A Physiological and Psychological Basis for Anti-Pronation Taping from a Critical Review of the Literature
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Sports Med 2008; 38 (8): 617-631 0112-1642/08/0008-0617/$48.00/0 © 2008 Adis Data Information BV. All rights reserved.
A Physiological and Psychological Basis for Anti-Pronation Taping from a Critical Review of the Literature Melinda Franettovich,1,2 Andrew Chapman,2,3,4 Peter Blanch1 and Bill Vicenzino2 1 2 3 4
Department of Physical Therapies, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia Musculoskeletal Pain and Injury Research Unit, University of Queensland, Brisbane, Queensland, Australia School of Kinesiology, Simon Fraser University, Vancouver, British Columbia, Canada Applied Research Centre, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
Abstract
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.
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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 da
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