661-667Journal of Orthopaedic & Sports Physical Therapy

l999;29(l l):661-667

Effect of Patellar Taping on Knee Kinetics of

Patients With patell-ofemoral Pain Syndrome
Gregory R Ernst, PhD, P'I; SCS, ATC1
leffrey Kawaguchi, P'I; ATCZ
Ethan Saliba, PhD, P'I; SCS, ATC3

Study Design: Single-group repeated measures examining patients with patellofemoral pain atellofemoral pain syn-
syndrome.
Objective: To examine the effect of McConnell patellar taping on single-leg vertical jump
height and knee extensor moment and power during a vertical jump and lateral step-up.
Background: htellar taping is used by clinicians in an attempt to maximize knee extensor
function during sporting activities and rehabilitation of patients with patellofemoral pain
syndrome. No studies have examined the effect of patellar taping on vertical jump height
and knee extensor moment and power during a maximal vertical jump or lateral step-up.
P drome is most preva-
lent in adolescent girls
and active individu-
a l ~ . ~ . 'Treatment
~.~'
grams for patellofemoral pain syn-
drome include various types of
strengthening and stretching pro-
pro-

+
Methods and Measures: Fourteen women (24.4 5.8 years) with unilateral patellofemoral grams, biofeedback, neuromuscu-
pain performed a single-leg vertical jump and lateral step-up during 4 knee conditions: lar electrical stimulation, thermal
patellar tape, placebo tape, no tape, and the uninvolved knee. Maximal knee extensor modalities, bracing, foot orthotics,
moment, knee power, and vertical jump height were measured for each condition using a and taping.l.l 1.25.26.92S.57 A
force platform and motion analysis system. common feature in all of these re-
Results Analyses of variance and post hoc analyses revealed a main effect for knee habilitation programs is the inclu-
condition. The patellar tape condition resulted in a greater knee extensor moment (1.57 2 sion of quadriceps femoris mus-
+
0.32 N.m/kg) and power (3.47 0.67 Wlkg) than did the no-tape (1.31 2 0.39 N m k g and cle-strengthening exercise. Studies
+
2.79 1.21 Wkg) and placebo tape (1.33 2 0.30 N m k g and 2.70 0.99 Wkg) + have shown that specific training
conditions. Additional analyses showed that the vertical-jump height was significantly of the vastus medialis may alleviate
+
greater in the uninvolved lower extremity (25.69 2.66 cm) compared with the patellar symptoms in patients with patello-
tape (23.33 5 4.22 cm), placebo tape (23.08 5 4.20 cm), and no-tape (23.45 4.54 cm) + femoral pain s y n d r ~ m e .Many ~~.~~
conditions. The patellar tape condition did not show a different vertical jump height than the clinicians therefore advocate vari-
placebo or no-tape conditions. ous methods to isolate and
Conclusions: These results suggest that patellar taping compared with no tape may improve strengthen the vastus medialis to
the knee extensor moment and power during weight-bearing activities such as the lateral maintain proper patellar align-
step-up exercise and the vertical jump. / Orthop Sports Phys Ther 1999;29:661-667. ment during movement.17
Key Words: lower-extremity kinetics, patellar taping patellofemoral pain Bracing has also been used to
align the patella in patients with
patellofemoral pain syndrome.
Levine16 reported a decrease in
perceived patellofemoral pain with
an infrapatellar strap. Palumbon
Commander, Medical Service Corps, US Navy, Assistant professor, US Army-Baylor University Pro- used a survey to examine the ef-
gram in Physical Therapy, Ft Sam Houston, Tex. fectiveness of an elastic sleeve with
Assistant athletic trainer, University of Virginia, Charlottesville, Va. a patella cutout, lateral patella
Associate athletic trainer and Assistant professor, University of Virginia, Charlottesville, Va. pad, and 2 circumferential straps
The views expressed in this article are those of the author and do not reflect the official policy or
position of the Department of the Navy, the Department of Defense, nor the US Government.
that applied a medially directed
Send correspondence to Gregory t? Ernst, 182 Artillery Post, Ft Sam Houston, TX 78234. E- mail: force to the patella. More than
gernst 1@juno.com 93% of the patients with patello-
 femoral pain reported a decrease in pain and in- and vastus lateralis. Since no differences were found
crease in activity with use of the brace.= Lysholm et between the groups, the authors concluded that pa-
al1"eported a significant increase in concentric iso- tellar taping had little benefit over a standard reha-
kinetic peak torque of the knee extensors for s u b bilitation program.
jects who wore a patellar brace compared with those No studies have examined the effect of patellar
who wore no brace. The authors theorized that mala- taping on knee extensor strength or power during
lignment of the knee extensor mechanism causes pa- functional activities. The primary purpose of this
