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actions such as exercise are considered more appropriate&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> Among the latter&#44; exercise plays an important role in reducing pain&#59; thus&#44; its inclusion has become essential in the treatment<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">7&#8211;9</span></a> and the execution of exercise with elastic band has proved to be a viable and effective option&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#8211;11</span></a> On the other hand&#44; Kinesio Taping &#40;KT&#41; is currently a technique that has generated a new trend in the treatment of pain&#44; strength&#44; functionality and other outcomes related to skeletal muscle and joint injuries&#44;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">12&#44;13</span></a> The popularity of KT demands special consideration in terms of its popularity because&#44; in the last decade&#44; there has arisen a great amount of distributors offering KT related seminars&#44; courses&#44; products and accessories&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">14&#44;15</span></a> Previous studies have been conducted for the outcome of pain in various clinical conditions &#40;knee&#44; shoulder&#44; neck&#44; spine&#44; plantar fascia&#41; with different methodologies and results&#44; giving different qualities of evidence also&#44; so the application of KT continues to have little value among clinicians&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> There have been some preceding studies of KT effects over the OA&#44;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17&#8211;23</span></a> where the exercise is not present or does not play an important role due to the short duration of the interventions&#46; So&#44; we consider important to emphasize the incorporation of the exercise when carrying out an investigation of these characteristics&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The aim of this study was to determine the effectiveness of KT along with exercise therapy in women with OA&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Materials and methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">A single center randomized clinical trial&#44; single blind&#44; 6 weeks duration was conducted&#46; Inclusion criteria&#58; women aged between 50 and 70 years&#44; with BMI between 25 and 34&#46;9&#44; and diagnosed with bilateral knee OA according to European League Against Rheumatism &#40;EULAR&#41; criteria&#44; classified as grade 2 or 3 by the radiographic scale of Kellgren and Lawrence&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> It is important to note that although OA was bilateral&#44; only the most affected knee was evaluated&#46; Exclusion criteria&#58; knee joint replacement&#58; pain associated with other knee injuries&#59; strengthening therapy at the time of intervention&#59; &#60;90&#176; knee flexion&#59; known sensitivity to tape materials&#44; or contraindication for exercise&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Assignment and randomization</span><p id="par0020" class="elsevierStylePara elsevierViewall">A member of the research team generated a randomized list of 32 patients assigned to two groups&#46; The randomization method used was by blocks&#46; Free license software&#44; recommended by Suresh<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a> and available at <a href="http://www.randomization.com/">www&#46;randomization&#46;com</a> was used&#46; In this study&#44; the number of patients per block was 4&#44; with a total of 8 blocks&#44; thus considering the 30 patients calculated for the sample size and two more that were added to balance the groups&#46; 32 opaque envelopes containing a card with two possible legends were listed&#58; A &#40;experimental&#41; or B &#40;control&#41;&#46; The envelopes were previously delivered to another member of the team &#40;blinded&#41;&#44; located in another hospital&#44; who by telephone transmitted the assignment to a sports doctor &#40;not blinded&#41; who gave the participants instructions regarding the intervention that would be given to them &#40;taping technique and exercise&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">WOMAC scale</span><p id="par0025" class="elsevierStylePara elsevierViewall">To determine the change in the degree of knee pain&#44; the WOMAC scale was applied&#46; This scale consists of three dimensions&#58; pain&#44; stiffness and functionality&#46; It is graded with a Likert scale of 0&#8211;4 and a higher score denotes a worst situation &#40;96 points &#8211; 20 for pain&#44; 8 for stiffness and 68 for functionality&#41;&#46; Several studies have been published about its reliability&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Intervention</span><p id="par0030" class="elsevierStylePara elsevierViewall">The exercise intervention was based on the quadriceps strengthening program published by Chang et al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> We developed a program in which the patients performed a dynamic-type strengthening exercise &#40;6&#8211;8 per Omni Perceived Exertion Scale-Resistance Exercise Scale &#91;OMNI-RES&#93;&#41; in their home&#44; with a volume of 3 sets of 15 unilateral repetitions&#44; with extension and flexion movement for both knees &#40;2-s duration per movement&#41;&#44; with a frequency of twice a day&#46; For calculation of 1-Repetition Maximum &#40;1RM&#41;&#44; a red&#44; green&#44; or blue band test &#40;Theraband&#174;&#41; was