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A Physiological and Psychological Basis for Anti-Pronation Taping from a Critical Review of the Literature.
Franettovich M, Chapman A, Blanch P, Vicenzino B. Sports Med. 2008;38(8):617-631.
Quote:
Anti-pronation taping is a treatment technique commonly used by clinicians in the management of lower extremity musculoskeletal pain and injury. The clinical efficacy of anti-pronation tape is described anecdotally and has some support through clinical trials for some foot conditions. However, the mechanism(s) underlying its clinical efficacy is unknown, but are broadly categorized under mechanical, neurophysiological and psychological hypotheses. This article explores these hypotheses and contributes to the understanding of the technique.A computer database search was conducted to identify relevant experimental studies using an a priori defined search strategy. Data were extracted from reviewed articles and wherever possible mean differences between baseline and taped condition and the 95% confidence interval, as well as percentage change scores and effect size statistics were calculated. Articles were organized pertaining to the hypothetical mechanism investigated and presented accordingly into biomechanical, neurophysiological or psychological paradigms.Overall, the research to date has focused predominantly on the mechanical paradigm with far fewer papers being found for the neurophysiological and psychological paradigms. The literature provides evidence that anti-pronation tape has a biomechanical effect, which has been demonstrated by increases in navicular height and medial longitudinal arch height, reductions in tibial internal rotation and calcaneal eversion and alteration of plantar pressure patterns, under both static (i.e. standing) and dynamic (i.e. walking, jogging, running) conditions. The reduction in pronation was dependent on the surrogate measure of pronation used, but generally ranged from as little as 5% increase in longitudinal arch height during jogging to as much as a 33% change in calcaneal eversion during walking.Preliminary evidence from few studies suggests that anti-pronation tape has a neurophysiological effect as it has been shown to reduce the activity of several muscles of the leg during dynamic tasks such as walking, hopping, cutting, back pedalling and drop jumps. Data were difficult to extract from these papers, but it would appear from a small study that the reduction is in the order of about 45% for tibialis posterior.To date, there has been limited investigation of the psychological effects of anti-pronation tape. A main issue, as with most placebo or sham interventions for physical therapy research, is that of an appropriate comparator in this regard. Consequently, these effects are currently not well understood.This article reports of evidence in support of anti-pronation tape exerting a biomechanical effect. As its name suggests, it does reduce pronation. There is emerging evidence of a neurophysiological effect, which is generally one of reduction in muscle activity, but caution is urged in over-interpreting a few studies on small sample sizes. Further research is required in this paradigm before sports medicine practitioners can utilize these findings in day-to-day clinical practice. Due to insufficient evidence, this article was unable to draw any conclusions as to the psychological effects of the tape, but the article does prompt the need for further exploration into the possible role of placebo in the clinical effects of anti-pronation taping.
Re: Physiological and Psychological Basis for Anti-Pronation Taping
Use of antipronation taping to determine foot orthoses prescription: a case series.
Meier K, McPoil TG, Cornwall MW, Lyle T. Res Sports Med. 2008;16(4):257-71
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In order to determine if the use of antipronation taping could be used to direct foot orthoses prescription, seven high school athletes with lower extremity or foot pain caused by overuse stress were taped for 3 days during practice sessions. A visual pain scale and the Foot and Ankle Ability Measure sports subscale were used to monitor pain and function improvement caused by taping. If the taping was effective, foot orthotics were fabricated and posted according to the change in foot posture created by the tape. After wearing the foot orthotics for 4 weeks, all athletes reported a substantial short-term (4-week) reduction in pain and an increase in function. The results of this case series indicate that changes in foot posture created by taping can be used to guide foot orthosis prescription.
Background: This study investigated the effects of two low-Dye and two high-Dye strapping techniques that are commonly used to treat pronatory sequelae.
Methods: Plantar pressure distribution in normal adults with a pronated foot type was assessed with a commercially available pressure platform system. Twenty study participants first walked across the platform barefoot and then with each of the four strapping conditions applied. The footprints were averaged and divided into seven areas for analysis.
Results: Paired t tests found significant differences between the barefoot and strapping conditions. Overall, there was a general lateralization of pressures indicating an antipronation effect from all strapping conditions. Low-Dye strap 2, used to limit the degree of calcaneal eversion, produced the most significant changes at the foot pressure areas analyzed.
Conclusions: The data reported in this study suggest that the four strapping techniques offer different levels of control, and this should be considered during the decision-making process and clinical management of pronatory conditions. It was the contention of this study that low-Dye strap 2 was the most effective strapping technique to control foot mechanics associated with a pronated foot type
Physiological and Psychological Basis for Anti-Pronation Taping
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