Isokinetics and Exercise Science 18 (2010) 1–6 1

DOI 10.3233/IES-2010-0352
IOS Press

The effects of Kinesio-Taping
on quadriceps

strength during isokinetic exercise in healthy
non athlete women
I. Vithoulkaa, A. Benekab,∗, P. Mallioub , N. Aggelousisb , K. Karatsolisa and K. Diamantopoulos a
a
Polyklinik Olympic Village, Acharnes, Greece
b
Department of Physical Education and Sports, Democritus University of Thrace, Komotini, Greece

Abstract. Purpose: The purpose of the study was to investigate the effect of Kinesio Taping on quadriceps strength at maximum
concentric and eccentric isokinetic exercise mode in healthy non-athlete women in order to examine the Kinesio taping effect in
increasing or decreasing the muscular quadriceps strength.
Methods: Three different quadriceps taping modes have been used (no taping, placebo taping, Kinesio-Taping) for the study. and
isokinetic concentric and eccentric strength assessments have been done for both knee extensors and flexors.
Results: One-way ANOVA for repeated measures revealed no significant differences in max concentric torque between the three
different taping modes but significant differences in max eccentric torque during both the concentric and eccentric mode of the
quadriceps muscle.
Conclusion: The results suggest that application of Kinestio Taping on the anterior surface of the thigh, in the direction of vastus
medialis, laterallis and rectus femoris fascia, could increase the eccentric muscle strength (isokinetic eccentric peak torque), in
healthy adults.

Keywords: Concentric exercise, eccentric exercise, isokinetic torque

1. Introduction the fascia, facilitates the strength of that muscle [10].

On the contrary, Tieh-Cheng Fu and his colleagues [3]
For several decades taping has been a content of have shown that K.T. doesn’t influence muscle strength,
study, by many researchers, in the field of prevention when placed on the knee in healthy athletes. These
and rehabilitation [1,5]. Recently, the effect of taping results are in agreement with Janwantanakul and Gao-
techniques, such as Kinesio Taping (K.T.), on muscle gasigam [7], who did not find any effect on muscular ac-
strength, has been a content of research with contro- tivity, measured by electromyography, on subjects with
versial results [7,10–14,3]. For example, the research taping at both vastus lateralis and medialis quadriceps
of Murray H. [11] has shown an increase in the elec- muscle.
tromyographic quadriceps muscular activity with K.T. The name of the technique, comes from the field of
application, applied by patients after ACL repair in the kinesiology, because the application of the tape allows
postoperative phase. This research gave new perspec- the body to move normally, and reacts to the fascia via
tive related to Taping and its application. It seemed biomechanical or proprioceptive mechanisms. Fascia
that this application under tendency, at the direction of is a dense irregular connective tissue which surrounds
and connects anatomically and functionally every mus-
∗ Address
cle. According to the latest scientific data it plays an
for correspondence: Anastasia Beneka, Assistant Pro-
fessor, Department of Physical Education and Sports, Democritus
important active role in the function of musculoskele-
University of Thrace, 69100 Komotini, Greece. Tel.: +30 697 611 tal system. [2,4,6,16–18,20]. The present study took
1324; E-mail: [email protected]. place in healthy adults in an effort to study the K.T

ISSN 0959-3020/10/$27.50  2010 – IOS Press and the authors. All rights reserved
2 I. Vithoulka et al. / Kinesio taping and quadriceps strength during isokinetic exercise