performed&#44; requesting that the patient perform at least 10 repetitions of extension&#46; The band was tied to a belt worn by the participant&#44; which that would aid in stabilizing the exercise&#46; The participant leaned against a wall&#44; sitting on the floor with both knees in extension&#46; They were asked to flex and adjust the elastic band to generate tension against the extension of the knee&#46; The band was adjusted to the level of effort requested according to the OMNI-RES scale&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> With this elastic band&#44; the participants performed&#44; in their homes&#44; 3 sets of 15 repetitions of extension and 3 sets of 15 repetitions of knee flexion unilaterally&#46; Rest intervals between each series were 30<span class="elsevierStyleHsp" style=""></span>s&#46; Frequency of execution was 3 days per week&#46; The patient was also asked to perform stretching exercises for quadriceps and hamstring muscles&#44; lasting 15<span class="elsevierStyleHsp" style=""></span>s per muscle group&#44; twice a day and 6 days which lasted a week&#46; In order to increase adherence to the intervention&#44; a daily control register was issued for the participant&#39;s exclusive use&#44; in which he&#47;she would record the exercises they performed on the corresponding days&#44; the time it took to do them&#44; and whether there were any adverse events&#46; The KT was installed according to the manufacturer&#39;s specifications &#40;Kinesio&#174;&#41;&#44; contained in the envelope in which the pre-cut product is sold&#46; This was done during each follow-up visit during the study&#46; Installation was accomplished by a single applier&#44; which is certified by the manufacturing company for a basic course and declares no conflict of interest&#46; The kinesiotape pre-cut knee tape pack contains 3 sections of tape&#58; 2 black &#40;I-strip and Y-strip&#41; and 1 blue &#40;I-strip&#41; tape&#46; With the knee flexed at 90&#176;&#44; the base of the black &#8220;I&#8221; strip was adhered on the leg midline about 15<span class="elsevierStyleHsp" style=""></span>cm above the interarticular line &#40;IAL&#41;&#46; No tension was applied and the strip was spread over the same midline to about 5 &#8211;7&#46;5<span class="elsevierStyleHsp" style=""></span>cm below the IAL&#46; The Y-strip was then applied&#44; also without tension&#44; and each tail extended to the sides of the midline&#46; After applying the KT to each participant&#44; generation of the &#8220;convolution&#8221; effect on the skin was confirmed&#44; requesting the participants&#8217; complete extension of both knees&#46; The placebo technique was installed under the same conditions&#44; on days different from those of the participants of the experimental group&#46; The same material was used&#44; but without the specifications contained in the envelope&#58; a single black &#8220;I&#8221; strip with high tension &#40;&#62;50&#37;&#41; and while the knees were flexed at 90&#176; with a bearing surface&#46; applications were carried out by means of an unblinded applier&#44; given the nature of the intervention&#46; To maintain the sample blind&#44; in each evaluation participants were asked to wear pants or long skirts to prevent them from showing the applied technique&#46; Participants were given an appointment after 1 week to reinstall the corresponding tape&#44; check the daily control register&#44; and confirm permanence in or withdrawal from the study&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Measurements</span><p id="par0035" class="elsevierStylePara elsevierViewall">In the first session&#44; prior to application of the tape&#44; the Visual Analog Scale &#40;VAS&#41; for pain intensity &#40;0&#8211;10<span class="elsevierStyleHsp" style=""></span>cm&#41; and the WOMAC index were applied for baseline measurement&#46; At the end of weeks 2&#44; 4&#44; and 6&#44; the VAS and WOMAC were again applied&#46; At the end of week 6&#44; the notebook was reviewed and a final appointment was assigned to inform the participants of the results&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">Our hypothesis was that the group with strengthening exercise and KT would have 2 fewer points of difference in knee pain&#44; compared with the control group&#44; measured through the WOMAC pain subscale&#46; With a <span class="elsevierStyleItalic">&#945;</span> of a 0&#46;05 and a <span class="elsevierStyleItalic">&#946;</span> of 80&#37;&#44; we consider data published by Chang et al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> to express a mean difference of 1&#46;7 points for pain &#40;Standard Deviation &#91;SD&#93;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;9 and 1&#46;5&#41; and of 8&#46;2 points for physical function &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;8 and 8&#46;3&#41; of WOMAC subscales&#44; a sample of 12 participants was calculated per group&#46; The sample was increased by 20&#37; to prevent losses&#44; and two more participants were added to balance the groups for the performance of block randomization&#46; <span class="elsevierStyleItalic">N</span> was 16 women per group&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Descriptive analysis of demographic variables was performed&#46; Baseline comparisons were made with the Student&#39;s <span class="elsevierStyleItalic">t</span> test and the <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test and the correlation coefficient for pain was carried out by the VAS and the WOMAC