Effect of Kinesotaping on Management of Supraspinatus Tendinitis

Supraspinatus tendonitis is a common clinical problem that causes functional and labor disabilities. It is the most frequent cause of shoulder pain. Manual therapy is a common intervention used by physical therapist for management of supraspinatus tendonitis. Joint mobilization, stretching and strengthening exercises are commonly used techniques for management of this condition. In this study KT will be added to conventional manual therapy and its efficacy will be investigated. The study design will be Randomized Clinical Trial (RCT) that will be used to compare the effects of KT added to manual therapy for management of supraspinatus tendonitis. 38 patients will be participate in this study who will be assigned randomly (biased coin method) to experimental and control groups (19+19). The data collection will be carried out at Railway Hospital Rawalpindi. Patients with shoulder pain at rest and positive for special tests (Neer's, Empty Can, Drop Arm, Hawkin's Kennedy) will be included in this study. There is no restriction on gender and age group will be between 25 and 60 years. Patients with cervical post op, referred pain, open wounds, allergic to KT and with signs of radiculopathy will be excluded from this study. Pre and post treatment evaluation will be done using Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI) and goniometry. Data will be collected on 1st day, 4th day and 7th day for both groups. After data collection is completed, SPSS will be used to analyze the collected data

Shoulder pain is a very common musculoskeletal disorder affecting a large portion of population . Prevalence ranges from 6% to 26% and it is estimated that 33% of population will have one episode of shoulder pain in lifetime. Rotator cuff tendonitis is considered as most common pathology of shoulder . Supraspinatus is one of the four muscles that can cause rotator cuff tendonitis. It is a common clinical disorder that causes functional and labor disorders. It is also the most frequent cause of shoulder pain. The origin of supraspinatus is fossa of scapula and its insertion is at superior facet on greater tuberosity of humerus. The nerve supply is at C4, C5 and C6. The main function of supraspinatus is abduction of shoulder. Indications: Supraspinatus tendonitis present following conditions Pain and inflammation Decreased ROM Decreased strength Decreased functional activity Injury Mechanisms: Supraspinatus tendonitis is caused by extrinsic as well as intrinsic factors. Extrinsic factors include increased subacromial activity, trauma, overhead activity, soft tissue imbalance, eccentric muscle overload and glenohumeral laxity. Intrinsic factorare acromial morphology, aging, acromioclavicular arthrosis and coracoacromial ligament hypertrophy. Kinesiotaping (KT) is widely used in clinical settings for rehabilitation of shoulder disorders . It is designed to facilitate the body's natural healing process while providing support and stability to muscles and joints without restricting the body's range of motion. The functioning of kinesio tap is based on following: Lifting effects of epidermis layers and papillary dermis, caused by micro-convolutions formed on the taped skin . Due to wrinkles generated by the KT, vascular networks in deep vessels under the skin are increased, reducing swelling and inflammation in injured tissues . KT contributes to pain relief by producing increased stimulation of cutaneous mechanoreceptors, and provides muscle activation. Akbaba et. al. investigated the effects of kinesio tape in management of rotator cuff tear and found that application of KT is effective in improving pain and function but the improvement was not clinically significant . Desjardins et. al. studied the efficacy of KT for rotator cuff tendonitis and found that KT significantly improved pain free range of motion. However, it couldn't be concluded with sufficient evidence that tendonitis was reduced significantly.

For application of kinesotaping following procedure will be adopted: The skin will be cleaned properly with alcohol The first strip will be applied in Y-shape (15-20% stretch) surrounding the deltoid muscle to provide inhibition and muscle relaxation A second strip (I-shape) will be applied for functional correction (50-75% stretch), passing over the supraspinatus, trapezius, glenohumeral joint and middle deltoid Daily Strengthening Exercises (3 sets / 10~30 reps) Joint mobilization (3 sets / 60 seconds hold / 30 seconds interval) Stretching Exercises (3 sets / 30 seconds hold / 30 seconds interval

Joint mobilization (3 sets / 60 seconds hold / 30 seconds interval) Stretching Exercises (3 sets / 30 seconds hold / 30 seconds interval) Strengthening Exercises (3 sets / 10~30 reps)

Visual analogue scale (VAS) is a psychometric measuring instrument designed to document the characteristics of disease-related symptom severity in individual patients and use this to achieve a rapid (statistically measurable and reproducible) classification of symptom severity and disease control.

The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire that consists of two dimensions, one for pain and the other for functional activities. The pain dimension consists of five questions regarding the severity of an individual's pain. Functional activities are assessed with eight questions designed to measure the degree of difficulty an individual has with various activities of daily living that require upper-extremity use. The SPADI takes 5 to 10 minutes for a patient to complete and is the only reliable and valid region-specific measure for the shoulder.

Inclusion Criteria: Both Gender / Age b/w 25-60 Shoulder Pain at rest Positive Neer's Test Positive Drop Arm Test Positive Empty Can Test Positive Hawkin's Kennedy Test Exclusion Criteria: Cervical Post op, referred pain, radiculopathy, open wound, allergy to KT

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