DOI 10.
36803/indojpmr.
Indonesian Journal of Physical Medicine and Rehabilitation | Volume 14.
Issue 02, 2025
ORIGINAL ARTICLE
Effectiveness of Elastic Taping Compared to Sham Taping on Upper Trapezius Muscle Elasticity in Patients with Myofascial Pain Syndrome Clarissa1,2.
Fitri Anestherita1,2.
Ibrahim Agung1,2.
Amilya Agustina3 Department of Physical and Rehabilitation Medicine.
Faculty of Medicine Universitas Indonesia.
Dr.
Cipto Mangunkusumo General Hospital Jakarta.
Indonesia.
Department of Community Medicine.
Faculty of Medicine Universitas Indonesia.
Jakarta.
Indonesia
ABSTRACT
Introduction: Elastic taping (ET) is believed to improve muscle elasticity in patients with myofascial pain syndrome (MPS).
however, studies employing objective measurements of muscle elasticity remain scarce.
This study aims to provide empirical evidence demonstrating that ET can objectively improve muscle elasticity.
Methods: This double-blind randomized clinical trial investigated the efficacy of ET versus sham taping on upper trapezius muscle elasticity and pain pressure threshold (PPT) in patients with MPS.
Participants were assigned to ET using the inhibition technique or sham taping without stretch.
Shear wave elastography (SWE) and PPT were measured pre-intervention, 20 minutes, and 24 hours post-intervention.
Results: The ET group demonstrated significant improvements in muscle elasticity .
educed SWE) and increased PPT at both 20 minutes and 24 hours .
<0.
The sham group showed non-significant changes at 20 minutes .
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and partial improvement at 24 hours.
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Between-group comparisons revealed statistically significant differences at both post-intervention time points .
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Conclusion: ET proved effective as an adjunct to stretching, eliciting immediate and sustained benefits, and represents a non-invasive, easily applicable modality with potential for wide clinical use in upper trapezius MPS.
Keywords: myofascial pain syndrome, upper trapezius, elastic taping, shear wave elastography, pain pressure Correspondence Detail:
Clarissa Department of Physical and Rehabilitation Medicine.
Faculty of Medicine Universitas Indonesia.
Jakarta.
Indonesia.
Dr.
Cipto Mangunkusumo General Hospital.
Jakarta.
Indonesia.
Email: clarissazhang@live.
A Indonesian Journal of Physical Medicine and Rehabilitation Ai Published by PP PERDOSRI This is an open access article under the CC -BY .
ttp://creativecommons.
org/licenses/by/4.
0/).
Indonesian Journal of Physical Medicine and Rehabilitation | Volume 14.
Issue 02, 2025
INTRODUCTION
Myofascial pain syndrome (MPS) is a musculoskeletal disorder characterized by sensory, motor, and autonomic disturbances, including referred pain, reduced range of motion, and diminished muscle A.
A These manifestations arise from myofascial trigger points (MTrP.
, defined as palpable hyperirritable nodules within skeletal muscleA.
MPS
most frequently affects the upper trapezius, particularly in individuals of productive age, leading to decreased productivity and reduced quality of life.
A,AA
The pathophysiology of MTrPs involves sustained muscle fiber hypercontraction, reduced tissue elasticity, and altered mechanoreceptor activityAiincluding the muscle spindle and Golgi Tendon OrganAiaffecting both the MTrP region and adjacent tissue.
A-A Diagnosis remains largely clinical and subjective, relying on tenderness, referred pain, local twitch response, and restricted motion.
A Shear wave elastography (SWE) has emerged as an objective imaging modality capable of quantitatively assessing muscle elasticity.
AA-AA
Management MPS pharmacological options .
ocal anesthetics, steroids.
NSAIDs, botulinum toxi.
and non-pharmacological interventions such as stretching, physiotherapy, acupuncture, ultrasound, and elastic taping (ET).