tellofemoral pain, which results in reduced knee ex- study was to examine the effect of McConnell patel-
tensor torque. The lateral pad on the brace im- lar taping on the knee extensor moment and power
proved the alignment of the knee extensor mecha- during a lateral stepup and vertical jump. Examin-
nism, which was thought to reduce pain and allow a ing the effect of patellar taping on vertical jump
greater torque production compared with that in the height was a secondary purpose.
nonbraced condition.ln It was hypothesized that (1) the injured knee ex-
McConnellm proposed a rehabilitation program tensor moment and power would be less than that of
hallmarked by a detailed evaluation of patellar orien- the uninvolved knee during the lateral stepup and
tation and subsequent taping of the patella to opti- vertical jump, (2) the knee extensor moment and
mize tracking within the femoral groove. Mc- power of the involved knee would be greater with pa-
Connellm also emphasized a specific training regime tellar taping than in the placebo or netape condi-
of the vastus medialis oblique through electromye tions during a lateral stepup and vertical jump, and
graphic (EMG) biofeedback, stretching lateral knee (3) vertical jump height would be greater with patel-
structures, and training in a weight-bearing position. lar taping than without taping in the injured knee.
Several other studies examined the efficacy of
McConnell patellar-taping techniques. Conway et a17 METHODS
compared the effect of patellar taping and the use of
a patellar brace on isokinetic knee extensor strength Subjects
and perceived pain. They reported that patellar t a p
ing or a patellar brace resulted in a greater concen- Fourteen women (height = 173 2 7 cm; weight =
tric knee extensor torque compared with that in a 66.5 2 12 kg) a mean age of 24.4 2 5.8 years with
control condition. Patellar taping also resulted in a unilateral patellofemoral pain were recruited from a
greater eccentric knee extensor torque compared university setting for participation in this study. The
with that in a control condition. Both the brace and duration of patellofemoral pain symptoms varied
tape conditions resulted in significantly less pain from 6 weeks to 10 years. The subjects were diag-
compared with the control, with no difference in nosed with patellofemoral pain and met the inclu-
pain between the 2 experimental conditions. Bock- sion criteria for our study if they had anterior knee
rath et al-xamined the effects of patellar taping on pain that worsened with stairs, squatting, kneeling, or
the patellofemoral congruence angle at 45" of knee running. Subjects with any history of traumatic knee
flexion. Using radiographs, they reported that the injury, ligamentous laxity, or other musculoskeletal
taping had no effect on the patellofemoral congru- injury to either lower extremity were excluded. The
ence angle during a non-weight-bearing isometric left knee was the injured knee in 12 of the subjects,
quadriceps contraction, but patients had an average whereas all but one subject kicked with their right
of 50% less pain with taping while performing a foot. All subjects were tested under 4 knee condi-
stepdown. Larsen et all3also used radiographs to as- tions in a randomized order: McConnell patellar t a p
sess the effect of patellar taping on patellofemoral ing, placebo patellar taping, and no tape for the in-
congruence angle. In uninjured subjects, they report- volved knee. The uninvolved contralateral lower ex-
ed that taping to facilitate a medial patellar glide was tremity was also tested without patellar taping as the
initially effective in displacing the patella medially. fourth knee condition. Prior to participation, all s u b
Following 10 to 15 minutes of exercise, the patella jects signed an informed consent that was approved
was again in the same position as prior to taping. by the Institutional Review Board at the University of
However, the control group (no tape) had a lateral Virginia.
displacement of the patella after exercise compared
with the tape group. The authorslJ concluded that Instrumentation
the patellar taping prevented this lateral displace-
ment caused by the exercise. Kowall et all2 examined Data collection was performed at the University of
the effects of patellar taping over a 4week-long reha- Virginia's motion analysis laboratory using the Vicon
bilitation program. Both the patellar-taping group Motion Analysis System (Oxford Metrics, Oxford, En-
and a standard rehabilitation group had a decreased gland). The system consisted of 6 charged, coupled
frequency of pain, increased isokinetic strength, and device cameras, a force plate (Kistler, Winterthur,
increased EMG activity of the vastus medialis oblique Switzerland),an IBMcompatible personal computer,

