Sixteen studies (n=431) were included: 4 parallel-group RCTs (n=249), 1 crossover RCT (n=14) and 11 non-randomised studies, most of which used patients as their own controls (n=168).
The studies scored between 3 and 9 out of 10 for quality on the PEDro scale (mean 4.25).
Pain (4 RCTs and 7 other studies).
One RCT (n=81; PEDro score 7) reported no significant difference between (1) exercise, taping plus education, (2) exercise plus education, (3) taping plus education, and (4) education alone in VAS pain, Western Ontario and McMaster lower limb function scores, Hospital Anxiety and Depression scores at 3 or 12 months. One RCT (n=113, PEDro score 5) reported that a taping plus biofeedback plus a physiotherapist-directed programme (that included McConnell taping, biofeedback and exercise) significantly improved scores on various pain scales and questionnaires (VAS, Functional Index Questionnaire, clinical change score and Patellofemoral Function Score) during a step test at 1 month compared with an exercise programme monitored by a physiotherapist (P<0.05), but there was no statistically significant difference between the physiotherapist-directed programme (that included taping) and a home strengthening and flexibility exercise programme.
One RCT (n=25; PEDro score 3) reported no significant difference in pain between taping and no taping in patients who were instructed about physical therapy and a home exercise programme.
One RCT (n=30; PEDro score 9) reported that patellar taping plus exercise significantly reduced VAS scores for pain at 2, 3 and 4 weeks compared with placebo taping plus exercise and exercise alone (VAS: 1.1 versus 2.4 and 2.9 respectively, P<0.001). The RCT also reported that patellar taping plus exercise significantly reduced pain during a step-down task (VAS: 1.8 versus 3.4 and 3.4; P<0.001) and the mean Functional Index Questionnaire scores at weeks 2, 3 and 4 compared with the other two interventions. Patellar taping was administered daily.
The results of the 7 non-randomised studies (n=118) were also reported.
Quadriceps activity (3 studies): there were significant improvements in quadriceps power at 3 months after exercise, taping plus education, exercise plus education, taping plus education and education alone (1 RCT, n=81), significant improvements in quadriceps strength after physical therapy but no statistically significant difference between taping and no taping (1 RCT, n=25), and significantly increased quadriceps peak torque during isokinetic quadriceps contraction with taping (1 non-randomised study, n=14).
Onset of VMO activity relative to vastus lateralis (5 non-randomised studies): taping was associated with a significant decrease in the EMG ratio of VMO to VL (1 study, n=15, P=0.05), an earlier onset of VMO EMG activity during a step-up and step-down test (1 study, n=14, P=0.0008), increased VMO activity but no effect on VL activity (1 study, n=30; P<0.01 and P>0.05, respectively), and an increase in the EMG amplitude of the VMA for lateral stretch compared with other directions (P<0.001). The fifth study reported that VMO activity started earlier during stair ascent in 10 patients with PFPS compared with 12 healthy controls.
Knee joint biomechanics during activity (3 studies): taping was associated with increased cadance, knee flexion angles and knee extension movements but no effect on VL EMG activity (1 non-randomised study, n=10), increased stride length during ramp, ascent and increased loading response knee flexion but no effect on other stride characteristics (1 non-randomised study, n=15), and greater knee extensor movement (1 crossover RCT, n=14).
Patellar positioning (3 non-randomised studies): 2 studies reported no effect of patellar taping on patellar lateralisation or patellar tilt (1 study, n=16) or on patellofemoral congruency or patellar rotation angles (1 study, n=15). The third study (n=12) reported that patellar taping plus bracing significantly decreased patellofemoral congruence angle at 10 degrees of knee flexion compared with no taping; the study measured eight angles of knee flexion.