AA,AA
Stretching reduces muscle stiffness and improves tissue viscoelasticity, although its effects are often AA-AA ET provides mechanical and cellular effectsAiincluding muscle elongation, improved tissue elasticity, edema control, and fibroblast modulationAi potentially prolonging the benefits of stretching.
AA-AA
Although ET has been shown to reduce pain and improve muscle strength, objective evidence regarding its effect on upper trapezius elasticity remains limited.
20-23 This study compares ET with sham taping, as an adjunct to standard stretching, to provide evidence for a practical, non-invasive therapeutic intervention.
METHODS
This study was a double-blind randomized clinical trial designed to evaluate the effectiveness of ET compared with sham taping on upper trapezius muscle elasticity and pain pressure threshold (PPT) in patients with MPS.
The study was conducted at the Department of Physical Medicine and Rehabilitation.
Faculty of Medicine Universitas Indonesia Ae Cipto Mangunkusumo Hospital (FMUIAeRSCM) from July 2024 to December 2024.
Participants were patients aged 18Ae59 years with a Visual Analog Scale (VAS) pain score of 1Ae7 who provided informed consent.
Exclusion criteria included a history of trauma or surgery to the shoulder or neck, allergy to taping materials, infection or open wounds in the shoulder region, malignancy, deep vein thrombosis (DVT), myofascial pain treatment within the previous 2 weeks, other musculoskeletal disorders .
, fibromyalgia, frozen shoulder, impingement, scoliosi.
, and obesity.
Subjects were recruited through consecutive sampling and randomly assigned to the ET or sham taping group.
A minimum of 24 subjects per group .
, including a 20% anticipated drop-out rate, was required.
Subjects were considered dropouts if they withdrew, failed to attend the 24-hour post-intervention assessment, or used analgesic medications during the study period.
Participants meeting the inclusion and exclusion criteria were consecutively recruited and provided written informed consent.
Researcher A performed demographic and clinical assessments, including physical examination, identification of MTrP, and measurement of the PPT.
PPT was measured with the participant seated in a neutral head The examiner applied perpendicular pressure on the identified MTrP using a pressure algometer (FPX 25.
Wagner Pain TestE.
Canad.
and recorded the pressure value at the moment the subject first reported pain.
The measurement was repeated three times, and the mean value was used for analysis .
g/cm.
Participants were randomly allocated by sealed-envelope method into the ET or sham taping In the ET group.
BSN Leukotape K .
cm y 5 cm, beig.
was applied using an inhibition AuYAy technique from insertion to origin with 25% tension, leaving a probe window over the marked region.
In the sham group, the same tape was applied without tension nor direction of the tape attachment.
All participants received standardized static stretching consisting of neck flexion, ipsilateral rotation, and contralateral lateral bending, held for 30s and repeated three times.
Muscle elasticity was measured by researcher B using shear wave elastography (SWE, in m/.
at the A Indonesian Journal of Physical Medicine and Rehabilitation Ai Published by PP PERDOSRI This is an open access article under the CC -BY .
ttp://creativecommons.
org/licenses/by/4.
0/).
228 Effectiveness of Elastic Taping Compared to Sham Taping on Upper Trapezius Muscle upper trapezius, with subjects seated and markers placed between C4 and the acromion.
Ten regions of interest (ROI) were analyzed in the longitudinal plane.
Measurements were taken at baseline, 20 minutes, and 24 hours post-intervention.
SWE measurements were obtained using a LOGIQ P8 ultrasound system equipped with a 9Ae12 MHz linear transducer (GE Healthcare.
Chicago.
IL.
USA).
PPT was reassessed at the same time points.
Researcher B, a trained musculoskeletal physiatrist, was blinded to group Data was analyzed using IBM SPSS version Initial analyses included descriptive statistics and data normality testing.
Between-group differences were examined using the independent two-sample ttest for parametric data or the MannAeWhitney U test for non-parametric data, whereas within- group changes were analyzed using the paired t-test.
