Not All Evidence Is Equal
Dear Editor:
A recent article in the Journal of Physiotherapy (PatrÃcia do Carmo Silva Parreira, et al. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. J Physiother, 2014 Mar;60(1):31-39) has raised some eyebrows in the Kinesio Taping community. As is to be expected, it has also provided a juicy topic for the usual naysayers and debunkers.
The biggest misconception in the entire study is the title. Although "Current Evidence Does Not Support the Use of Kinesio Taping in Clinical Practice" is true on the face of it, the article's emphasis is on the need for larger and more rigorous studies. It is the current evidence with which the authors have a problem – not the taping. Although it might get less attention and sell fewer copies, a true title for this review might be, "Current Evidence Does Not Go Deep Enough to Support or Refute Use of Kinesio Taping in Clinical Practice."
In fact, the study makes that exact point: "However, the conclusions from this review are based on a number of underpowered studies. Therefore, large and well-designed trials are greatly needed. The research group for this review is currently conducting two large randomised controlled trials."
For instance, our experts noted that some of the studies included in the review did not demonstrate a clear understanding of what Kinesio Taping is designed to do – and not to do. Although an attempt was made by the Parreira team to rule out studies that explicitly investigated performance enhancement, issues dependent on whether the elastic tape strengthened muscles, increased velocity or otherwise "made normals into supernormals" still seem to dominate the results.
Many of the articles were vague or misinformed about how to place the tape for the desired effect. We also saw discrepancies such as one cited article explaining that the tape "corrects muscle function strengthening weak muscle." Which is more important, correcting function or strengthening the muscle? Muscles are not strengthened by the application of a piece of tape alone, no matter how well-placed the tape strips might be or how well-intentioned the therapist.
Kinesio Taping experts, whether focused on research, education, or purely on patient care, agree that there need to be larger, more rigorous and just plain more work done to support the treatment as an evidence-based practice. The Kinesio Taping Association International is developing a set of fundamental standards to help future researchers avoid the pitfalls highlighted in this research.
Hong Yim, DC, CCSP, CKTI, PES
Skokie, Ill.
Research Committee
Kinesio Taping Assoc. International
Editor's note: The following comments were submitted by readers in response to our recent ChiroPoll questions inquiring about whether they vaccinate their own children and how they discuss the issue of immunization with their patients.
An Abundance of Misinformation
Dear Editor:
I indicate to patients that it is their choice and to be aware that here is an abundance of misleading information about vaccinations. Most patient do not know there is no mercury in the current vaccines, unless the dispensing entity is using a multi-dose vial – and no one uses these anymore due to hygiene reasons. I also tell them that in areas of our state where the population does not vaccinate, we have outbreaks of diseases such as measles. That said, it's still their choice, in my opinion.
Michael McIrvin, DC, CME
McPherson, Kan.
A Well-Researched Decision
Dear Editor:
I have made a well-researched, educated decision not to vaccinate my two girls and they almost never ever get sick. They are two of the healthiest at their school.
Michael Tarr, DC
Morgan Hill, Calif.
Far Too Dangerous
Dear Editor:
As a personal choice for myself and my family, I determined immunizations were far too dangerous and potentially deadly. With my patients I never advised them to forgo immunizations for their children; I did, however, always recommend they read as much as possible about the potential harms resulting from immunization and with that information, make their own informed decision.
George Le Beau, DC
Vista, Calif.