index&#46; On intergroup analysis&#44; a Friedman test was used for related samples&#44; calculation of percentage change for EVA and WOMAC and recalculation of Spearman&#39;s correlation coefficient between pain variables during the comparison of repeated measures&#46; Intergroup comparison was conducted as follows&#58; calculating analysis of covariance &#40;general linear model&#41; with Bonferroni statistic&#59; Hotelling trace criterion to determine the significance of interaction between times &#40;repeated measures&#41; per treatment group&#59; percentage of change for VAS and WOMAC &#40;from the baseline value of the covariable corresponding to the baseline mean of both groups at week 6 of follow-up&#41;&#44; and correlation coefficient between VAS and WOMAC variables during comparison of repeated measures and by interaction between assignment type and BMI category on percentage of change in pain&#46; Analysis was performed by intention-to-treat&#46; The software used was IBM SPSS Statistics for Windows &#40;Version 23&#46;0&#59; IBM Corp&#46;&#44; Armonk&#44; NY&#44; USA&#41; Significance level was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#46;05 throughout the study&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Ethical aspects</span><p id="par0050" class="elsevierStylePara elsevierViewall">This study took into account the principles of respect&#44; beneficence&#44; and justice&#44; as well as international ethical guidelines with regard to recommendations for an additive design&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">27&#44;28</span></a> The study was initiated once approval was obtained from the Institutional Review board and Ethics Committee&#46; Informed consent was accepted and signed by each participant&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Results</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Baseline</span><p id="par0055" class="elsevierStylePara elsevierViewall">We interviewed 39 subjects who fulfilled inclusion criteria&#46; 7 of them were excluded by diverse conditions&#46; In the control group&#44; there were 2 voluntary dropouts &#40;change of address and labor issues&#41; and in the experimental group there were 4 &#40;two reactions associated with the use of the KT but not with the materials &#8211; use of an external fixative substance and adhesive tape&#8211;&#44; voluntary dropout for academic reasons and other due to mechanopostural low back pain&#41;&#46; We followed up the corresponding cases &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">In the baseline state&#44; there were no significant differences in demographic variables&#44; but the allocation groups differed in terms of mean stiffness &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#44; with a higher score in the placebo group &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; In this baseline data&#44; as might be expected&#44; pain measured by VAS and WOMAC correlated with a Pearson <span class="elsevierStyleItalic">r</span> coefficient of 0&#46;445 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#59; BMI correlated with physical function &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;400&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#46; Within WOMAC&#44; pain with stiffness &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;553&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and pain with physical function &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;601&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; also exhibited correlation&#46; Finally&#44; stiffness and physical function correlated with a coefficient of <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;363 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46; Only physical function tended to be different according to the degree of obesity&#44; with 27&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;9 points for participants with grade I and 21&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;6 points for those with overweight &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;07&#41;&#46; The remaining variables &#40;age&#44; VAS&#44; pain&#44; and stiffness&#41; were similar between patients with obesity and those with overweight &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; There was also no association between degrees of obesity and the affected knee &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;28&#41; or with degree of OA &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;32&#41;&#44; and the latter were not associated with each other &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;53&#41;&#46; Baseline VAS was higher in cases in which the affected knee was the right one with 7&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;9 points vs&#46; 6&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6 with the left one &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#59; pain and stiffness&#46; On the other hand&#44; Baseline VAS also differed according to the degree of OA&#58; grade 3 was more painful &#40;10&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;3 points&#41; than grade 2 with 7&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;5 points &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#44; and there was greater stiffness&#44; with 4&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;2 points for grade 3 vs&#46; 2&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;3 points for grade 2 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Intragroup