I Orthoo S w r u Phvs Therevolume 29. Number 11. November 1999

 .--. ,
and Vicon software. Fifteen l c m balls covered in re- era1 stepups for each condition (McConnell tape,
flective tape were used as surface markers with the placebo tape, no tape, and the uninvolved lower ex-
lateral thigh and leg markers attached to the end of tremity). The order of the lateral stepup and vertical
6-cm long wands. The pelvis, knee, and ankle mark- jump was alternated for each condition. Subjects
ers were attached to the skin with double-sided tape, were allowed 3 to 6 practice trials of each activity pri-
and the wands were secured around the thigh and or to data collection. For the single-leg vertical jump,
calf with elastic tape. The cameras captured kinemat- the subject took 1 step onto the force plate with the
ic data at a frequency of 60 Hz while the force plat- tested lower extremity, flexed the hip, knee, and an-
form sampled ground reaction forces at 1200 Hz. kle (countermovement), and performed a maximal
The Vicon software synchronized the force platform vertical jump. The subject was required to land back
and camera data at 60 Hz when calculatingjoint m e on the same force plate but, to minimize discomfort,
ments and power. The system was calibrated accord- was allowed to land on both feet. To achieve the
ing to the manufacturers' instructions prior to each most natural jumping form, there were no restric-
data collection session. tions on the countermovement or on use of the
arms. The lateral stepup was performed with an 1 8
Procedure cm-high step mounted on the force plate with pre-
loading as described by Besser et a14 While standing
Anthropometric data necessary for the kinetic on the step with the tested lower extremity, the s u b
analysis was recorded with the use of a balance scale, ject flexed this extremity until the heel of the contra-
a tape measure, and calipers. This included height, lateral lower extremity just tapped a flexible card-
weight, leg length, and knee and ankle joint diame- board surface on the floor then extended the tested
ters. Surface markers were taped on the sacrum and lower extremity completely to return to the starting
on both lower extremities to include the anterior su- position. To simulate the lateral stepup in a clinical
perior iliac spines, the knee joint centers (lateral setting, no other restrictions regarding technique or
femoral epicondyle), lateral thighs and legs, lateral speed were imposed. Kinematic and force platform
malleoli, the second metatarsal heads, and the poste- data were collected and analyzed to calculate the
rior calcanei. Knee extensor moments were calculat- maximal knee extensor moment and power for each
ed by the Vicon software using the inverse-dynamics trial. Vertical jump height was obtained for each trial
approach. The inverse-dynamics approach is a meth- by determining the vertical displacement of the sa-
od of determining joint forces and internal moments cral marker from the standing position to the high-
from the known motion that is produced by the ex- est point reached. The maximum knee extensor mo-
ternal forces and moments." Maximal power in 3" of ment, 3" of freedom knee power, and vertical jump
freedom was calculated first by determining the pow- height values obtained for each of the 3 trials were
er (moment X angular velocity) in each of the 3 averaged.
planes. These 3 maximal powers were then summed
together to arrive at the maximal 3" of freedom pow- Data Analysis
er. All calculations were performed by Vicon Clinical
Management Software (Oxford Metrics, Oxford, En- A 2-way, repeated-measures analysis of variance
gland). (ANOVA) with 2 within-subject factors (activity and
An evaluation for patellofemoral orientation was knee condition) was used to examine the effect of
performed by a single physical therapist who took patellar taping on maximal knee extensor moment
advanced course work and had 2 years' experience during a vertical jump and lateral stepup. The same
using the McConnell patellar evaluation and treat- analysis was also performed with maximal 3" of free-
ment program. According to the randomized order, dom knee power as the dependent variable. A 1-way,
the appropriate taping condition was performed us- repeated-measures ANOVA with 1 within-subject fac-
ing Cover Roll and Leukotape P (Beirsdorf, Inc, Nor- tor (condition) was used to assess the effect of patel-
walk, Conn). For the McConnell patellar tape condi- lar taping on maximal vertical jump height. The ini-
tion, the taping procedure was customized according tial alpha level for the analyses of variance was set at
to the subjects' patella orientation as described by .05 and was divided by the number of analyses (3) to
. ~ ~ placebo taping procedure was per- reduce the risk of a type I error. The corrected al-
M c C ~ n n e l lThe
formed in the same manner as the McConnell taping pha level for each of the 3 analyses of variance was
procedure except that the tape was merely placed now .016. For each analysis of variance that resulted
over the patella without correcting patellar align- in a significant F ratio, we performed a Tukey's hon-
ment. No tape was applied for the remaining condi- estly significant difference (HSD) post hoc analysis to
tion on the injured side. The contralateral, unin- examine pairwise differences. In addition, the unin-
jured lower extremity was tested without patellar t a p volved knee extensor moment and power values
ing. from 2 consecutive trials of the vertical jump and lat-
Each subject performed 3 vertical jumps and 3 lat- eral stepup from the first 10 subjects were analyzed

