"date-parts":[["2012",9,30]]}}},{"id":843,"uris":["http://zotero.org/users/961722/items/WJ629FKM"],"uri":["http://zotero.org/users/961722/items/WJ629FKM"],"itemData":{"id":843,"type":"article-journal","title":"Acromio-Humeral Distance Variation Measured by Ultrasonograp... : Clinical Journal of Sport Medicine","container-title":"Clinical Journal of Sport Medicine","page":"197-205","volume":"14","issue":"4","abstract":"Objective: First, to validate an ultrasonographic measure of the acromio-humeral distance (AHD); second, to compare the AHD variation during active abduction in patients with shoulder impingement syndrome (SIS) and healthy subjects; and third, to evaluate the relationship between functional statu...","DOI":"00042752-200407000-00002","shortTitle":"Acromio-Humeral Distance Variation Measured by Ultrasonograp...","author":[{"family":"Desmeules","given":"F"},{"family":"Minville","given":"L"},{"family":"Riederer","given":"B"},{"family":"C�t�","given":"C"},{"family":"Fr�mont","given":"P"}],"issued":{"date-parts":[["2004",7]]},"accessed":{"date-parts":[["2013",6,27]]}}},{"id":310,"uris":["http://zotero.org/users/961722/items/CDHKTHS4"],"uri":["http://zotero.org/users/961722/items/CDHKTHS4"],"itemData":{"id":310,"type":"article-journal","title":"The Effect of Isometric Shoulder Internal and External Rotation on the Acromiohumeral Distance","container-title":"American Journal of Physical Medicine & Rehabilitation","page":"193-199","volume":"91","issue":"3","source":"CrossRef","DOI":"10.1097/PHM.0b013e31823c74ab","ISSN":"0894-9115","author":[{"family":"White","given":"Conny E."},{"family":"Dedrick","given":"Gregory S."},{"family":"Apte","given":"Gail G."},{"family":"Sizer","given":"Phillip S."},{"family":"Brism�e","given":"Jean-Michel"}],"issued":{"date-parts":[["2012",3]]},"accessed":{"date-parts":[["2012",8,6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 8,12,36. The notion that inadequate subacromial space is primary cause factor of subacromial impingement has been increasingly challenged ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1lo7hkpl00","properties":{"formattedCitation":"{\\rtf \\super 17\\nosupersub{}}","plainCitation":"17"},"citationItems":[{"id":302,"uris":["http://zotero.org/users/961722/items/C732EMV4"],"uri":["http://zotero.org/users/961722/items/C732EMV4"],"itemData":{"id":302,"type":"article-journal","title":"Rotator cuff tendinopathy: a model for the continuum of pathology and related management","container-title":"British Journal of Sports Medicine","page":"918-923","volume":"44","issue":"13","source":"bjsm.bmj.com","abstract":"Background Pathology of the soft tissues of the shoulder including the musculotendinous rotator cuff and subacromial bursa are extremely common and are a principal cause of pain and suffering. Competing theories have been proposed to explain the pathoaetiology of rotator cuff pathology at specific stages and presentations of the condition. This review proposes a model to describe the continuum of the rotator cuff pathology from asymptomatic tendon through full thickness rotator cuff tears.\nConclusions The pathoaetiology of rotator cuff failure is multifactorial and results from a combination of intrinsic, extrinsic and environmental factors. Recently a new and generic model detailing the continuum of tendon pathology has been proposed. This model is relevant for the rotator cuff and provides a framework to stage the continuity of rotator cuff pathology. Furthermore, it provides a structure to identify the substantial deficiencies in our knowledge base and areas where research would improve our understanding of the pathological and repair process, together with assessment and management. The strength of this model adapted for the rotator cuff tendons and subacromial bursa will be tested in its ability to incorporate and adapt to emerging research.","DOI":"10.1136/bjsm.2008.054817","ISSN":", 14730480","note":"PMID: 19364757","shortTitle":"Rotator cuff tendinopathy","journalAbbreviation":"Br J Sports Med","language":"en","author":[{"family":"Lewis","given":"Jeremy S."}],"issued":{"date-parts":[["2010",10,1]]},"accessed":{"date-parts":[["2013",6,27]]},"PMID":"19364757"}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 17. Despite the controversy, reduction in this space is noted in patients with shoulder impingement syndrome ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"23cknmjl7i","properties":{"formattedCitation":"{\\rtf \\super 4,35\\nosupersub{}}","plainCitation":"4,35"},"citationItems":[{"id":315,"uris":["http://zotero.org/users/961722/items/CIQPIB2P"],"uri":["http://zotero.org/users/961722/items/CIQPIB2P"],"itemData":{"id":315,"type":"article-journal","title":"Congenital subacromial stenosis","container-title":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","page":"63-68","volume":"11","issue":"1","source":"ScienceDirect","abstract":"Congenital subacromial stenosis is a previously undescribed entity that causes narrowing of the height of the subacromial space without proximal migration of the humerus. This study comprised 25 shoulders with congenital subacromial stenosis. All patients had either an impingement syndrome or rotator cuff tear. The average acromiohumeral interval was 4.7 mm. Fifteen of the 25 shoulders (60%) had rotator cuff tears. Patients requiring surgery comprised a bimodal age distribution: those with an impingement syndrome requiring decompression had an average age of 42, whereas those with rotator cuff tears requiring surgical treatment had an average age of 66. Study of a separate standard asymptomatic population of 84 patients showed that some younger individuals with congenital subacromial stenosis may be asymptomatic. However, the natural history seems to be a relentless progression to impingement and eventually to complete rotator cuff tear. Therefore, subacromial decompression is recommended in younger symptomatic individuals to prevent later rotator cuff tear.","DOI":"10.1016/0749-8063(95)90090-X","ISSN":"0749-8063","journalAbbreviation":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","author":[{"family":"Burkhart","given":"Stephen S."}],"issued":{"date-parts":[["1995",2]]},"accessed":{"date-parts":[["2013",6,27]]}}},{"id":493,"uris":["http://zotero.org/users/961722/items/ICHXUEIJ"],"uri":["http://zotero.org/users/961722/items/ICHXUEIJ"],"itemData":{"id":493,"type":"article-journal","title":"Intermethod agreement and interobserver correlation of�radiologic acromiohumeral distance measurements","container-title":"Journal of Shoulder and Elbow Surgery","page":"237-240","volume":"17","issue":"2","source":"ScienceDirect","abstract":"The acromiohumeral distance (AHD) measured on conventional, true anteroposterior radiographs taken with the patient standing and the arm held in neutral rotation can predict the presence or absence of a large, chronic rotator cuff tears, and narrowing of the acromiohumeral distance can predict irreparability of rotator cuff tears. The relation between AHD measured on conventional radiographs and the integrity of the rotator cuff tendons is well known. Conversely, the correlation between the AHD on conventional radiographs and that measured on magnetic resonance imaging (MRI) or computed tomography (CT) scans is unknown. It has also not been determined which method correlates better with fatty infiltration of the rotator cuff muscles and might thereby be a better prognostic value for the outcome of rotator cuff repair. Conventional radiographs, plus MRI and or CT studies taken at the same time of patients with rotator cuff tears, shoulder instability, primary glenohumeral osteoarthritis, or idiopathic frozen shoulder, were randomly selected, and the AHD was measured both on conventional radiographs and on MRI or CT. The values were correlated with the stage of fatty degeneration of the rotator cuff muscles in the cases of rotator cuff tears. The AHD on conventional radiographs was larger than on MRI and CT, and correlation of the values measured (conventional radiography vs MRI and CT) could be demonstrated. For rotator cuff diseases, a significant but moderate correlation (r = 0.6; P &lt; .05) between conventional and MRI was identified, and the conventional values were approximately 0.6 mm greater than the corresponding MRI values. It is, therefore, possible to use the AHD read on MRI or CT studies for prognostic reasons, provided the values obtained are converted accordingly and remembering that the correlation of the values is only moderate.","DOI":"10.1016/j.jse.2007.06.002","ISSN":"1058-2746","journalAbbreviation":"Journal of Shoulder and Elbow Surgery","author":[{"family":"Werner","given":"Cl�ment M.L."},{"family":"Conrad","given":"Samuel J."},{"family":"Meyer","given":"Dominik C."},{"family":"Keller","given":"Adreas"},{"family":"Hodler","given":"Juerg"},{"family":"Gerber","given":"Christian"}],"issued":{"date-parts":[["2008",3]]},"accessed":{"date-parts":[["2013",6,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 4,35. Whether subacromial space reduction is cause or consequence is not clear but interventions to increase the space may be therapeutic in pain reduction. The primary aim of the present study was to use RTUS to measure the AHD in order to establish the effect on the AHD when rigid taping was applied to passively reposition the scapula.  The second aim of the study was to compare the effects that each taping technique had on the AHD. 
Method
A one-group pre-post-test repeated measures design was used to compare the effects of taping application on AHD in healthy participants. AHD was measured by one examiner who had had 2 years of experience with ultrasound in research collecting data on the shoulder to quantify the AHD. Real time ultrasound was used to capture the AHD pre and post taping on each participant in 60� passive arm abduction in the coronal plane. Taping techniques were applied by a second investigator who had more than 5 years experience as a musculoskeletal physiotherapist.