Table 1
Anthropometric characteristics of the participants
2.3. Measurements
Antropometric characteristics Women (N = 20)
M (± SD)
2.3.1. Anthropometric measurements
Age 27 (± 3.77)
Subjects’ body weight was measured while they were
Weight 61.4 (± 8.19) wearing underclothes on a balance scale (Seca 707,
Height 168 (± 8.17) Hamburg Germany) calibrated to the nearest 0.4 Kg
after an 8–10 hour fast (between 7,00–8,00). Barefoot
effect in increasing or decreasing the muscular quadri- standing height was measured to the nearest 0.1 cm by
ceps strength in terms of two different function modes, using a wall mounted stadiometer.
concentric and alternation of concentric and eccentric
mode, simulating more the athletic activities. The re- 2.3.2. Isokinetic concentric-eccentric strength
sults of this study would be very beneficial for healthy assessments of the knee extensors-flexors
athletes for injury prevention but also for enhancing muscle group
their performance. Particularly, the purpose of this Peak muscle torque of the dominant knee extensors
study was to investigate the effect of Kinesio Taping was measured using an isokinetic dynamometer (Con-
on quadriceps strength at maximum concentric and ec- Trex MJ Zurich). Subjects performed the same tasks
centric isokinetic testing mode in healthy non-athlete while in a seated position on a standard dynamometer
women. chair with the subject’s back slightly reclined and thigh
well supported on the seat. Stabilization in the seated
position was accomplished using pelvic strapping. The
2. Materials and methods subjects were instructed to grip their hands around the
chest. The axis of rotation of the knee joint and lever
2.1. Subjects arm were carefully aligned. The tested dominant limb
was firmly stabilized at the distal femur, the lower leg
Considering the fact that K.T is related to several at the distal tibia above the ankle joint superior to the
therapeutic effects such as pain reduction, joint align- medial malleolus. Before each test there was a warm-
ment, improvement of haematic and lymphoid circula- up session (10 minutes) including cycling (Monark)
tion [8,9], healthy subjects have been selected in order followed by three sub-maximal and two maximal trials
to ensure reliability of the results. on the isokinetic device.
Twenty women (Table 1) randomly selected volun- The test protocol included one bout of 5 concentric
teered to participate in the present study. All partic- maximal knee extension/flexion repetitions at 60 and
ipants gave their written informed consent regarding 240◦/s (CON/CON) and one bout of 3 eccentric max-
participation in the study after being informed of all imal knee flexion repetitions at 60 ◦ /s (CON/ECC) in
risks, discomforts and benefits associated with the pro-
the same order, separated by 2 min rest intervals. It
cedures followed the present study. Procedures were
is important to clarify that during the first testing bout
in accordance with the ethical standards of the Com-
(CON/CON), quadriceps was working in a concentric
mittee on Human Experimentation at the Institution at
mode for knee extension but was relaxed for knee flex-
which the work was conducted and with the Helsinki
ion. In the second bout (CON/ECC) quadriceps was
declaration of 1975.
working continuously in both movements, concentri-
cally for knee extension and eccentrically for knee flex-
2.2. Screening
ion, meaning that there was a substantial difference in
the muscular effort between the two testing modes. The
Participants were selected based on the following
criteria: CON/ECC testing mode has been selected also because
the alteration of concentric and eccentric muscle func-
1. Subjects were completely inactive prior to the tion simulates athletic activities where muscle function
study. is never exclusively concentric or eccentric.
2. Subjects were healthy, without any knee pain or The peak torque of the best 5 and 3 trials respectively
other muscular, skeletal discomfort. for each velocity was used as the recorded value. Maxi-
3. Subjects followed a physical examination for po- mal test efforts began with the leg flexed that is with the
tentially damaging orthopedic and neuromuscu- knee joint at 110 ◦ before flexion and ended at full ex-
lar problems. tension. Correction was applied for the elimination of
 I. Vithoulka et al. / Kinesio taping and quadriceps strength during isokinetic exercise 3

Fig. 1. Kinesiotaping applied on quadriceps muscle.