Results were presented in tables or narrative form, with a significant level of p<0.
05 and a 95% confidence This study was conducted after obtaining ethical approval from the Research Ethics Committee of the Faculty of Medicine.
Universitas Indonesia.
(KET-1798/UN2.
F1/ETIK/PPM.
00/02/2023.
Table 1.
Characteristics of subjects Characteristic Age .
ean A SD) Gender Stretching and Elastic Taping, n (%) Stretching and Sham Taping, n (%) 31,20A2,483 30,64A2,396 0,421 Male Female 18 .
%) 21 .
%) 0,306 Upper trapezius elasticity (SWE) .
4,27A0,87 4,03A1,03 0,382 Pain pressure baseline (PPT) .
g/cm.
0,313 : Independent T-test : Chi-square, : Mann-Whitney U test Table 2.
Analysis of the Difference in Mean SWE Upper Trapezius Pre-intervention and post-intervention Variables Stretching Elastic Taping Stretching and Sham Taping Mean Difference (CI 95%) Mean difference of elasticity pre and post 20minute of -0,54A0,75 -0,29A0,91 -0,24 (-0,72-0,.
0,309 Mean difference of elasticity pre and post 24hours of -0,56A0,89 -0,56A1,12 0,01 (-0,57-0,.
0,982 RESULTS The study subjects consisted of 50 patients diagnosed with upper trapezius myofascial pain syndrome who met the inclusion criteria and had no exclusion criteria.
Baseline characteristics were conducted before assessing the effectiveness of the therapy program.
The results of the baseline characteristics are shown in Table 1, which shows no significant differences in the baseline characteristics of the study subjects between the two groups, either in terms of age or gender.
Clarissa et al.
,2025
: Paired T-test, *statistically significant, p<0,05 Table 3.
Analysis of the Difference in Mean SWE Pre and Post in the Elastic Taping and Sham Taping Groups Baseline .
20 minutes .
24 hours .
Elastic Taping P- value Mean Difference Sham Taping Pvalue 4,27A0,87 4,03A1,03 3,73A0,78 0,002* 3,71A0,81 : Paired T-test, *statistically significant, p<0,05 0,001* 0,54 .
,22-0,.
0,56 .
,19-0,.
Mean Difference 3,74A0,80 0,122* 0,29 (-0,08Ae0,.
3,46A0,78 0,56 .
,10Ae1,.
0,019* Indonesian Journal of Physical Medicine and Rehabilitation | Volume 14.
Issue 02, 2025 Table 4.
Analysis of the Difference in Mean Pain Pressure Threshold (PPT) Pre-Intervention and Post-Intervention Variable Stretching and Elastic Taping Stretching and Sham Taping P value PPT difference pre and post 20-minute of intervention 14 .
Ae .
3 (-29-.
0,001* PPT difference pre and post 24-hours of intervention 5 (-2-.
2 (-20-.
0,001* : Mann-Whitney U test, * statistically significant, p<0,05 Table 5.
Analysis of the Difference in Average PPT Pre and Post in the Elastic Taping and Sham Taping Groups Elastic Taping P-value Sham Taping P- value 28 .
20 menit 43 .
0,001* 33 .
0,033* 24 jam 37 .
0,001* 37 .
0,035* Baseline PPT : Wilcoxon Test, * statistically significant, p<0,05 DISCUSSION This study involved patients aged 18Ae59 years with upper trapezius myofascial pain syndrome, with a mean age of 30.
9 A 2.
43 years, consistent with previous studies reporting mean subject ages ranging 8 to 34 years.
A,AA,AA Myofascial pain syndrome is more commonly observed in individuals of productive age due to work-related neck disorders, particularly in occupations requiring prolonged sitting and overactivation of the upper trapezius, which may contribute to muscle fiber degeneration, increased stiffness, tenderness, and alterations in muscle Women represented 78% of the study population, consistent with literature indicating a higher risk of MPS in females, potentially influenced by hormonal factors such as estrogen and relaxion, which affect extracellular matrix remodeling, tissue stiffness, and fascial nociceptor sensitization.