A power analysis was carried out using G Power software (version 3.1.7; Heinrich Heine University, Dusseldorf, Germany),   with an effect size of 0.5 ,  a significance level of 0.05, and a statistical power of 0.8, the required sample size was calculated to be sixteen  participants. Twenty participants (10 males and 10 females) were volunteered with a mean age was 27 years (STD = 8.0 years). For inclusion, participants needed to meet the following criteria: have no history of shoulder pain or stiffness six months previous to participation, be between the ages of 18 and 50, have no history of previous fracture or surgery to the shoulder girdle, or any dermatological condition or injury around the shoulder. Approval for the study was received from the Institutional Review Board at the host University, in accordance with the latest revision of the Declaration of Helsinki. 

Participants were seated on a customized armless chair with a short back support for the lumbar region.  The participants� hips and knees were flexed at 90 degrees, and feet rested flat on the floor.  The participant�s arm was passively placed in 60 degrees of passive arm abduction, in the coronal plane and rested on a pre-cut 60 degrees foam wedge, which rested on a table with adjustable height (Figure 1), which could be adjusted according to the participant�s body length thus ensuring that the arm was abducted to 60 degrees without shoulder girdle elevation. Neutral humeral rotation was maintained as the foam wedge supported the humerus and forearm, with 90 degrees of elbow flexion and the participant�s palm resting on the wedge.  The right shoulder of each participant was evaluated.

Three taping techniques were evaluated:  upper trapezius (UT) taping technique, a taping technique proposed to increase posterior scapular tilt and inhibit upper trapezius muscle activity ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LkQU5p8R","properties":{"formattedCitation":"{\\rtf \\super 7,19,32\\nosupersub{}}","plainCitation":"7,19,32"},"citationItems":[{"id":542,"uris":["http://zotero.org/users/961722/items/K7ZUH5X8"],"uri":["http://zotero.org/users/961722/items/K7ZUH5X8"],"itemData":{"id":542,"type":"article-journal","title":"Does taping influence electromyographic muscle activity in the scapular rotators in healthy shoulders?","container-title":"Manual Therapy","page":"154-162","volume":"7","issue":"3","source":"ScienceDirect","abstract":"Although taping techniques are commonly used in addition to exercise programmes in the rehabilitation of shoulder instability and secondary subacromial or internal impingement, few studies exist on the effect of taping on the muscle activity of the scapular rotators. The purpose of our study was to examine the influence of one particular tape on muscular activity in scapular muscles. Twenty healthy shoulders were examined with surface EMG recordings on the three parts of trapezius and serratus anterior muscle during dynamic full range of motion abduction and forward flexion. The movement direction, and tape and no-tape conditions were randomized. The statistical analyses with ANOVA repeated Measures (GLM model) showed significant differences among the means between the four muscles (P&lt;0.05), two movement directions (P&lt;0.05), applied resistance (P&lt;0.01), and movement period (P&lt;0.01). However, no significant difference was observed based on the application of tape. The results of our investigation revealed no significant influence of tape application on EMG activity in the scapular muscles in healthy subjects. Future research will be necessary to examine other parameters of neuromuscular control in order to determine possible proprioceptive changes in muscle recruitment with tape application.","DOI":"10.1054/math.2002.0464","ISSN":"1356-689X","journalAbbreviation":"Manual Therapy","author":[{"family":"Cools","given":"A.M"},{"family":"Witvrouw","given":"E.E"},{"family":"Danneels","given":"L.A"},{"family":"Cambier","given":"D.C"}],"issued":{"date-parts":[["2002",8]]},"accessed":{"date-parts":[["2013",11,11]]}}},{"id":833,"uris":["http://zotero.org/users/961722/items/WATWC4JU"],"uri":["http://zotero.org/users/961722/items/WATWC4JU"],"itemData":{"id":833,"type":"article-journal","title":"Upper and lower trapezius muscle activity in subjects with subacromial impingement symptoms: Is there imbalance and can taping change it?","container-title":"Physical Therapy in Sport","page":"45-50","volume":"10","issue":"2","source":"ScienceDirect","abstract":"To investigate (i) whether subacromial impingement symptoms (SIS) were associated with upper and lower trapezius muscle imbalance and (ii) the effect of a scapula taping technique on upper and lower trapezius muscle activity.\nCross-sectional study with nested within-subject intervention.\nUniversity research laboratory.\nSubjects who demonstrated SIS (n = 16) on clinical testing and an age and gender matched group of asymptomatic subjects (n = 32).\nSurface electromyography (EMG) to measure activity in the upper (UFT) and lower (LFT) fibres of trapezius during repeated humeral elevation in the scapular plane.\nSymptomatic subjects demonstrated a significantly (95% CI 2.13 to 4.17, p = 0.019) higher ratio of UFT:LFT activity than the asymptomatic subjects (95% CI 1.35 to 2.25). With tape in situ the symptomatic subjects demonstrated a significant (95% CI "8.6% to "17.3%, p < 0.001) reduction in UFT activity but no significant (95% CI +2.8% to "17.5%, p = 0.145) change in activity of LFT. No relationship (r = " 0.116, p = 0.669) was found between the degree of underlying muscle imbalance and the reduction in UFT under the taped condition for the symptomatic group.\nSubacromial impingement symptoms are associated with altered upper and lower trapezius muscle activity which can be partially addressed by the application of tape.","DOI":"10.1016/j.ptsp.2008.12.002","ISSN":"1466-853X","shortTitle":"Upper and lower trapezius muscle activity in subjects with subacromial impingement symptoms","journalAbbreviation":"Physical Therapy in Sport","author":[{"family":"Smith","given":"Mike"},{"family":"Sparkes","given":"Valerie"},{"family":"Busse","given":"Monica"},{"family":"Enright","given":"Stephanie"}],"issued":{"date-parts":[["2009",5]]},"accessed":{"date-parts":[["2014",3,28]]}}},{"id":602,"uris":["http://zotero.org/users/961722/items/NMCUW773"],"uri":["http://zotero.org/users/961722/items/NMCUW773"],"itemData":{"id":602,"type":"article-journal","title":"The effects of scapular taping on electromyographic muscle activity and proprioception feedback in healthy shoulders","container-title":"Journal of Orthopaedic Research","page":"53-57","volume":"29","issue":"1","source":"Wiley Online Library","abstract":"We investigated the effects of scapular tape on the electromyographic (EMG) activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), anterior deltoid (AD), and shoulder proprioception in 12 healthy shoulders. Participants were blindfolded and required to complete a target end/mid range position with the hand. They performed six trials under two experimental conditions; no tape and therapeutic tape. EMG activity was measured by surface electrodes, and proprioception was measured by the FASTRAK electromagnetic motion tracking system. Two-way repeated measures ANOVA showed that UT and AD activities decreased 2.65% (p	 =	 0.001), and SA muscular activities increased 1.9% (p	 =	 0.015) in the taping condition. The proprioceptive feedback magnitude was significantly lower in the taping condition than in the no taping condition (11.9�, p	 <	 0.005). Additionally, correlation coefficients were higher than 0.5 between muscle activity and proprioceptive feedback with the taping condition; UT and magnitude in the mid range task (R	 =	 0.516); LT and magnitude in the end range task (R	 =	 "0.524); and SA and magnitude in the mid range task (R	 =	 "0.576). The results suggest that scapular tape affects the muscle activity of UT, AD, and SA, and that the effects are related to proprioception feedback. These results implicate that the mechanisms by which scapular taping induces effects can be explained by neuromuscular control and proprioceptive feedback factors. � 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:53�57, 2011","DOI":"10.1002/jor.21146","ISSN":"1554-527X","journalAbbreviation":"J. Orthop. Res.","language":"en","author":[{"family":"Lin","given":"Jiu-jenq"},{"family":"Hung","given":"Cheng-Ju"},{"family":"Yang","given":"Pey-Lin"}],"issued":{"date-parts":[["2011",1,1]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 7,19,32; serratus anterior (SA) taping technique, a taping technique proposed to increase scapular upward rotation and stimulate serratus anterior muscle activity; and combined UT&SA technique.   Standard 5 cm wide Hypafix tape was used as a base layer, and 3.75cm wide rigid zinc oxide tape was applied over the Hypafix. 