errors against the effect of gravity on the lower leg and medial tail. While stabilizing the tails and pulling prox-
lever arm. During testing there was no visual feedback imally to increase tissue tension, the tape was stretched
the verbal instruction at the beginning of the test was slightly and applied to the superior border of the patel-
“try as hard as you can during flexion and extension la. Finally the hip and knee were placed into flexion
of the knee”. The dynamometer was calibrated prior with the foot flat on the table and the Kinesio Tex was
to the testing session according to the procedures pre- peeled off the paper liner and placed the tape temporar-
scribed by the manufacturer. To verify the reliability ily on the skin. The glue was not activated by rubbing.
of the torque measurements in female adults, the peak The other end of Kinesio Tex was applied to the tibial
torque of the knee extensors at 60 and 240 ◦ /s (concen- tuberosity (Fig. 1).
tric mode) and 60 ◦ /s (eccentric mode) was measured
twice (within a week, at the same time of day) in the 2.4.2. Positioning of Kinesio-Taping on vastus
dominant leg, which was defined as the leg used to kick medialis
a ball. The intraclass correlation coefficients between The patient was at the spine position. The one end,
the repeated measurements were 0.96. which was not made a slit, of Kinesio Tex was applied
to lower part of intertrochanteric line. Kinesio Tex was
2.4. Taping modes peeled from a release paper (liner) and the tape was
put there temporarily. The inner part of the other end,
Three different quadriceps taping modes were used which was made a slit of Kinesio Tex was applied to
(no taping, placebo taping, Kinesio-Taping) for the pes anserinus. Then the knee was flexed and the outer
study. Each type of taping had a specific way of posi- part of the other end, which was made a slit of Kinesio
tioning as described below. For the quadriceps Kinesio Tex was applied to the patella (Fig. 1).
Taping mode, the tex was applied on rectus femoris,
vastus medialis and vastus lateralis (Fig. 1). 2.4.3. Positioning of Kinesio-Taping on vastus
lateralis muscle
2.4.1. Positioning of Kinesio-Taping on rectus femoris The patient was at the spine position. The one end,
muscle which was not made a slit, of Kinesio Tex was applied
The subject was at the supine position, with the thigh to greater trochanter of the femur. The examiner needed
hanging off the table in order to increase tissue tension. to pull the skin in a direction toward the patient’s head
Then the medial tail of the “Y” tape has been applied while putting his/her one hand on greater trochanter
to the anterior inferior iliac spine and the lateral tail of of the femur. Then Kinesio Tex was applied to lateral
the “Y” tape two to three fingerbreadths lateral to the aspect of the patella like the part of terminal end on the
4 I. Vithoulka et al. / Kinesio taping and quadriceps strength during isokinetic exercise

Fig. 2. Placebo taping applied on quadriceps.

slit of Kinesio Tex was put on superior aspect of the 3. Results

knee. Kinesio Tex was peeled off a release paper (liner)
and the tape was put there temporarily. The lateral part The characteristics of the participants are presented
of the other end, which was made a slit, of Kinesio Tex in Table 1. The statistical analysis revealed no sig-
was applied to lateral fibular head. Then the knee was nificant differences in peak concentric torque at 60 ◦ /s
flexed and the medial part of the other end, which was (CON1/CON) among the three different taping modes.
made a slit, of Kinesio Tex was applied to the patella (F(1,20) = 1.880, p > 0,05), (Tables 2, 3). Similar
like it is enclosed by the tape (Fig. 1). results were found for peak concentric torque at 240 ◦/s
(CON2/CON) and between the three different taping
2.4.4. Positioning of placebo Kinesio-Taping
modes. (F(1,20) = 0,165, p > 0,05), (Tables 2, 4).
The patient was at the supine position. Kinesio Tex
Nevertheless, the statistical analysis revealed sig-
was applied transverse to the muscle groups of the
nificant differences in max eccentric torque at 60 ◦ /s
quadriceps in two levels. One level 5 cm above the
middle distance of the femur and the other one 5 cm (CON3/ECC) and between the three different taping
below (Fig. 2). modes during both the concentric and eccentric mode
of the quadriceps muscle. [F(1,20) = 6.892, p < 0.05,
2.5. Design of the study F(1,20) = 5.184, p < 0.05], (Tables 2, 5, 6).