comparisons</span><p id="par0065" class="elsevierStylePara elsevierViewall">In the experimental group &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; the VAS decreased from 6&#46;4 to 4&#46;6 &#40;&#8722;28&#37;&#41; from baseline to week 6 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; while pain decreased from 7&#46;6 to 5&#46;5 &#40;&#8722;27&#46;5&#37;&#41; during the same time period &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46; There was no significant change in stiffness&#44; and the physical function scale decreased &#8722;14&#46;7&#37; with respect to the baseline score &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;07&#41;&#46; The percentage of change in pain correlated with percentages of change in stiffness &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;772&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and physical function &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;693&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#59; therefore&#44; as pain decreased&#44; stiffness decreased and physical function improved&#46; On the other hand&#44; the change in pain and the decrease in stiffness correlated with a change in an increase in physical function &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;880&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; In the placebo group &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; VAS decreased from 6&#46;7 to 5&#46;2 &#40;&#8722;22&#46;3&#37;&#41; of the baseline value at week 6 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; while pain decreased from 9&#46;0 to 5&#46;9 &#40;&#8722;34&#46;4&#37;&#41; during the same time period &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#59; stiffness decreased from 4&#46;0 to 2&#46;9 &#40;&#8722;25&#46;7&#37;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41; and the functional scale was reduced by 26&#46;0&#37; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Similar to the correlations observed in the experimental group&#44; in the control group&#44; the percentage of change in pain correlated with the percentages of changes in stiffness &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;888&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and in physical function &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;612&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;012&#41;&#44; implying that&#44; as pain decreased&#44; stiffness decreased and functionality improved&#46; In addition&#44; the change in the decrease in stiffness correlated with a change in the increase of functionality &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;521&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Intergroup comparisons</span><p id="par0070" class="elsevierStylePara elsevierViewall">The change percentage was calculated from the baseline value of the covariate&#44; which corresponds to the baseline mean of both groups up to week 6 of follow-up&#46; Respectively for placebo and experimental group&#44; there was a difference of 8&#46;2&#37; improvement in the VAS &#40;1&#46;9 and 1&#46;3 points&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;16&#41;&#44; while for the subscales there were 1&#46;1&#37; for pain &#40;2&#46;7 points for both groups&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;2&#41;&#44; 8&#46;3&#37; for stiffness &#40;0&#46;7 and 0&#46;4 points&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;1&#41; and 5&#37; for physical function &#40;4&#46;5 and 5&#46;7 points&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;65&#41;&#46; None was significant&#46; According to the Bonferroni test&#44; no significant differences were observed in any of the measurements of weeks 2&#44; 4 and 6&#44; except for week 4 for the pain subscale &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; with a difference of 1&#46;3 points and in week 2 for the stiffness subscale &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41; with a difference of 0&#46;9 points&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">Although KT is a widely used technique for the control of pain in several joint pathologies&#44; in our study the use of KT was not associated with a significant improvement in the WOMAC scale when evaluating knee OA&#46; The results obtained here indicate that quadriceps strengthening exercise accompanied by KT or a placebo technique decreases the pain measured by VAS and WOMAC after 6 weeks of treatment&#44; by 27&#46;5 and 34&#46;4&#37;&#44; respectively&#46; However&#44; at the time of comparing the two interventions with each another by means of covariance analysis&#44; the results exhibited a certain fluctuation&#44; such as the difference in pain at week 4 and in stiffness at week 2 in the placebo technique group&#46; However&#44; there were not significant differences between them&#46; In other words&#44; it is equally effective to apply KT or to apply the placebo technique&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Specifically&#44; we had negative results similar to authors like Wageck&#44; Aydogdu and Kocygit&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17&#8211;19</span></a> Wageck gives an intervention of only 4 days of in situ KT without taking into account the degree of OA&#44; while Aydogdu is the only one that includes the exercise as part of the experiment and gives a 3-week intervention in a study where it is not clear if among the participants there was a method to avoid contamination between groups&#46; In this