The UT taping technique was applied with the participant�s arm in neutral, the Hypafix tape was applied without any tension starting from the anterior shoulder below the coracoid and over the muscle belly of the upper trapezius (UT) in line with the mid clavicle ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"2f1d3k0u34","properties":{"formattedCitation":"{\\rtf \\super 7\\nosupersub{}}","plainCitation":"7"},"citationItems":[{"id":542,"uris":["http://zotero.org/users/961722/items/K7ZUH5X8"],"uri":["http://zotero.org/users/961722/items/K7ZUH5X8"],"itemData":{"id":542,"type":"article-journal","title":"Does taping influence electromyographic muscle activity in the scapular rotators in healthy shoulders?","container-title":"Manual Therapy","page":"154-162","volume":"7","issue":"3","source":"ScienceDirect","abstract":"Although taping techniques are commonly used in addition to exercise programmes in the rehabilitation of shoulder instability and secondary subacromial or internal impingement, few studies exist on the effect of taping on the muscle activity of the scapular rotators. The purpose of our study was to examine the influence of one particular tape on muscular activity in scapular muscles. Twenty healthy shoulders were examined with surface EMG recordings on the three parts of trapezius and serratus anterior muscle during dynamic full range of motion abduction and forward flexion. The movement direction, and tape and no-tape conditions were randomized. The statistical analyses with ANOVA repeated Measures (GLM model) showed significant differences among the means between the four muscles (P&lt;0.05), two movement directions (P&lt;0.05), applied resistance (P&lt;0.01), and movement period (P&lt;0.01). However, no significant difference was observed based on the application of tape. The results of our investigation revealed no significant influence of tape application on EMG activity in the scapular muscles in healthy subjects. Future research will be necessary to examine other parameters of neuromuscular control in order to determine possible proprioceptive changes in muscle recruitment with tape application.","DOI":"10.1054/math.2002.0464","ISSN":"1356-689X","journalAbbreviation":"Manual Therapy","author":[{"family":"Cools","given":"A.M"},{"family":"Witvrouw","given":"E.E"},{"family":"Danneels","given":"L.A"},{"family":"Cambier","given":"D.C"}],"issued":{"date-parts":[["2002",8]]},"accessed":{"date-parts":[["2013",11,11]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 7 as illustrated in Figure 2a. The tape was anchored posteriorly at the level of the thoracic vertebra 9 or 10, following the muscle fibres of the lower trapezius.  Next the rigid tape was applied with tension in the same manner to cover the Hypafix tape ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1vd2lde6e5","properties":{"formattedCitation":"{\\rtf \\super 7,19,32\\nosupersub{}}","plainCitation":"7,19,32"},"citationItems":[{"id":542,"uris":["http://zotero.org/users/961722/items/K7ZUH5X8"],"uri":["http://zotero.org/users/961722/items/K7ZUH5X8"],"itemData":{"id":542,"type":"article-journal","title":"Does taping influence electromyographic muscle activity in the scapular rotators in healthy shoulders?","container-title":"Manual Therapy","page":"154-162","volume":"7","issue":"3","source":"ScienceDirect","abstract":"Although taping techniques are commonly used in addition to exercise programmes in the rehabilitation of shoulder instability and secondary subacromial or internal impingement, few studies exist on the effect of taping on the muscle activity of the scapular rotators. The purpose of our study was to examine the influence of one particular tape on muscular activity in scapular muscles. Twenty healthy shoulders were examined with surface EMG recordings on the three parts of trapezius and serratus anterior muscle during dynamic full range of motion abduction and forward flexion. The movement direction, and tape and no-tape conditions were randomized. The statistical analyses with ANOVA repeated Measures (GLM model) showed significant differences among the means between the four muscles (P&lt;0.05), two movement directions (P&lt;0.05), applied resistance (P&lt;0.01), and movement period (P&lt;0.01). However, no significant difference was observed based on the application of tape. The results of our investigation revealed no significant influence of tape application on EMG activity in the scapular muscles in healthy subjects. Future research will be necessary to examine other parameters of neuromuscular control in order to determine possible proprioceptive changes in muscle recruitment with tape application.","DOI":"10.1054/math.2002.0464","ISSN":"1356-689X","journalAbbreviation":"Manual Therapy","author":[{"family":"Cools","given":"A.M"},{"family":"Witvrouw","given":"E.E"},{"family":"Danneels","given":"L.A"},{"family":"Cambier","given":"D.C"}],"issued":{"date-parts":[["2002",8]]},"accessed":{"date-parts":[["2013",11,11]]}}},{"id":833,"uris":["http://zotero.org/users/961722/items/WATWC4JU"],"uri":["http://zotero.org/users/961722/items/WATWC4JU"],"itemData":{"id":833,"type":"article-journal","title":"Upper and lower trapezius muscle activity in subjects with subacromial impingement symptoms: Is there imbalance and can taping change it?","container-title":"Physical Therapy in Sport","page":"45-50","volume":"10","issue":"2","source":"ScienceDirect","abstract":"To investigate (i) whether subacromial impingement symptoms (SIS) were associated with upper and lower trapezius muscle imbalance and (ii) the effect of a scapula taping technique on upper and lower trapezius muscle activity.\nCross-sectional study with nested within-subject intervention.\nUniversity research laboratory.\nSubjects who demonstrated SIS (n = 16) on clinical testing and an age and gender matched group of asymptomatic subjects (n = 32).\nSurface electromyography (EMG) to measure activity in the upper (UFT) and lower (LFT) fibres of trapezius during repeated humeral elevation in the scapular plane.\nSymptomatic subjects demonstrated a significantly (95% CI 2.13 to 4.17, p = 0.019) higher ratio of UFT:LFT activity than the asymptomatic subjects (95% CI 1.35 to 2.25). With tape in situ the symptomatic subjects demonstrated a significant (95% CI "8.6% to "17.3%, p < 0.001) reduction in UFT activity but no significant (95% CI +2.8% to "17.5%, p = 0.145) change in activity of LFT. No relationship (r = " 0.116, p = 0.669) was found between the degree of underlying muscle imbalance and the reduction in UFT under the taped condition for the symptomatic group.\nSubacromial impingement symptoms are associated with altered upper and lower trapezius muscle activity which can be partially addressed by the application of tape.","DOI":"10.1016/j.ptsp.2008.12.002","ISSN":"1466-853X","shortTitle":"Upper and lower trapezius muscle activity in subjects with subacromial impingement symptoms","journalAbbreviation":"Physical Therapy in Sport","author":[{"family":"Smith","given":"Mike"},{"family":"Sparkes","given":"Valerie"},{"family":"Busse","given":"Monica"},{"family":"Enright","given":"Stephanie"}],"issued":{"date-parts":[["2009",5]]},"accessed":{"date-parts":[["2014",3,28]]}}},{"id":602,"uris":["http://zotero.org/users/961722/items/NMCUW773"],"uri":["http://zotero.org/users/961722/items/NMCUW773"],"itemData":{"id":602,"type":"article-journal","title":"The effects of scapular taping on electromyographic muscle activity and proprioception feedback in healthy shoulders","container-title":"Journal of Orthopaedic Research","page":"53-57","volume":"29","issue":"1","source":"Wiley Online Library","abstract":"We investigated the effects of scapular tape on the electromyographic (EMG) activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), anterior deltoid (AD), and shoulder proprioception in 12 healthy shoulders. Participants were blindfolded and required to complete a target end/mid range position with the hand. They performed six trials under two experimental conditions; no tape and therapeutic tape. EMG activity was measured by surface electrodes, and proprioception was measured by the FASTRAK electromagnetic motion tracking system. Two-way repeated measures ANOVA showed that UT and AD activities decreased 2.65% (p	 =	 0.001), and SA muscular activities increased 1.9% (p	 =	 0.015) in the taping condition. The proprioceptive feedback magnitude was significantly lower in the taping condition than in the no taping condition (11.9�, p	 <	 0.005). Additionally, correlation coefficients were higher than 0.5 between muscle activity and proprioceptive feedback with the taping condition; UT and magnitude in the mid range task (R	 =	 0.516); LT and magnitude in the end range task (R	 =	 "0.524); and SA and magnitude in the mid range task (R	 =	 "0.576). The results suggest that scapular tape affects the muscle activity of UT, AD, and SA, and that the effects are related to proprioception feedback. These results implicate that the mechanisms by which scapular taping induces effects can be explained by neuromuscular control and proprioceptive feedback factors. � 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:53�57, 2011","DOI":"10.1002/jor.21146","ISSN":"1554-527X","journalAbbreviation":"J. Orthop. Res.","language":"en","author":[{"family":"Lin","given":"Jiu-jenq"},{"family":"Hung","given":"Cheng-Ju"},{"family":"Yang","given":"Pey-Lin"}],"issued":{"date-parts":[["2011",1,1]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 7,19,32 
   