Subjects randomly accomplished three isokinetic

tests (as described above), with the different quadri- 4. Discussion
ceps taping modes (no taping, placebo taping, Kinesio-
Taping) in a random order. Two or three days prior to The results suggest that application of K.T. on the
the isokinetic tests all subjects accomplished an isoki- anterior surface of the thigh, in the direction of vastus
netic test session in order to be familiar with the isoki- medialis, laterallis and rectus femoris fascia may in-
netic device. All tests took place in the same room every crease the eccentric muscle strength (isokinetic eccen-
3 days, with the same environmental circumstances. tric peak torque) in healthy adults. The results revealed
a significant statistical increase of the peak torque dur-
2.6. Statistical analysis
ing eccentric isokinetic exercise of quadriceps muscle.
Data were analyzed using the SPSS PC (version More specifically, the results were statistically signif-
10.0). Means ± SD were calculated. One-way ANO- icant when the peak torque produced during the K.T.
VA for repeated measures was performed on each de- application in the same direction of the fascia on rec-
pended variable (max torque on concentric 60 ◦ /s, con- tus femoris, vastus lateralis and vastus medialis was
centric 240 ◦ /s and eccentric 60 ◦ /s) to detect difference compared with the peak torque produced by placebo
in each different taping mode (3 different types). positioning of taping, with the K.T. application running
 I. Vithoulka et al. / Kinesio taping and quadriceps strength during isokinetic exercise 5

Table 2
Peak torque (in Nm) for extensors muscle group at 60 and 240◦ /s (concentric) and 60◦ /s (eccentric) exercise (Nm)
CON1 CON2 CON3 ECC
kn60 pl60 no60 kn240 pl240 no240 kn60 pl60 no60 kn60 pl60 no60
101.1 108.1 99.3 60.3 60.5 59.7 103.8 98.5 98.6 116.1 137.6 122.4
91.8 89 103.3 65.6 61.1 64.8 84.4 92 85.9 100.9 133.3 118.4
131.7 152.2 140.6 78.7 91.7 86.7 123.2 124.5 110.2 146.4 130.1 141.8
91.8 106.5 94.8 62.3 66.6 60.3 78.8 112 23.1 107.5 81.4 88.7
71.9 71.8 77.8 39.7 48.6 41.7 63.2 37.4 24.5 81.7 50.5 61.5
123.8 105.6 104.3 64.7 61.2 61.5 111.8 99.8 97.9 113.2 103.8 110.4
82.7 83.6 87.9 53.9 54.4 53.2 83.2 91.5 81.5 97.9 80.1 88.6
85.6 94.1 96.2 56.2 55.6 58.5 78.6 83.8 78.2 113.9 92.5 106.8
141.2 129.4 133.1 82.9 89.8 88.7 124 131.1 108.7 175 158.8 155.5
132.6 117 133.4 72.1 71.1 68.5 130.9 111 113.9 176 152.6 163.7
93.2 82.6 88.1 51.5 52.2 56.4 92.3 87.8 83.4 115.6 135.4 124.9
160.6 155.8 166.9 91.3 72.5 81.7 163.6 159.6 163.3 205.3 179.6 191.8
169.7 159.7 167.1 100.3 100.1 109.6 166.5 157 173.3 213.7 216.4 206.9
113.6 113.2 119.5 73.1 77.3 74.2 116.4 115.9 101.3 148.4 157.1 140.4
1378 123.1 114.1 86.7 83.2 80 111.3 113.8 107 192 171.8 186.1
144.1 134.2 155.8 83.7 79.8 78.8 129 128.9 102.6 182.5 151.5 178.7
105.8 97.5 108.9 61.8 60.4 60.3 95.7 98.7 97.5 163.1 156.5 140.8
110.6 109.9 103.5 62.1 69.4 65 106.8 109.3 96.8 143.4 132.8 117.6
165.9 1302 138.7 97.6 98.5 96.4 160.7 144.5 143.1 221.4 196.5 216.2
157.6 153.9 147.8 98.5 99.6 94.7 168.5 156.5 148.9 181.3 179.5 166.7

Table 3 Table 5
Quadriceps peak torque (in Nm) at 60◦ /s during the concentric exer- Quadriceps peak torque (in Nm) at 60◦ /s during the eccentric exercise
cise (CON1/CON) (CON3/ECC)
Taping modes Peak torque at 60 deg/sec for extensors Taping modes Peak torque at 60 deg/sec for extensors
muscle group (CON1) muscle group (CON3)
Kinesiotape (kn) 120.65 ± 30.06 Kinesiotape(kn) 114.63 ± 31.57
Placebo(pl) 115.87 ± 26.14 Placebo(pl) 112.68 ± 29.40
No taping(no) 119.05 ± 27.14 No taping(no) 101.98 ± 37.6
F (1,20) = 1.880, p > 0.05 F (1,20) = 6.892, p < 0.05