study the number of exercise sessions is less than in our study and we consider that the presence of electrotherapy and cryotherapy makes the sum of effects more complex&#46; Kocygit&#44; on the other hand&#44; measures effects of the KT after 12 days&#44; with a continuous application every 4&#44; which we think&#44; is a more adequate way to maintain the effect that could have been enhanced by the exercise of having been applied&#46; This author extends the age range from 30 to 70 years&#44; which makes it difficult to determine if some participants had a greater degree of variability with respect to muscle condition and cartilage injury&#46; In contrast&#44; Akinbo&#44; Anandkumar&#44; Cho and Kaya<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">20&#8211;23</span></a> have results contrary to ours in their studies&#46; Akinbo finds important&#44; but perhaps obvious&#44; differences in favor of the population with knee injury due to sports activity&#44; who will have a better response to pain due to their physical condition and age&#46; Due to the inequality between the interventions and the characteristics of the groups&#44; the value of their measurements is compromised and restricts the comparisons&#46; With Anandkumar&#44; the convolution effect seems to be responsible for an improvement in strength&#44; but the taping techniques were very similar to each other&#46; Probably varying the taping intervention would have differentiated the techniques and given more reliability to the measurements&#46; Other drawbacks are that it does not indicate whether the measurements were made with or without the taping applied and that incorporates participants with OA grade I&#44; in whom strength can be seen best expressed&#46; Cho has very significant results in relation to pain and proprioceptive capacity and like the Anandkumar study&#59; the convolution effect seems to be responsible for the improvement&#44; since the tension seems to be large enough to eliminate this possible effect in the placebo&#46; We think that if the number and size of convolutions is a factor to improve the effects on pain and strength&#44; then somatotype and age are important&#44; because skin folds can be formed more easily in the elderly and in ectomorphic subjects&#46; Regarding Kaya&#44; it presents pain improvement during the walk qualified with ALF score and degree of pain to the activity qualified with VAS&#46; An important contribution is the application of KT on hamstring musculature&#44; as other techniques suggest only applies to the quadriceps region&#46; Related to this&#44; it should be noted that there is a relationship of unilateral forces in the knee and that maintaining the best balance between the quadriceps and the hamstrings can give important clinical improvements&#46; We found that other authors present their conclusions considering immediate measurements to the installation of the KT&#44; include male and female population producing unbalanced categories&#44; take into account grades 1 and 4 of OA and it is intended to award the KT short-term effects on a chronic injury that requires a treatment with proven effects&#44; such as exercise&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In this study&#44; we attempted to pay attention to the risk of having a high BMI and its possible consequences for pain as part of the secondary objectives&#59; however&#44; the results remained inconsistent&#44; in that pain correlating with stiffness and physical function exhibited no decrease according to OA grade and overweight&#47;obesity characteristics&#46; Application of the placebo is very debatable under different circumstances as follows&#58; if the material is of the same type&#44; the effect is not clear of the tape&#39;s different tensions and extensions&#44; in addition to the mechanisms involved at the neurobiological level that continue to be investigated&#46; However&#44; the intention of the study was to apply what was indicated by the creator and the manufacturer of the KT&#44; which is to give rise to the convolution effect that increases the blood and lymphatic flow as well as the decompression of local pain receptors&#46; In another study&#44; Parreira<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a> reported similar results in a clinical trial with intervention for low back pain&#46; In shoulder injuries&#44; Kaya<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> and Thelen<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> also found improvements for each group that was associated with the application of therapeutic exercise&#44; in the same manner and without differences between groups&#46; In these cases&#44; as in our experiment&#44; the difference in the application of the tape present in both groups was the tension of the strips and the generation of the previously mentioned effect&#46; We are in agreement in mentioning that this technique may not possess the manufacturer&#39;s stated vascular or nervous effect&#44; which could be related to muscle activation&#44; at least in these chronic injuries&#46; This is similar to a study published by Lins&#44;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> in which the authors experimented with variables of balance and strength at the electromyographic level without finding significant effects&#46; Nonetheless&#44; but it is noteworthy that their population comprised healthy women in which the differences may be more difficult to find and with measurements at the short term&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">We