For the SA Taping technique application the participant�s arm was positioned in 20 degrees abduction and the Hypafix tape was applied without any tension from 2 cm medial to the scapula border, over the inferior angle of the scapular following the line of the ribs down around the chest wall to the mid-axillary line. Then, the same procedure was repeated with tension with the rigid tape to cover the Hypafix layer see Figure 2b.

The combined UT & SA taping technique involved application of the UT Taping technique first followed by the SA taping technique as shown in Figure 2c. 

Using the same methodology as in this study, intra- rater reliability of three repeated measures on 20 subjects, one week apart, for the use of ultrasound to measure the AHD in 60 degrees of passive abduction had been established in a pilot study (ICC = 0.76-0.98. SEM=0.24mm MDC95% =0.67mm). Ultrasound measurement of the AHD was performed by the first investigator using Mylab 60 Esaote, Xvisoin model, with a 523 linear transducer and the frequency of the image set at 13 MHz.  The ultrasound transducer was placed on the lateral aspect of the acromion in line with the longitudinal axis of the humerus to visualise the shortest distance between the humerus and acromion. With the arm in 60 degrees of passive abduction in the coronal plane three consecutive baseline ultrasound images were captured of the AHD. The second investigator then applied the chosen taping method to the participant. The AHD was then re measured with three further consecutive ultrasound images by the first investigator in 60 degrees of passive shoulder abduction in the coronal plane. This process took 5 minutes and after each strapping application a washout period of 5 minutes was allowed during which the subject moved their arm. Both researchers were blinded to the AHD measurements during image capture. The stored images were reviewed using Image J 1.32 software. Hyper echoic landmarks were consistently marked on the stored images to identify the inferior aspect of the acromion and the most superior aspect of the humerus, thus yielding the shortest distance between the two hyper echoic landmarks on ultrasound images. The first investigator reviewed the stored images.  Electronic line callipers were used to make the measurements.

The data were analysed using SPSS version 20. All   p values were 2-tailed and p <0.05 was considered statistically significant. Kolmogrov-Smirnov test established normality of distribution for the variables acromion-humeral distance.  Paired t-tests were used to identify the differences between the AHD pre- and post- the three taping techniques. For each taping method a repeated measures ANOVA was used to detect between-group differences in measure of acromio-humeral distance. Post-hoc analysis was done using Bonferroni correction for multiple comparisons.

Results

Descriptive statistics for the measure of AHD pre and post the three taping techniques are presented in Table 1. For the UT taping technique, the mean AHD distance before using the tape was 9.20mm (SD=1.36mm) and after tape 9.70mm (SD= 1.49mm). The difference of 0.50 mm was significant with p = 0.01(Paired t-test) (Table 1.). For the SA taping technique, the mean AHD distance before using the tape was 9.00mm (SD = 1.49mm) and after tape application 9.75mm (SD= 1.68mm). The difference of 0.75mm was significant with p = 0 .01(Paired t-test) (Table 1.). For the combined UT&SA taping technique, the mean AHD distance before using the tape was 9.00mm (SD = 1.58mm) and after tape application 9.75mm (SD= 1.74mm). The difference of 0.75mm was significant with p = 0 .01(Paired t-test) (Table 1.). It is noted that AHD increased significantly after all three taping technique with p values <0.01(Paired t-test). 

Repeated measures ANOVA analysis shows a significant difference in the increase of AHD between the three methods of taping (Greenhouse Geisser=3.10, p-value=.02).  Post-hoc tests compared each taping method found a significant difference in AHD increase between the two taping techniques UT and SA (t=-2.99, p=.01) with the SA taping technique having the greatest effect on AHD. A significant difference was also noted between the UT taping technique and the combined UT & SA taping technique (t=-2.46, p=.024), with the combined UT&SA taping technique having the greater influence on AHD.  No difference in AHD increase was found between the SA versus combined UT&SA taping techniques (t=-.69, p=.50).  

