Kinesio Tape Bandage

Kinesio Tape Bandage

PEP Topic 
Lymphedema
Description 

Kinesio tape is a type of bandage for taping that allows longitudinal stretch, so is somewhat elastic, and is composed of cotton fibers and acrylic heat sensitive glue. Kinesio tape is waterproof and is worn for 1-3 days without removal. Kinesio tape has been used for sports application and was evaluated as an alternative to standard compression bandaging for lymphedema in patients with cancer.

Benefits Balanced With Harm

Systematic Review/Meta-Analysis

Rodrick, J. R., Poage, E., Wanchai, A., Stewart, B. R., Cormier, J. N., & Armer, J. M. (2013). Complementary, alternative, and other non-complete decongestive therapy (CDT) treatment methods in the management of lymphedema: A systematic search and review. PM&R, 6, 250–274.

doi: 10.1016/j.pmrj.2013.09.008
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Purpose:

STUDY PURPOSE: To provide a critical analysis of the contemporary published research that pertains to complementary, alternative, and other noncomplete decongestive therapies for treatment of lymphedema (LE) and to provide practical applications of that evidence to improve care of patients with or at risk for LE


TYPE OF STUDY: Systematic review

Search Strategy:

DATABASES USED: PubMed, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PapersFirst, Proceedings-First, Worldcat, PEDro, National Guideline Clearing House, ACP Journal Club, DARE, and the authors' archives


KEYWORDS: Best practice for the management of lymphoedema, plus expanded terms for all literature related to lymphedema (2004–2012)


INCLUSION CRITERIA: No specific inclusion criteria identified


EXCLUSION CRITERIA: No gray literature was included; nonrefereed articles, abstracts, and dissertations were excluded. Exclusion of 574 articles took place due to duplication, inability to obtain the English translation, inadequate sample size, insufficient level of evidence due to study design, and failure to meet inclusion criteria. Another 47 articles were rejected because they fell outside the systematic review inclusion criteria by definition of four categories (i.e.,botanical, pharmaceutical, physical agent modalities, and modalities of contemporary value), by design, or for lack of an English translation. The categories of pharmaceuticals and botanicals were excluded as well.

Literature Evaluated:

TOTAL REFERENCES RETRIEVED: 659 articles were reviewed.

 

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: The authors used first screening, second screening, and third screening to determine final body of reviewed articles. The level of evidence for each study assessed by using the research grading system from the Putting Evidence into Practice (PEP) level of evidence guidelines.

Sample Characteristics:

  • FINAL NUMBER STUDIES INCLUDED = 22
  • SAMPLE RANGE ACROSS STUDIES/TOTAL PATIENTS INCLUDED IN REVIEW: Not applicable; included several singles and several review articles
  • KEY SAMPLE CHARACTERISTICS: Human being with lymphedema and animal model with lymphedema (i.e., a rabbit ear model with “created” secondary lymphedema and rat tail model with “created” secondary lymphedema)

Phase of Care and Clinical Applications:

PHASE OF CARE:  Mutliple phases of care

Results:

Limited high-level evidence was available for all categories. Well-constructed randomized, controlled trials related specifically to lymphedema were limited. Objective outcome measures over time were absent from several studies. The rationale for the use and benefits of the specific modality, as related to lymphedema, was often anecdotal. Participant numbers were fewer than 50 for most studies.

Conclusions:

No interventions were ranked as "recommended for practice." Two treatment modalities (low-level laser therapy and Kinesio taping combined with decongestive lymphatic therapy and pneumatic compression, with Kinesio taping compared with compression bandaging) in three studies were ranked as "likely to be effective." The literature review indicated that many of the physical agent modalities demonstrated long-standing support within the literature, with broad parameters for therapeutic application and benefit for secondary conditions associated with lymphedema. However, additional investigation regarding the individual contributory value and the factors that contribute to their efficacy specific to lymphedema is critically needed.

Limitations:

Inclusion criteria were not clearly stated. Sample range across studies and total patients included in review were not specified.

Nursing Implications:

More rigorous human research in complementary and alternative modalities is needed to optimize patient outcomes.

Research Evidence Summaries

Tsai, H.J., Hung, H.C., Yang, J.L., Huang, C.S., & Tsauo, J.Y. (2009). Could Kinesio tape replace the bandage in decongestive lymphatic therapy for breast-cancer-related lymphedema? A pilot study. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 17(11), 1353–1360.

doi: 10.1007/s00520-009-0592-8
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Study Purpose:

To compare the treatment and retention effects between standard decongestive lymphatic therapy (DLT) combined with pneumatic compression and modified DLT in which the use of a short-stretch bandage is replaced with the use of Kinesio tape (K-tape) combined with penumatic compression

Intervention Characteristics/Basic Study Process:

Patients were randomly grouped into the DLT group or the modified DLT group. During each treatment session, patients had skin care treatment, 30 minutes of manual lymphatic drainage, one hour of pneumatic compression therapy, application of a short-stretch bandage or K-tape, and 20 minutes of physical therapy. Evaluations were executed before and after the control period, after the intervention period, and after the three-month follow-up. A well-trained physical therapist who was blind to the groupings evaluated all patients.

Sample Characteristics:

  • The study sample (N = 41) was comprised of two groups, a DLT group (n = 21) and a modified DLT group (n =20), of female patients with breast cancer.
  • Mean age of patients was 54.6 years with a range of 36–75 years.
  • Patients were included in the study if they had unilateral breast cancer-related lymphedema for more than three months that was moderate to severe (circumference of affected limb greater than that of the unaffected limb by more than 2 cm at one or more sites.

Setting:

The study took place in Taiwan.

Study Design:

The study used a randomized, single-blinded, controlled design.

Measurement Instruments/Methods:

  • Upper-extremity circumference and water displacement volume were measured.
  • Water composition of the upper extremity: An eight-polar tactile-electrode impedance meter was used in the water composition analysis of the upper extremity.
  • Lymphedema-related symptoms were assessed by a visual analog scale from 0–10 (0 = none, 10 = worst possible).
  • Quality of life was assessed using The Taiwan Chinese Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30 and QLQ-BR23)
  • Subjects’ response to bandage or K-tape was noted.

Results:

There was no significant difference between groups in all outcome variables (p > 0.05). Excess limb size (circumference and water displacement) and excess water composition were reduced significantly in the bandage group. Excess circumference and excess water composition were reduced significantly in the tape group. The acceptance of K-tape was better than the bandage and benefits included longer wearing time, less difficulty in usage, and increased comfort and convenience (p < 0.05). However, there were more wounds that occurred for those in the K-tape group (p < 0.05).

Conclusions:

The study results suggest that K-tape could be an alternative choice for patients with breast cancer-related lymphedema with poor short-stretch bandage compliance after one month of intervention.

Limitations:

  • The study sample was small with less than 100 patients.
  • There were more wounds caused by the use of K-tape than bandages.
  • The exact reasons why there were a greater number of wounds in the K-tape group needs to be further explored.

Nursing Implications:

The safety of application of K-tape (i.e., wound) needs to be closely monitored. Patients need to be educated regarding how to use K-tape.


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