Table 4 Table 6
Quadriceps peak torque (in Nm) at at 240◦ /s during concentric isoki- Quadriceps peak torque (in Nm) at 60◦ /s eccentric isokinetic exercise
netic exercise (CON2/CON, Nm) (CON3/ECC) at eccentric mode (ECC) of the quadriceps muscle
Taping modes Peak torque at 240 deg/sec for extensors Taping modes Peak torque at 60 deg/sec for extensors
muscle group (CON2) muscle group (ECC)
Kinesiotape(kn) 72.15 ± 17.19 Kinesiotape(kn) 149.76 ± 42.38
Placebo(pl) 72.68 ± 16.58 Placebo(pl) 139.89 ± 41.80
No taping(no) 72.03 ± 17.13 No taping(no) 141.39 ± 41.67
F (1,20) = 0.165, p > 0.05 F (1,20) = 5.184, p < 0.05

vertical to the fascia and without K.T. application. No cally for knee flexion and therefore there was a substan-
significant results were indicated when the peak torque tial difference in the muscular effort between the two
produced during concentric contraction of quadriceps testing modes. This might be the reason why K.T. en-
muscle (60◦ /sec, 240◦ /sec) with K.T. application were hanced muscular performance only in this testing mode
compared with the peak torque produced by the place- where muscular effort was maximal both concentrical-
bo application or without K.T. applicationunder same ly and eccentrically. A possible explanation for these
conditions. results would be that K.T might be a muscular tone
It is important to clarify at this point that during the regulator [8,9]. This is further reinforced by the fact
first testing bout (CON/CON) the quadriceps was work- that the total work produced in the CON/ECC bout was
ing in a concentric mode for knee extension but was re- bigger than that in the CON/CON.
laxed for knee flexion. In the second bout (CON/ECC) It is well known that the direction of Kinesio Tex ap-
quadriceps was working continuously in both move- plied has an influence on the muscle tone. Application
ments, concentrically for knee extension and eccentri- of the tape from muscle origin to insertion is supportive,
6 I. Vithoulka et al. / Kinesio taping and quadriceps strength during isokinetic exercise