Discussion 
The current study investigated the effect of using rigid tape to influence the AHD in 60� of passive arm abduction in asymptomatic participants. Results show that AHD, measured with RTUS, increased significantly immediately after the application of all three rigid taping techniques with p values <0.01 (Paired t-test) see Table 1. The changes in AHD measured after application of each taping technique have to be interpreted with relation to the MDC95% to be sure that the change in measurement is not just due to random measurement error. In a pilot study conducted by the authors it was established that inter-rater intra-session reliability for the use of US to measure the AHD and determined that the MDC95% in AHD required was 0.67mm. The average change in AHD after the UT taping technique (0.38mm) did not exceed this measure and therefore cannot be interpreted with complete confidence, though individual values may exceed it as a group the change brought about by UT taping failed to exceed the MDC95%. The change potential occurring due to measurement error. However, the average changes in AHD after the� SA taping technique (0.75mm) and the combined UT&SA taping (0.75mm) in the present study do exceed this measure and therefore can be interpreted with confidence that the overall change exceeds the potential level of measurement error. 

Taping techniques are frequently used in clinical practice to improve symptoms and correct scapular position at rest and during motion. Previous research has considered the effect of scapular taping on the electromyographic activity of surrounding muscles ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aWWWdQ1M","properties":{"formattedCitation":"{\\rtf \\super 1,2,7,19,28\\nosupersub{}}","plainCitation":"1,2,7,19,28"},"citationItems":[{"id":2585,"uris":["http://zotero.org/users/961722/items/W7MFPGS3"],"uri":["http://zotero.org/users/961722/items/W7MFPGS3"],"itemData":{"id":2585,"type":"article-journal","title":"The effect of scapula taping on electromyographic activity and musical performance in professional violinists","container-title":"Australian Journal of Physiotherapy","page":"197-203","volume":"48","issue":"3","source":"ScienceDirect","abstract":"Taping the scapula has been suggested as a method of improving both scapula position and muscular efficiency of the shoulder girdle. These factors have been linked to neck and arm problems in violinists. The purpose of this study was to evaluate the effects of taping the scapulae of violinists into a position that prevented excessive elevation and protraction whilst playing. Eight professional violinists played three different musical excerpts with and without scapula taping applied in random order. Electromyographic activity was recorded from the upper trapezii, the scapula retractors and the right sternocleidomastoid muscles. Performances were recorded onto videotape and audiocassette, and self-report data collected for later analysis. Compared with the control condition, scapula taping increased electromyographic activity in the left upper trapezius muscle during playing by 49% as an overall effect, with a 60% increase in the most physically demanding piece played. Lower music quality was detected in the same piece by raters blinded to performance conditions. Taping also had significant negative effects on subjects� reports of concentration and comfort. Short-term application of scapula taping did not enhance selected scapula stabilising muscles during playing and was not well tolerated by professional violinists.","DOI":"10.1016/S0004-9514(14)60224-5","ISSN":"0004-9514","journalAbbreviation":"Australian Journal of Physiotherapy","author":[{"family":"Ackermann","given":"Bronwen"},{"family":"Adams","given":"Roger"},{"family":"Marshall","given":"Elfreda"}],"issued":{"date-parts":[["2002"]]},"accessed":{"date-parts":[["2014",11,21]]}}},{"id":913,"uris":["http://zotero.org/users/961722/items/ZHKG5ENV"],"uri":["http://zotero.org/users/961722/items/ZHKG5ENV"],"itemData":{"id":913,"type":"article-journal","title":"Does tape facilitate or inhibit the lower fibres of trapezius?","container-title":"Manual Therapy","page":"37-41","volume":"8","issue":"1","source":"ScienceDirect","abstract":"The application of tape to the skin overlying the lower fibres of trapezius is generally thought to facilitate this muscle. However, this facilitation has not been thoroughly investigated. In this study, the effect of tape upon trapezius motoneurone pool excitability was assessed using the trapezius H reflex. The amplitude of the H reflex was measured across four conditions: before tape application, with Endura Fix tape, with the addition of Endura Sports tape and finally with the tape removed. Instead of the expected facilitation of lower trapezius, this tape inhibited lower trapezius activity. On average, the application of Endura Fix tape inhibited trapezius by 4%. The application of Endura Sports tape overlaying the Endura Fix tape inhibited trapezius on average by 22%. This inhibition did not last once the tape was removed. This suggests that any change in shoulder girdle symptoms or movement, which occurs with the application of this particular tape is not explicable on the basis of the facilitation of the lower fibres of trapezius.","DOI":"10.1054/math.2002.0485","ISSN":"1356-689X","journalAbbreviation":"Manual Therapy","author":[{"family":"Alexander","given":"C. M"},{"family":"Stynes","given":"S"},{"family":"Thomas","given":"A"},{"family":"Lewis","given":"J"},{"family":"Harrison","given":"P. J"}],"issued":{"date-parts":[["2003",2]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":542,"uris":["http://zotero.org/users/961722/items/K7ZUH5X8"],"uri":["http://zotero.org/users/961722/items/K7ZUH5X8"],"itemData":{"id":542,"type":"article-journal","title":"Does taping influence electromyographic muscle activity in the scapular rotators in healthy shoulders?","container-title":"Manual Therapy","page":"154-162","volume":"7","issue":"3","source":"ScienceDirect","abstract":"Although taping techniques are commonly used in addition to exercise programmes in the rehabilitation of shoulder instability and secondary subacromial or internal impingement, few studies exist on the effect of taping on the muscle activity of the scapular rotators. The purpose of our study was to examine the influence of one particular tape on muscular activity in scapular muscles. Twenty healthy shoulders were examined with surface EMG recordings on the three parts of trapezius and serratus anterior muscle during dynamic full range of motion abduction and forward flexion. The movement direction, and tape and no-tape conditions were randomized. The statistical analyses with ANOVA repeated Measures (GLM model) showed significant differences among the means between the four muscles (P&lt;0.05), two movement directions (P&lt;0.05), applied resistance (P&lt;0.01), and movement period (P&lt;0.01). However, no significant difference was observed based on the application of tape. The results of our investigation revealed no significant influence of tape application on EMG activity in the scapular muscles in healthy subjects. Future research will be necessary to examine other parameters of neuromuscular control in order to determine possible proprioceptive changes in muscle recruitment with tape application.","DOI":"10.1054/math.2002.0464","ISSN":"1356-689X","journalAbbreviation":"Manual Therapy","author":[{"family":"Cools","given":"A.M"},{"family":"Witvrouw","given":"E.E"},{"family":"Danneels","given":"L.A"},{"family":"Cambier","given":"D.C"}],"issued":{"date-parts":[["2002",8]]},"accessed":{"date-parts":[["2013",11,11]]}}},{"id":602,"uris":["http://zotero.org/users/961722/items/NMCUW773"],"uri":["http://zotero.org/users/961722/items/NMCUW773"],"itemData":{"id":602,"type":"article-journal","title":"The effects of scapular taping on electromyographic muscle activity and proprioception feedback in healthy shoulders","container-title":"Journal of Orthopaedic Research","page":"53-57","volume":"29","issue":"1","source":"Wiley Online Library","abstract":"We investigated the effects of scapular tape on the electromyographic (EMG) activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), anterior deltoid (AD), and shoulder proprioception in 12 healthy shoulders. Participants were blindfolded and required to complete a target end/mid range position with the hand. They performed six trials under two experimental conditions; no tape and therapeutic tape. EMG activity was measured by surface electrodes, and proprioception was measured by the FASTRAK electromagnetic motion tracking system. Two-way repeated measures ANOVA showed that UT and AD activities decreased 2.65% (p	 =	 0.001), and SA muscular activities increased 1.9% (p	 =	 0.015) in the taping condition. The proprioceptive feedback magnitude was significantly lower in the taping condition than in the no taping condition (11.9�, p	 <	 0.005). Additionally, correlation coefficients were higher than 0.5 between muscle activity and proprioceptive feedback with the taping condition; UT and magnitude in the mid range task (R	 =	 0.516); LT and magnitude in the end range task (R	 =	 "0.524); and SA and magnitude in the mid range task (R	 =	 "0.576). The results suggest that scapular tape affects the muscle activity of UT, AD, and SA, and that the effects are related to proprioception feedback. These results implicate that the mechanisms by which scapular taping induces effects can be explained by neuromuscular control and proprioceptive feedback factors. � 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:53�57, 2011","DOI":"10.1002/jor.21146","ISSN":"1554-527X","journalAbbreviation":"J. Orthop. Res.","language":"en","author":[{"family":"Lin","given":"Jiu-jenq"},{"family":"Hung","given":"Cheng-Ju"},{"family":"Yang","given":"Pey-Lin"}],"issued":{"date-parts":[["2011",1,1]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":547,"uris":["http://zotero.org/users/961722/items/KCAZP79A"],"uri":["http://zotero.org/users/961722/items/KCAZP79A"],"itemData":{"id":547,"type":"article-journal","title":"The Effects of Scapular Taping on the Surface Electromyographic Signal Amplitude of Shoulder Girdle Muscles During Upper Extremity Elevation in Individuals With Suspected Shoulder Impingement Syndrome","container-title":"Journal of Orthopaedic & Sports Physical Therapy","page":"694-702","volume":"37","issue":"11","source":"CrossRef","DOI":"10.2519/jospt.2007.2467","ISSN":"0190-6011, 1938-1344","language":"en","author":[{"family":"Selkowitz","given":"David M."},{"family":"Chaney","given":"Casey"},{"family":"Stuckey","given":"Sandra J."},{"family":"Vlad","given":"Georgeanne"}],"issued":{"date-parts":[["2007",11]]},"accessed":{"date-parts":[["2014",3,28]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 1,2,7,19,28, and investigated the effect of taping on scapular kinematics  ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"KwoH1D0c","properties":{"formattedCitation":"{\\rtf \\super 13,14,29\\nosupersub{}}","plainCitation":"13,14,29"},"citationItems":[{"id":119,"uris":["http://zotero.org/users/961722/items/65S9KRIB"],"uri":["http://zotero.org/users/961722/items/65S9KRIB"],"itemData":{"id":119,"type":"article-journal","title":"Scapular Taping in the Treatment of Anterior Shoulder Impingement","container-title":"Physical Therapy","page":"803-812","volume":"75","issue":"9","source":"ptjournal.apta.org","ISSN":"0031-9023, 1538-6724","journalAbbreviation":"Physical Therapy","language":"en","author":[{"family":"Host","given":"Helen H."}],"issued":{"date-parts":[["1995",9,1]]},"accessed":{"date-parts":[["2012",8,23]]}}},{"id":248,"uris":["http://zotero.org/users/961722/items/AGVIMSAN"],"uri":["http://zotero.org/users/961722/items/AGVIMSAN"],"itemData":{"id":248,"type":"article-journal","title":"Scapular taping alters kinematics in asymptomatic subjects","container-title":"Journal of Electromyography and Kinesiology","page":"326-333","volume":"23","issue":"2","source":"ScienceDirect","abstract":"Scapular taping is frequently used in the management of shoulder pain and as a part of injury prevention strategies in sports. It is believed to alter scapular kinematics and restore normal motion. However, there is little evidence to support its use. The aim of the study was to investigate the effect of shoulder taping on the scapular kinematics of asymptomatic subjects.\nThirteen asymptomatic subjects performed elevations in the sagittal and scapular planes with no tape and after the application of tape. A motion tracking system and a scapula locator method were used to measure the shoulder movement. Co-ordinate frames were defined for the thorax, humerus and scapula and Euler angles were used to calculate joints rotations.