J Orthop Sports Phys Ther Volume 29. Number 1 1 November 1999 663
TABLE 1. lntraclass correlations, means, and standard errors of measure-
ment for knee extensor moment and power during a lateral step-up and
vertical jump in the uninvolved knee.
-
--

Mean (N mlkg
Measure ICC or WAR)* SEM (WAR)
Knee moment, LSU 0.83 1.30 0.130
Knee moment, VJ 0.91 1.52 0.084
Knee power, LSU 0.86 1.57 0.288
Knee power, Vl 0.92 4.60 0.470
ICC indicates intraclass correlation coefficient (3,l); SEM, standard error of
measurement; LSU, lateral step-up; VJ, vertical jump.
n = 14 for each mean.
Mc T a p No T a p PI Tap. Unlnvolvad

Condition
by an intraclass correlation coefficient (KC), model FIGURE 1. The main effect of knee condition on knee extension moment
3.1 to determine their reliability.*' (averaged across activity). Significantly different than no-tape and pla-
cebo tape conditions (Mc indicates McConnell; PI, placebo).

RESULTS
The results of the ICC (3,l) for reliability of the
kinetic measures are listed in Table 1. The means
and standard deviations of the knee extensor mo-
ments and power values for the vertical jump and lat-
eral step-up are listed in Table 2.
Maximal Knee Extensor Moment
The first ANOVA evaluating the effect of patellar
taping on knee extensor moment revealed a main ef-
fect for knee condition (F9,, = 5.50, P = .003). Tu-
key's HSD post hoc analysis demonstrated that the
McConnell tape condition resulted in a greater knee
extensor moment than the no-tape and placebo tape
knee conditions (Figure 1). There were no differ-
ences between the McConnell tape and uninvolved-
knee conditions, the no-tape and placebo tape condi-
tions, the no-tape and uninvolved-knee conditions,
and the placebo tape and uninvolved-knee condi-
tions. There was also a main effect for activity (Fl,13 onstrated that the uninvolved lower extremity had a
= 14.45, P = .002), with the vertical jump (VJ) hav-
ing a greater maximal knee extensor moment than
the lateral step-up (LSU; VJ = 1.5 [?0.36] N.m/kg
and LSU = 1.30 [+0.31] N.m/kg). There was no ac-
tivity-bycondition interaction effect for maximal knee
extensor moment (F,., = 2.98, P = .04).
Maximal 3" of Freedom Power
A main effect for knee condition was demonstrat-
ed (F3,, = 4.23, P = .011). Tukey's HSD post hoc
analysis revealed that the patellar tape condition re-
sulted in a greater knee power than the no-tape and
placebo tape conditions (Figure 2). There were no
other differences between the remaining conditions.
A main effect for activity also existed for knee power
(F,.13= 107, P < .001), with power values during the
vertical jump greater than the lateral step-up (VJ =
4.55 [?1.63] W/kg and LSU = 1.43 [?0.67] W/kg).
There was no activity-bycondition interaction effect
for knee power (F3,, = 1.98, P = .13).
Maximal Vertical Jump Height
The 1-way ANOVA for vertical jump height re-
vealed a difference between knee conditions (F3,, =
6.97, P = .001). Tukey's HSD post hoc analysis dem-

TABLE 2. Means for knee extensor moments and knee power during the
vertical jump and lateral step-up.
Moments (N .m/ks)* Power (W/kg)*
Knee condition LSU vl LSU '4
Patellar tape 1.40 (0.27) 1.73 (0.36) 1.58 (0.77) 5.36 (1.go) Mc Tape No Tape PI Tape Unlnvolvd
Placebo tape 1.28 (0.28) 1.38 (0.32) 1.32 (0.52) 4.09 (1.46)
No tape 1.21 (0.33) 1.40 (0.46) 1.24 (0.53) 4.1 5 (1.89) Condition
Uninvolved knee 1.30 (0.36) 1.52 (0.30) 1.57 (0.84) 4.60 (1.28)
FIGURE 2. The main effect of knee condition on knee power (averaged
LSU indicates lateral step-up; VI, vertical jump. across activity). Significantly different than no-tape and placebotape con-
Means (SD); n = 14 for each mean. ditions (MC indicates McConnell; PI, placebo).

