| Summary: | 碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 107 === Background and purpose: Anterior glenohumeral instability is one of the factors that causes shoulder pain in overhead athletes. Although taping is commonly used to treat these situations, no study has been found to investigate the effect of biomechanical taping in symptomatic athletes. Only a few studies have examined the effects of taping in healthy people and asymptomatic overhead athletes, showing that rigid taping could provide better stability for the shoulder. A newly developed biomechanical taping method using an elastic dynamic tape is considered to be beneficial in controlling symptoms without restricting joint movements. However, there are no studies examining whether the dynamic taping method is effective in treating individuals with shoulder problems. The purpose of this study is to compare the effect of the dynamic taping with the rigid taping on pain and shoulder stability in volleyball players with anterior glenohumeral instability. Methods: This study was a prospective, randomized crossover trial. We recruited 30 volleyball players (15 females and 15 males, average age: (23.15±3.38yr) with anterior shoulder instability. All subjects received both taping methods, the dynamic taping (DT) and the rigid taping (RT), on the same day. The sequence of the two taping conditions was randomly ordered. Two taping conditions were separated by a 15-minute break to wash out the carryover effect of the first taping. In order to compare the effect between these two taping methods on sporting activities, the second taping was left on the subject’s shoulder for two days and the subjects were asked to play a volleyball game within two days for the follow-up test. Outcome variables included (1) pain intensity; (2) passive anterior displacement of the humeral head; (3) feeling of tape comfort and restriction (self-reported questionnaire); (4) active shoulder range of motion (ROM); (5) dynamic anterior displacement of the humeral head; (6) perceived improvement. All outcomes were tested immediately after each taping method (post-test) while the pain intensity, tape comfort/restriction, and perceived improvement were also tested at the 2-day follow-up. Statistical analysis: To determine whether there was any carryover effect from the order of taping, the taping order was used as an independent variable in the repeated measures ANOVAs with all of the outcomes as the dependent variables. Repeated measures multivariate analyses of variance (MANOVAs), two-way repeated measures analyses of variance (ANOVAs) and chi-square tests were used to compare the treatment effects between two taping methods. Results: Both taping methods significantly decreased pain at the post-test and the follow-up test (P<0.001). Compared with the rigid tape, subjects reported that dynamic tape was more comfortable and less restricted both at the post-test and the follow-up test (P<0.001). Ranges of shoulder internal rotation and external rotation were decreased significantly after the rigid taping (P=0.001, P<0.001) while the shoulder mobilities were not affected by the dynamic taping. Passive and dynamic humeral head anterior displacement (P<0.001) were significantly decreased by both taping methods. The proportion of subjects who perceived a significant improvement was high in both taping methods (RT: 67%, DT: 83%) immediately after taping (the post-test). However, during the follow-up test, only the dynamic taping group retained the high proportion (DT: 80%) of subjects who perceived a significant improvement. The extent of perceived improvement decreased in subjects of the rigid taping group (RT: 40%) at the follow-up test. Discussion: Through the mechanical effect, both rigid taping and dynamic taping could prevent the humeral head from excessive anterior displacement so that the excessive loading stress on the anterior structures of shoulder could be reduced. Shoulder taping also improve the motor control of scapular muscles. Although the rigid taping provided more shoulder stability, its non-elastic property caused more discomfort and restriction in young volleyball players during the daily life as well as when playing volleyball. Conclusion: Both taping methods significantly decreased pain and increased stability. Dynamic taping was superior to rigid taping in treating symptomatic volleyball players with shoulder anterior instability.
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