improves contraction and increases muscle strength. Taping Association (2005), Available in url http://www.
Application from muscle insertion to its origin assists kinesiotaping.com.
[2] L. Chaitow (ed), Muscle Energy Techniques, 2nd Edition,
relaxing the muscle tone [8,9]. The wrinkles of the Churchill Livingstone, (2001), 29-54.
skin formed after the application of K.T. in combina- [3] T.C. Fu, A. Wong, Y.C. Pei, K. Wu, S.W. Chou and Y.C. Lin,
tion with the direction of the tape, pulls the insertion of Effect of Kinesio taping on muscle strength in athletes -A pilot
the muscle towards the direction of the contraction and study, J Sci Med Sport 11(2) (2008), 198–201.
[4] T. Halseth, J. McChesney, M. DeBeliso, R. Vaughn and J.
increases the muscle tone. Lien, The effects of Kinesio Taping on proprioception at the
Despite the fact that effect of K.T. is still unknown, ankle, J Sci Med Sport 3 (2004), 1–7.
this application has been suggested as a possible propri- [5] L. Herrington, The effect of patella taping on quadriceps
oceptive facilitator in the acute phases of the injury pro- strength and functional performance in normal subjects, Phys
Ther Sport 5 (2004), 33–36.
cess [12]. In this research K.T. was applied to the skin [6] B. Hinz, G. Celetta, J. Tomasek, G. Gabbiani and C. Chapon-
in order to provide tactile stimulation to the examined nier, Alpha-Smooth Muscle Actin Expression Upregulates Fi-
muscles. This tactile stimulation seems to interact with broblast Contractile Activity, Mol Biol Cell 12 (September
2001), 2730–2741.
the kinetic control at the central nervous system [15,
[7] P. Janwantanakul and C. Gaogasigam, Vastus lateralis and
19]. Furthermore, fascia plays an important role as vastus medialis obliquus muscle activity during the application
force transmitter in human posture and movement reg- of inhibition and facilitation taping techniques, Clin Rehabil
ulation. Fascia is usually seen as having a passive role, 19 (2005), 12–19.
[8] K. Kase (ed), Illustrating Kinesio Taping, (3rd Edition), Print-
transmitting mechanical tension which is generated by
ed in United States, 1997) 6–12.
muscle activity or external forces. However, there is [9] K. Kase, T. Hashimoto and O. Tomoki, Development of Kine-
some evidence to suggest that fascia maybe able to sio Taping Perfect Manual, Kinesio Taping Association 6–10
actively contract in a smooth muscle-like manner and (1996), 117–118.
[10] D. Morrissey, Proprioceptive shoulder taping, J Bodyw Mov
consequently influence musculoskeletal dynamics. Ther 4 (2000), 189–194.
It is not clear yet, if the results presented in this study, [11] H. Murray, Kinesio Taping, Muscle Strength and ROM after
are related to skin or fascia mechanoreceptors, or to ACL Repair, JOSPT 30 (2000), 1.
the biomechanical support of the muscle through the [12] H. Murray and L. Husk, The Effects of Kinesio Taping on
Proprioception in the Ankle. (2001) Available in url http://
application of the tape at the direction of the fascia. It www.kinesiotaping.com.
is not also known, if the increased muscle contraction [13] K. Nosaka, The Effect of Kinesio Taping on Muscular Micro-
observed immediately after the positioning of K.T. last Damage Following Eccentric Exercises. 15th Annual Kine-
for a long duration. These questions require further sio Taping International Symposium Review. Tokyo, Japan,
Kinesio Taping Association (1999), 70–73.
researches directed at the efficacy of K.T. for the relief [14] D. Osterhues, The use of Kinesio Taping in the management of
of pain, the improvement of microcirculation and the traumatic patella dislocation. A case study, Physiother Theory
decrease of muscle spasm. Pract 20 (2004), 267–270.
This research would be the first step for further use [15] M.C. Ridding, B. Brouwer and T.S. Miles, Changes in muscle
responses to stimulation of the motor cortex induced by pe-
of Kinesio Taping such as strengthening weak muscles ripheral nerve stimulation in human subjects, Exp Brain Res
systems during activities that require eccentric activa- 131 (2000), 135–143.
tion. Many elite athletes (e.g. jumpers) who are con- [16] R. Schleip, Fascial plasticity – a new neurobiological explana-
tion, J Bodyw Mov Ther 7(1),11–19 & 7(2) (2003), 104–116.
sidered to be healthy already use Kinesio Tape in order [17] R. Schleip, W. Klingler and F. Lehmann-Horn, Active fas-
to improve their techniques and facilitate their perfor- cial contractility: Fascia may be able to contract in a smooth
mance. We hope for the improvement of both function- muscle-like manner and thereby influence musculoskeletal dy-
al and athletic performance, as well as to a different ap- namics, Med Hypotheses 65 (2005), 273–277.
[18] R. Schleip, I. Naylor, D. Ursu, W. Melzer, A. Zorn, H.J. Wilke,
proach in prevention and rehabilitation of symptomatic F. Lehmann-Horn and W. Klingler, Passive muscle stiffness
subjects. may be influenced by active contractility of intramuscular con-
nective tissue, Med Hypotheses (2006), 66–71.
[19] G.G. Simoneau, R.M. Degner and C. Kramper, Changes in
ankle joint proprioception resulting from strips of athletic tape
References applied over the skin, J Athl Train 32(2) (June 1997), 141–147.
[20] L.H. Yahia, S. Rhalmi, N. Newman and M. Isler, Sensory in-
[1] R. Brandon and L. Paradiso, The use of Kinesio Tape in nervation of the human thoracolumbar fascia – an immunohis-
patients diagnosed with Patellofemoral pain (PFP), Kinesio tochemical study, Acta Orthop Scand 63(2) (1992), 195–197.