664 J Orthop Sports Phys Ther.Volume 29.Nrrmber 11 .November 1999

TABLE 3. Mean (standard deviation) vertical jump height for each of the
4 knee conditions.
Knee condition Vertical jump height (an)
Patellar tape 23.33 (4.22)
Placebo tape 23.08 (4.20)
No tape 23.45 (4.54)
Uninvolved lower extremity 25.69 (2.66)'
Significantly different from all other conditions, P = .001.

significantly greater vertical jump height than did all

3 other conditions (Table 3). The remaining 3 con-
ditions were not significantly different from each
other.

DISCUSSION

Mechanisms FIGURE 3. An increase in trunk flexion moves the body's center of mass
anterior to reduce the moment arm for knee extension (from Berger et all
There are several possible explanations for the in- with permission).
creased knee extensor moment and power with Mc-
Connell patellar taping. One of these is the potential position moves the body's center of gravity more an-
change in the quadriceps lever arm. The lever arm teriorly, reducing the distance from the body's center
of the quadriceps is maximal at 30 to 45" of knee of mass to the knee joint center and increasing the
flexion and decreases until the minimum lever arm distance between the body's center of mass and hip
length is reached at full knee flexion when the patel- joint center (Figure 3). The change of the center of
la is seated distally in the intercondylar groove.28Any mass position with respect to the knee and hip joints
factor that alters the patella position or movement transfers the demand from the knee extensors to the
can potentially alter the length of the quadriceps lev- hip extensors to overcome the tendency of body
er arm and thus the knee extensor moment. The in- weight to flex the hip and knee. Because of the re-
frapatellar strap introduced by Levine16 altered the duced work of the quadriceps in this forward-lean
patella position in the extended knee. A radiograph position, a smaller patellofemoral joint reaction force
of the knee fitted with an inhpatellar strap showed existsI0 that may result in less pain in subjects with
that the patella displaced proximally and anteriorly patellofemoral pain syndrome. We did not measure
compared with the case without the strap. The proxi- trunk position, but the subjects in this study may
mal displacement of the patella may hinder further have also increased their trunk flexion to minimize
distal excursion into the intercondylar groove and the work done by the quadriceps to decrease pain.
maintain a longer quadriceps lever arm. However, Through some mechanism, such as decreasing pain
Levine16 did not assess whether an altered patella po- or promoting a sense of stability, patellar taping may
sition was maintained with knee flexion. It is possible make the altered trunk position unnecessary, thus al-
that patellar taping used in this study limited distal lowing a greater knee extensor moment.
displacement of the patella during knee flexion. This A potential biomechanical factor that explains the
would increase the knee extensor moment arm, increased knee extensor moment and power with pa-
which would contribute to a greater knee extensor tellar taping is a change in the vastus medialis
moment. oblique activity. The primary function of the vastus
A difference in knee extensor moment can also medialis oblique is to glide the patella medially to
occur with a change in trunk positioning. The m e maintain proper patella alignment.17 The mainte-
ment generated by the quadriceps to overcome the nance of proper patella alignment further enhances
resistance of the body weight during a squat or the ability of the vastus lateralis to produce a greater
climbing a stair is equal to the product of the body knee extensor force." Mariani and Carusolgreported
weight and the distance between the upper body's that surgical medial realignment of the patella re-
center of mass and the knee joint center.I0 Mc- sulted in greater EMG activity of the vastus medialis
Laughlin et al2I reported that weight lifters increased oblique. Perhaps the medial glide with patellar t a p
their forward lean during the squat, reducing the ing augments vastus medialis oblique activation, facil-
knee extensor moment and increasing the hip exten- itating a more efficient and strong quadriceps con-
sor moment. Berger et al9eported a compensatory tra~tion.l~.~O
increase in trunk flexion in patients ascending stairs Another explanation for the increase in knee ex-
after having a total knee arthroplasty. This change in tensor moment and power is that the patellar-taping