consider that the duration of the exercise&#44; the continuity in the application of the KT&#44; the selection of grades 2 and 3 of OA and limiting the selection to women with a common BMI in this population are strengths of our study&#46; Some limitations of our study are the non-determination of strength through objective methods such as isokinetic&#44; as this would have verified the changes resulting from the training&#46; As Cho did&#44; we did not install tape on the hamstring muscles&#44; which might have biomechanically favored the development of strength&#46; Only verbal control was taken with regard to the intake of medications &#40;only requesting that no NSAIDs or analgesics be taken during the duration of the intervention&#41;&#46; We also think that it is likely that a third group&#44; without taping and only with exercise&#44; contributed with more data&#46; Unfortunately&#44; although a sample size was calculated&#44; we believe that the number of measurements may have been reduced to apply parametric statistical analysis techniques&#46; Finally&#44; although an instruction session was given&#44; the exercise prescription was carried out at home&#44; so it was not supervised&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">We can conclude that in our study&#44; KT added to strengthening therapy does not offer a significant improvement in pain compared with quadriceps strengthening exercise alone in knee OA&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflict of interests</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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    "fechaRecibido" => "2017-07-21"
    "fechaAceptado" => "2018-03-07"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The beneficial effects of exercise in the treatment of Osteoarthritis &#40;OA&#41; of the knee have been verified in several studies&#46; Kinesiotaping &#40;KT&#41; has been popularized due to its reducing local pressure and increasing circulation&#44; resulting in decreased pain&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Determine the clinical effectiveness of strengthening therapy with KT in women with knee OA for pain reduction&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Thirty two women with knee OA&#44; aged 50&#8211;70 years&#44; with overweight or obesity grade I&#44; who were randomized into two groups&#58; one with exercise and KT&#44; and the other&#44; with exercise and placebo technique&#46; Both groups performed stretching and quadriceps strengthening exercise with the elastic band 3 days weekly for 6 weeks&#46; Measurement of the Western Ontario and McMaster Universities Osteoarthritis Index &#40;WOMAC&#41; pain subscale was taken as primary outcome&#46; Stiffness and functionality of the same index and the Visual Analog Scale &#40;VAS&#41; for pain intensity were measured&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">At the end of the study&#44; there were no significant differences between the groups&#46; Both groups had a difference of 2&#46;7 points with respect to the baseline measurement&#44; change percentage of 32&#46;2&#37; and 31&#46;1&#37; for placebo and experimental respectively &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;2&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">KT plus quadriceps strengthening exercise does not offer advantages for improvement of pain compared with quadriceps strengthening exercise alone in knee OA&#46;</p></span>"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Los efectos ben&#233;ficos del ejercicio en el tratamiento de la osteoartritis &#40;OA&#41; de rodilla han sido verificados en varios estudios&#46; El vendaje kinesiol&#243;gico o <span class="elsevierStyleItalic">kinesiotaping</span> &#40;KT&#41; se ha popularizado debido a la reducci&#243;n de la presi&#243;n local y el aumento de la circulaci&#243;n&#44; lo que resulta en disminuci&#243;n del dolor&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Determinar la efectividad cl&#237;nica de la terapia de fortalecimiento en conjunto con el uso de KT en mujeres con OA de rodilla para la reducci&#243;n del dolor&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Participaron 32 mujeres con OA de rodilla&#44; con edades comprendidas entre 50 y 70 a&#241;os&#44; sobrepeso u obesidad grado I&#44; que fueron asignadas al azar en 2 grupos&#58; uno con ejercicio y KT y otro con ejercicio y vendaje placebo&#46; Ambos grupos realizaron ejercicios de estiramiento y fortalecimiento de los cu&#225;driceps con banda el&#225;stica 3 d&#237;as semanales durante 6 semanas&#46; El desenlace primario fue medido con la subescala del dolor del Western Ontario y McMaster Universities Osteoarthritis Index &#40;WOMAC&#41;&#46; Se midieron la rigidez y la funcionalidad del mismo &#237;ndice y la escala anal&#243;gica visual &#40;VAS&#41; para la intensidad del dolor&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Al final del estudio&#44; no hubo diferencias significativas entre los grupos&#46; Ambos grupos tuvieron una diferencia de 2&#44;7 puntos respecto a la medici&#243;n basal&#44; porcentaje de cambio del 32&#44;2 y 31&#44;1&#37; para placebo y experimental&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;2&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">El KT en conjunto con el ejercicio de fortalecimiento no ofrece ventajas para mejorar el dolor en comparaci&#243;n solo con el ejercicio de fortalecimiento en la OA de rodilla&#46;</p></span>"
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