Elastic taping applied to the upper trapezius significantly improved muscle elasticity, with average SWE values decreasing by 12% at 20 minutes and 13% at 24 hours post-application.
This reduction reflects decreased muscle stiffness and improved muscle adaptability to passive tension.
Muscle elasticity measured through SWE represents the structural integrity of collagen and elastin fibers, key determinants of viscoelastic behavior.
A,A
These post-intervention SWE changes indicate an adaptive tissue response to external mechanical stimulation provided by taping.
The underlying mechanism involves stimulation of fascial mechanoreceptors, particularly Ruffini endings, which respond to slow stretch and shear forces.
Their activation sends afferent input to the central nervous system, modulating autonomic balance by increasing parasympathetic tone, reducing sympathetic activity, and decreasing gamma motor neuron drive.
These physiological effects promote muscle relaxation, reduce muscle tone, redistribute intramuscular pressure, and enhance local perfusion, reducing edema, adhesions, and stiffness.
Additionally, elastic taping imposes continuous mechanical pulling action on the superficial fascia, facilitating slow viscoelastic deformation and microstructural reorganization of collagen and muscle fibers.
This mechanism contributes to measurable reductions in stiffness observed on SWE.
3,8 Prior research demonstrates that viscoelastic changes typically require 15Ae30 minutes to manifest, consistent with slow-adapting mechanoreceptor responses.
Although sham taping also reduced elasticity, the onset of change occurred slower compared to elastic taping.
This may relate to differences in stretch intensity: sham taping provides 15% pre-stretch tension, whereas the inhibition taping technique uses 25% stretch, generating stronger mechanoreceptor stimulation and faster tissue adaptation.
10,11 Higher stimulus intensity and longer exposure are associated with shorter afferent transmission latency and more rapid physiological responses.
Overall, elastic taping influences upper modulation, fascial stimulation, redistribution of intramuscular pressure, and viscoelastic adjustments.
A Indonesian Journal of Physical Medicine and Rehabilitation Ai Published by PP PERDOSRI This is an open access article under the CC -BY .
ttp://creativecommons.
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0/).
230 Effectiveness of Elastic Taping Compared to Sham Taping on Upper Trapezius Muscle These findings provide objective evidence that elastic taping induces measurable physiological alteration in muscle mechanical properties beyond subjective pain relief, supporting its therapeutic role in MPS Elastic taping also significantly improved PPT at both 20 minutes and 24 hours compared with sham taping.
The analgesic effects may involve reduced activation of subcutaneous nociceptors, stimulation of large-diameter afferent fibers .
onsistent with the Gate Control Theor.
, and enhanced blood and lymphatic circulation facilitating removal of pro-inflammatory mediators.
Similar to the natural properties of other sensory systems, mechanoreceptors may undergo habituationAia reduction in neural responsiveness to prolonged or repetitive stimuliAiwhich may occur within hours when mechanical input is static or Nevertheless, stimulation from taping maintained its efficacy, as evidenced by the persistent improvements in SWE and PPT observed 24 hours after application.
CONCLUSION
The ET group demonstrated significant improvements in muscle elasticity .
ndicated by decreased SWE value.
and increased PPT at both 20 minutes and 24 hours post-intervention.
The sham taping group showed a nonsignificant reduction in SWE at 20 minutes but a significant reduction at 24 hours, along with increased PPT at both time points.
Between-group comparisons revealed statistically significant differences in SWE and PPT values at both measurement intervals.
It is proven in this study that elastic taping may serve as an effective non-invasive adjunct to stretching therapy in the treatment of upper trapezius myofascial pain syndrome, as application of ET is simple to perform, easily accessible, and safe, with no significant adverse effects observed throughout the course of this study.
REFERENCES