\nScapular taping increased the scapular external and upward rotations and posterior tilt in elevations in the sagittal plane (p < 0.001). In the scapular plane, taping increased scapular external rotation (p < 0.05).\nTaping affects scapulothoracic kinematics in asymptomatic subjects. The effect may be different for different planes of movement. The findings have implications on the use of taping as a preventive measure in high-risk groups. Further work is needed to assess the effect of taping on symptomatic populations.","DOI":"10.1016/j.jelekin.2012.11.005","ISSN":"1050-6411","journalAbbreviation":"Journal of Electromyography and Kinesiology","author":[{"family":"Shaheen","given":"Aliah F."},{"family":"Villa","given":"Coralie"},{"family":"Lee","given":"Yen-Ni"},{"family":"Bull","given":"Anthony M. J."},{"family":"Alexander","given":"Caroline M."}],"issued":{"date-parts":[["2013",4]]},"accessed":{"date-parts":[["2014",3,29]]}}},{"id":736,"uris":["http://zotero.org/users/961722/items/T7HNXC73"],"uri":["http://zotero.org/users/961722/items/T7HNXC73"],"itemData":{"id":736,"type":"article-journal","title":"The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome","container-title":"Journal of Electromyography and Kinesiology","page":"1092-1099","volume":"19","issue":"6","source":"CrossRef","DOI":"10.1016/j.jelekin.2008.11.003","ISSN":"10506411","author":[{"family":"Hsu","given":"Yin-Hsin"},{"family":"Chen","given":"Wen-Yin"},{"family":"Lin","given":"Hsiu-Chen"},{"family":"Wang","given":"Wendy T.J."},{"family":"Shih","given":"Yi-Fen"}],"issued":{"date-parts":[["2009",12]]},"accessed":{"date-parts":[["2012",5,9]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 13,14,29. There is lack of information in the literature with regard to the effect of scapular taping on the AHD. The study Luque-Suarez et al. (2013) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1f5p2cvta","properties":{"formattedCitation":"{\\rtf \\super 23\\nosupersub{}}","plainCitation":"23"},"citationItems":[{"id":860,"uris":["http://zotero.org/users/961722/items/WWE6NGAS"],"uri":["http://zotero.org/users/961722/items/WWE6NGAS"],"itemData":{"id":860,"type":"article-journal","title":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects: A randomised controlled trial","container-title":"Manual Therapy","page":"573-577","volume":"18","issue":"6","source":"ScienceDirect","abstract":"The first aim of this study was to investigate whether kinesiotaping (KT) can increase the acromiohumeral distance (AHD) in asymptomatic subjects in the short term. The second aim was to investigate whether the direction of kinesiotaping application influences AHD.\nIn recent years, the use of KT has become increasingly popular for a range of musculoskeletal conditions and for sport injuries. To date, we are unaware of any research investigating the effect of kinesiotaping on AHD. Moreover, it is unknown whether the direction of kinesiotaping application for the shoulder is important.\nForty nine participants were randomly assigned to one of three groups: kinesiotaping group 1 (KT1), kinesiotaping group 2 (KT2) and sham kinesiotaping (KT3). AHD ultrasound measurements at 0� and 60� of shoulder elevation were collected at baseline and immediately after kinesiotape application.\nThe results showed significant improvements in AHD after kinesiotaping, compared with sham taping. The mean difference in AHD between KT1 and KT3 groups was 1.28 mm (95% CI: 0.55, 2.03), and between KT2 and KT3 was 0.98 mm (95% CI: 0.23, 1.74). Comparison of KT1 and KT2 groups, which was performed to identify whether the direction of taping influences the AHD, indicated there were no significant differences.\nKT increases AHD in healthy individuals immediately following application, compared with sham kinesiotape. No differences were found with respect to the direction in which KT was applied.","DOI":"10.1016/j.math.2013.06.002","ISSN":"1356-689X","shortTitle":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects","journalAbbreviation":"Manual Therapy","author":[{"family":"Luque-Suarez","given":"A."},{"family":"Navarro-Ledesma","given":"S."},{"family":"Petocz","given":"P."},{"family":"Hancock","given":"M. J."},{"family":"Hush","given":"J."}],"issued":{"date-parts":[["2013",12]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 23, conducted investigated the effect of kinesiotaping on AHD, with results reflecting an increase on AHD when compared with sham taping in asymptomatic participants.  Despite the difference in taping techniques used between the two studies and the fact that one study used rigid tape and the other an elastic tape, and in the study by Luque-Suarez et al., (2013) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"23scnfqgnu","properties":{"formattedCitation":"{\\rtf \\super 23\\nosupersub{}}","plainCitation":"23"},"citationItems":[{"id":860,"uris":["http://zotero.org/users/961722/items/WWE6NGAS"],"uri":["http://zotero.org/users/961722/items/WWE6NGAS"],"itemData":{"id":860,"type":"article-journal","title":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects: A randomised controlled trial","container-title":"Manual Therapy","page":"573-577","volume":"18","issue":"6","source":"ScienceDirect","abstract":"The first aim of this study was to investigate whether kinesiotaping (KT) can increase the acromiohumeral distance (AHD) in asymptomatic subjects in the short term. The second aim was to investigate whether the direction of kinesiotaping application influences AHD.\nIn recent years, the use of KT has become increasingly popular for a range of musculoskeletal conditions and for sport injuries. To date, we are unaware of any research investigating the effect of kinesiotaping on AHD. Moreover, it is unknown whether the direction of kinesiotaping application for the shoulder is important.\nForty nine participants were randomly assigned to one of three groups: kinesiotaping group 1 (KT1), kinesiotaping group 2 (KT2) and sham kinesiotaping (KT3). AHD ultrasound measurements at 0� and 60� of shoulder elevation were collected at baseline and immediately after kinesiotape application.\nThe results showed significant improvements in AHD after kinesiotaping, compared with sham taping. The mean difference in AHD between KT1 and KT3 groups was 1.28 mm (95% CI: 0.55, 2.03), and between KT2 and KT3 was 0.98 mm (95% CI: 0.23, 1.74). Comparison of KT1 and KT2 groups, which was performed to identify whether the direction of taping influences the AHD, indicated there were no significant differences.\nKT increases AHD in healthy individuals immediately following application, compared with sham kinesiotape. No differences were found with respect to the direction in which KT was applied.","DOI":"10.1016/j.math.2013.06.002","ISSN":"1356-689X","shortTitle":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects","journalAbbreviation":"Manual Therapy","author":[{"family":"Luque-Suarez","given":"A."},{"family":"Navarro-Ledesma","given":"S."},{"family":"Petocz","given":"P."},{"family":"Hancock","given":"M. J."},{"family":"Hush","given":"J."}],"issued":{"date-parts":[["2013",12]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 23 the tape was applied to the shoulder and not the scapula, the results of the study by Luque-Suarez et al. (2013) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1rsmqvb1jk","properties":{"formattedCitation":"{\\rtf \\super 23\\nosupersub{}}","plainCitation":"23"},"citationItems":[{"id":860,"uris":["http://zotero.org/users/961722/items/WWE6NGAS"],"uri":["http://zotero.org/users/961722/items/WWE6NGAS"],"itemData":{"id":860,"type":"article-journal","title":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects: A randomised controlled trial","container-title":"Manual Therapy","page":"573-577","volume":"18","issue":"6","source":"ScienceDirect","abstract":"The first aim of this study was to investigate whether kinesiotaping (KT) can increase the acromiohumeral distance (AHD) in asymptomatic subjects in the short term. The second aim was to investigate whether the direction of kinesiotaping application influences AHD.\nIn recent years, the use of KT has become increasingly popular for a range of musculoskeletal conditions and for sport injuries. To date, we are unaware of any research investigating the effect of kinesiotaping on AHD. Moreover, it is unknown whether the direction of kinesiotaping application for the shoulder is important.\nForty nine participants were randomly assigned to one of three groups: kinesiotaping group 1 (KT1), kinesiotaping group 2 (KT2) and sham kinesiotaping (KT3). AHD ultrasound measurements at 0� and 60� of shoulder elevation were collected at baseline and immediately after kinesiotape application.\nThe results showed significant improvements in AHD after kinesiotaping, compared with sham taping. The mean difference in AHD between KT1 and KT3 groups was 1.28 mm (95% CI: 0.55, 2.03), and between KT2 and KT3 was 0.98 mm (95% CI: 0.23, 1.74). Comparison of KT1 and KT2 groups, which was performed to identify whether the direction of taping influences the AHD, indicated there were no significant differences.\nKT increases AHD in healthy individuals immediately following application, compared with sham kinesiotape. No differences were found with respect to the direction in which KT was applied.","DOI":"10.1016/j.math.2013.06.002","ISSN":"1356-689X","shortTitle":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects","journalAbbreviation":"Manual Therapy","author":[{"family":"Luque-Suarez","given":"A."},{"family":"Navarro-Ledesma","given":"S."},{"family":"Petocz","given":"P."},{"family":"Hancock","given":"M. J."},{"family":"Hush","given":"J."}],"issued":{"date-parts":[["2013",12]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 23, are consistent with this study in that the AHD was increased by passively taping the scapula.  In the study by Luque-Suarez et al., (2013) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1ugf015ahd","properties":{"formattedCitation":"{\\rtf \\super 23\\nosupersub{}}","plainCitation":"23"},"citationItems":[{"id":860,"uris":["http://zotero.org/users/961722/items/WWE6NGAS"],"uri":["http://zotero.org/users/961722/items/WWE6NGAS"],"itemData":{"id":860,"type":"article-journal","title":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects: A randomised controlled trial","container-title":"Manual Therapy","page":"573-577","volume":"18","issue":"6","source":"ScienceDirect","abstract":"The first aim of this study was to investigate whether kinesiotaping (KT) can increase the acromiohumeral distance (AHD) in asymptomatic subjects in the short term. The second aim was to investigate whether the direction of kinesiotaping application influences AHD.\nIn recent years, the use of KT has become increasingly popular for a range of musculoskeletal conditions and for sport injuries. To date, we are unaware of any research investigating the effect of kinesiotaping on AHD. Moreover, it is unknown whether the direction of kinesiotaping application for the shoulder is important.\nForty nine participants were randomly assigned to one of three groups: kinesiotaping group 1 (KT1), kinesiotaping group 2 (KT2) and sham kinesiotaping (KT3). AHD ultrasound measurements at 0� and 60� of shoulder elevation were collected at baseline and immediately after kinesiotape application.\nThe results showed significant improvements in AHD after kinesiotaping, compared with sham taping. The mean difference in AHD between KT1 and KT3 groups was 1.28 mm (95% CI: 0.55, 2.03), and between KT2 and KT3 was 0.98 mm (95% CI: 0.23, 1.74). Comparison of KT1 and KT2 groups, which was performed to identify whether the direction of taping influences the AHD, indicated there were no significant differences.\nKT increases AHD in healthy individuals immediately following application, compared with sham kinesiotape. No differences were found with respect to the direction in which KT was applied.","DOI":"10.1016/j.math.2013.06.002","ISSN":"1356-689X","shortTitle":"Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects","journalAbbreviation":"Manual Therapy","author":[{"family":"Luque-Suarez","given":"A."},{"family":"Navarro-Ledesma","given":"S."},{"family":"Petocz","given":"P."},{"family":"Hancock","given":"M. J."},{"family":"Hush","given":"J."}],"issued":{"date-parts":[["2013",12]]},"accessed":{"date-parts":[["2014",3,29]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 23 the use of elastic tape may have influenced the scapula position via proprioceptive feedback and in turn influenced the acromio-humeral distance. The use of rigid tape on the scapula in this present study passively held the scapula and in turn influenced acromio-humeral distance. Thus even with the arm at rest the subacromial space could be maintained with rigid tape.

