Pre-Cut Kinesiology Tape Compared to NSAIDs in the Treatment of Rotator Cuff

Impingement

Poster #54

AOSSM 2013 Annual Meeting Chicago, Illinois July 11-14, 2013

Nucap Medical Inc. has provided an unrestricted research grant in support of this study. None of the authors have any further disclosures.

Moira Deveraux MScPT Kinny Quan Velanoski BScPT

Amanda Pennings MScPT Amr ElMaraghy MD, FRCSC

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Background n  Shoulder Pain

•  Common n  7-36% lifetime prevalence

(Green, 2003)

•  Subacromial Impingement n  frequently diagnosed shoulder

disorder causing: •  Pain, decreased active range

of motion, weakness •  Defects in posture,

proprioception, muscle coordination, scapulo-thoracic movement

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Background n  Management of Impingement

•  Exercise n  Statistically and clinically significant effects on

pain reduction, functional improvement (Kuhn, 2009)

•  Possible Adjuvant Treatments n  Non-steroidal anti-inflammatory drugs (NSAIDs)

•  Utility: pain modulation •  Side effects: gastrointestinal, allergy, myocardial

infarction (Kvien, 2003)

n  Kinesiology Tape •  Mimic skin thickness, weight, elasticity •  Proposed Benefits: pain modulation, positional

stimulus, limit harmful motion, increased microcirculation

(Kaya, 2011; Thelen, 2008)

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Purpose

To assess the efficacy of pre-cut kinesiology tape versus NSAIDs as adjuvant treatment

to an exercise program for subacromial impingement

n  Hypothesis

•  Pre-cut kinesiology tape and exercise will be as effective as NSAIDs and exercise

n  Reducing pain

n  Improving function

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Methods n  Institutional REB approval n  Prospective, Single-Blind, Randomized Control Trial n  Screening:

•  Inclusion Criteria: shoulder impingement, 18 years of age •  Exclusion Criteria: previous surgery, complicated pathology, contraindications

n  Pre-Treatment Assessment n  Random Assignment

•  Group 1 – Pre-Cut Kinesiology Tape + Exercise [PCT] n  Pre-Cut Shoulder Spider

•  Group 2 – NSAIDs + Exercise [NSAIDs] n  Naproxen EC 500mg BID

•  Group 3 – Exercise Only [Control]

n  Two-week intervention •  4 sessions •  Usage Diary

n  Post-Treatment Assessment

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Standardized Shoulder Spider applied in PCT+ Exercise Group

Methods n  Outcome Measures

•  Numeric Pain Rating Scale (NPRS) n  Subjective pain rating at (1) rest and (2) arm elevation

•  Simple Shoulder Test (SST) n  Subjective shoulder function with 12 functional activities

•  Constant Score n  Subjective shoulder function n  Objective ROM and strength

n  Statistics •  Sample Size Determination

n  Minimum 26 per group n  α = 0.05, power = 0.80

•  Intention-to-treat analysis •  Statistical Tests

n  Normality: Shapiro-Wilk n  Categorical Variables: Chi-squared n  Between-group differences: ANOVA/Kruskall-Wallis n  Within-group differences: Paired t-test/Wilcoxin Signed Rank

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Results

n  No difference between groups in demographics or baseline scores n  Lost to Follow-up: 19 (no difference between groups)

•  PCT (n=6), NSAIDs (n=4), Control (n=9) n  Average Duration of Treatment: 18 ± 8.3 days

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Results n  No difference between

groups n  Within each group:

•  Statistically significant improvement:

n  Pain with elevation n  SST score n  Constant score

n  Within adjuvant groups: •  Statistically significant

improvement: n  ADLs n  Functional arm level

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Results n  Compliance

• Usage Diaries n  75% completion rate

• Exercise n  70% completed exercises at least 2 times per day n  Reasons for not performing exercises: lack of time, pain

• NSAIDs n  84% compliance as directed

• PCT n  100% compliance with continuous use n  No allergic or skin reactions

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Conclusions n  Exercise alone

•  Can be effective in the management of impingement •  Less compliance without adjuvant treatment

n  Adjuvant treatment •  Clinical benefits are best revealed with movement and

functional activities n  PCT is as effective as NSAIDs in the adjuvant

treatment of subacromial impingement •  Similar reduction in pain and improvement in function •  Well-tolerated and showed increased compliance •  Valid alternative to NSAIDs For further information, please contact: Amanda Pennings at (416) 530-0400 or amanda.l.pennings@gmail.com

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