When interpreting the results of this study there are a number of methodological limitations that should be considered. It was not possible to blind the investigator collecting the data to the taping technique used in order to rule out investigator bias. Only short term effects on AHD were investigated; further research is required to investigate the long term effects of taping on the AHD.  Participants in this study all had healthy shoulders, further research is necessary on participants with subacromial impingement syndrome to determine if the results from this study can be extrapolated to this group of patients. The AHD is most reduced between 60� and 120� of arm abduction  ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1m3anjocqf","properties":{"formattedCitation":"{\\rtf \\super 9\\nosupersub{}}","plainCitation":"9"},"citationItems":[{"id":234,"uris":["http://zotero.org/users/961722/items/9SQQECNT"],"uri":["http://zotero.org/users/961722/items/9SQQECNT"],"itemData":{"id":234,"type":"article-journal","title":"Excursion of the Rotator Cuff Under the Acromion Patterns of Subacromial Contact","container-title":"The American Journal of Sports Medicine","page":"779-788","volume":"22","issue":"6","source":"ajs.sagepub.com","abstract":"Nine fresh-frozen, human cadaveric shoulders were el evated in the scapular plane in two different humeral rotations by applying forces along action lines of rotator cuff and deltoid muscles. Stereophotogrammetry deter mined possible regions of subacromial contact using a proximity criterion; radiographs measured acromio humeral interval and position of greater tuberosity. Con tact starts at the anterolateral edge of the acromion at 0� of elevation; it shifts medially with arm elevation. On the humeral surface, contact shifts from proximal to dis tal on the supraspinatus tendon with arm elevation. When external rotation is decreased, distal and poste rior shift in contact is noted. Acromial undersurface and rotator cuff tendons are in closest proximity between 60� and 120� of elevation; contact was consistently more pronounced for Type III acromions. Mean acro miohumeral interval was 11.1 mm at 0� of elevation and decreased to 5.7 mm at 90�, when greater tuberosity was closest to the acromion. Radiographs show bone- to-bone relationship; stereophotogrammetry assesses contact on soft tissues of the subacromial space. Con tact centers on the supraspinatus insertion, suggesting altered excursion of the greater tuberosity may initially damage this rotator cuff region. Conditions limiting ex ternal rotation or elevation may also increase rotator cuff compression. Marked increase in contact with Type III acromions supports the role of anterior acromioplasty when clinically indicated, usually in older patients with primary impingement.","DOI":"10.1177/036354659402200609","ISSN":"0363-5465, 1552-3365","journalAbbreviation":"Am J Sports Med","language":"en","author":[{"family":"Flatow","given":"Evan L."},{"family":"Soslowsky","given":"Louis J."},{"family":"Ticker","given":"Jonathan B."},{"family":"Pawluk","given":"Robert J."},{"family":"Hepler","given":"Matthew"},{"family":"Ark","given":"Jon"},{"family":"Mow","given":"Van C."},{"family":"Bigliani","given":"Louis U."}],"issued":{"date-parts":[["1994",12,1]]},"accessed":{"date-parts":[["2013",2,25]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 9. This fact, combined with the limitation that visualisation of the AHD in more that 60� arm abduction with US is unreliable ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aS0Hv2Vs","properties":{"formattedCitation":"{\\rtf \\super 8\\nosupersub{}}","plainCitation":"8"},"citationItems":[{"id":843,"uris":["http://zotero.org/users/961722/items/WJ629FKM"],"uri":["http://zotero.org/users/961722/items/WJ629FKM"],"itemData":{"id":843,"type":"article-journal","title":"Acromio-Humeral Distance Variation Measured by Ultrasonograp... : Clinical Journal of Sport Medicine","container-title":"Clinical Journal of Sport Medicine","page":"197-205","volume":"14","issue":"4","abstract":"Objective: First, to validate an ultrasonographic measure of the acromio-humeral distance (AHD); second, to compare the AHD variation during active abduction in patients with shoulder impingement syndrome (SIS) and healthy subjects; and third, to evaluate the relationship between functional statu...","DOI":"00042752-200407000-00002","shortTitle":"Acromio-Humeral Distance Variation Measured by Ultrasonograp...","author":[{"family":"Desmeules","given":"F"},{"family":"Minville","given":"L"},{"family":"Riederer","given":"B"},{"family":"C�t�","given":"C"},{"family":"Fr�mont","given":"P"}],"issued":{"date-parts":[["2004",7]]},"accessed":{"date-parts":[["2013",6,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 8, influenced the choice of testing position. This passive arm position ensured that the participant did not experience fatigue during the testing process.  Thus this study did not evaluate the effect of taping in the active arm position nor above 60 degrees of arm abduction. Additionally, a sham taping method was not included in the present study. Lastly, the order or taping technique application was not randomised in this study and could lead to researcher bias.


Clinically, both rigid tape and elastic tape (such as Kinesiotape) are used, future research to compare the efficacy between the two could be of interest. Taping may have a beneficial effect on patients suffering from shoulder subacromial impingement syndrome. Further studies are needed to establish whether the changes reported in this study are clinically important and could improve treatment outcomes in participants with subacromial impingement syndrome.

Conclusion
Rigid taping techniques of the scapula had an immediate effect of increasing the acromio-humeral distance in healthy shoulders in 60 degrees of passive arm abduction.  Further studies are needed to establish whether these changes are clinically important and could improve treatment outcomes in participants with subacromial impingement syndrome.

Findings Rigid taping techniques of the scapula had an immediate effect of increasing the acromio-humeral distance in healthy shoulders in 60 degrees of passive arm abduction.  
Implication Taping may have a beneficial effect on patients suffering from shoulder subacromial impingement syndrome.
Caution Further studies are needed to establish whether these changes are clinically important and could improve treatment outcomes in participants with subacromial impingement syndrome.

References
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13. 	Host HH. Scapular Taping in the Treatment of Anterior Shoulder Impingement. Physical Therapy��		P	Q	R	n	o	p	t	�	�	�	�	


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$d�a$gd<"g�m�m�m�n�n�n�no�o�o�o�o�o�o�o�p�paqoqrrxr�rls�s_tntu+uDw�wxx�x�y�y zGz;{k{�{�{�ƴ�������W�f���������Ҳ�—��������������������������������������UhLp�hLp�6�]�hLp�hLp�h�Q�jh<"ghFd!Uh<"gh�n5�CJOJQJaJh<"gh �5�CJOJQJaJh<"ghZH5�CJOJQJaJh<"gh�C�CJOJQJaJh<"gh�C�5�CJOJQJaJh<"gh�?)CJOJQJaJ2 1995;75(9):803-812.
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FIGURE 1. Standardised participant position


Figure legends
FIGURE 1. Standardised participant position
FIGURE 2a. Upper trapezius strapping technique
FIGURE 2b. Serratus anterior strapping technique
FIGURE 2c. Combined strapping techniques
Figures 2a-2c attached separately 











 PAGE   \* MERGEFORMAT 18




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