J Orthop Sports Phys There Volume 29. Number I 1. November 1999 665
 procedure may provide proprioceptive input and fa- knee power = 0.59 with an effect size of 0.58 W/kg,
cilitate motor perf~rmance.~ Studies assessing knee standard deviation of 0.28 W/kg, and n of 28).
joint proprioception showed that the additional cuta- Despite the lack of difference in knee extensor
neous input from knee sleeves or from elastic band- moment and power between the uninvolved knee
ages wrapped around knees enhanced joint position and the non-taped involved knee, the uninvolved
~ense.~ InJ the
~ current study, the knee with the pa- lower extremity had a higher single-leg vertical jump
tellar tape produced significantly greater knee exten- height than the involved lower extremity. One would
sor moment and power than did the placebo tape think that an increase in vertical jump height would
and no-tape conditions with the vertical jump and be accompanied by an increase in the knee extensor
lateral stepup averaged together (main effect). moment or power. Biomechanical studies evaluating
There was no difference between the placebo and the vertical jump, however, report that the timing of
no-tape conditions. Thus, our findings show that the the activation of the lowerextremity muscle groups is
increase in maximal knee extensor moment and the most important factor in vertical jump perfor-
power is due to factors other than the cutaneous in- m a n ~ e .In~ .a~simulation
~ study, Bobbert and Van
put from the application of tape. !best5 reported that an increase in quadriceps force
The increase in knee extensor moment and power without adjustment in its time of activation resulted
may also be due to a reduction of pain with the pa- in a decreased vertical jump height. The finding of a
tellar taping. Bockrath et al%nd Conway et a17 re- higher vertical jump of the uninvolved extremity in
ported a significant decrease in pain with patellar the absence of differences in knee extensor mo-
taping. Pain can inhibit both quadriceps activation ments and power supports the importance of lower-
and force production." If patients had lower levels extremity muscle group synergy for skill perfor-
of pain, a potentially greater quadriceps activation mance.
would be possible. However, Conway et a17 reported
a poor correlation ( r = -0.14) between perceived Clinical Implications
pain and isokinetic strength. Therefore, these au-
thors did not theorize that a reduction of pain in pa- Lowerextremity weight-bearing exercise has been
tients with patellofemoral pain syndrome could result reported to be more effective than has non-weight-
in greater quadriceps force production. The current bearing (isolated-joint) exercise in restoring function
study did not examine the effect of patellar taping in patients with patellofemoral pain syndr~me.~.!"'
on pain, and it was difficult to make any conclusions The lateral stepup and jumping activities are often
regarding the reduction of pain as a reason for the prescribed as part of a functional rehabilitation p r e
increase in the knee extensor moment and power gram. During these weight-bearing activities, the hip
found with patellar taping. extensors and soleus muscle act in synergy with the
We expected the knee extensor moment and pow- quadriceps to extend the knee. With these 2 muscles
er of the uninvolved knee to be greater than that of assisting the quadriceps, less demand is placed on
the non-taped, involved knee. However, there was no the quadriceps, compared with having the quadri-
difference in these values between the 2 knees. Oth- ceps work in an isolated fashion during non-weight-
er authors also found symmetry in knees of subjects bearing knee extension. Wilk et alS demonstrated
with unilateral patellofemoral pain. Souza and this small activation of the quadriceps during a low-
GrosszYand Mariani and CarusolVemonstrated bilat- erextremity weight-bearing exercise. They reported
eral vastus medialis obliqueatus lateralis EMG ratio that quadriceps electromyographic activity was only
abnormalities in patients with unilateral patello- 59% of the level of a maximal voluntary isometric
femoral pain. The findings from these previous stud- quadriceps contraction during a squat. This maximal
ies and from the present study could be explained by EMG value occurred at 88 to 102" of knee flexion
alterations in motor programming in patients with and gradually declined as the knee extended with
unilateral patellofemoral pain syndrome. The inclu- the value being approximately 30% of a maximal vol-
sion of uninjured subjects in our study would have untary isometric contraction at 45" of knee flexion.%
provided an additional comparison to assess any ef- This leads one to question whether this is enough of
fect that unilateral patellofemoral pain may have on a training stimulus to result in quadriceps muscle
the contralateral lower extremity. Finally, it is difficult strengthening.
to make solid conclusions regarding the lack of dif-
ference between the uninvolved- and non-taped, in- CONCLUSION
volved-knee extensor moments and power, because
the sample size in this study may have been too small Our study showed that increases in knee extensor
to detect such a difference (observed statistical pow- moment and power were evident during a vertical
er for knee extensor moments = 0.30 with an effect jump and lateral step-up with patellar taping com-
size of 0.15 N.m/kg, standard deviation of 0.36 pared with no-tape, placebo tape, and the contralat-
N.m/kg, and n of 28; observed statistical power for era1 knee conditions. Patellar taping produced no

1 Orthop Sports Phys Ther.Volume 29.N11mbr 1 1 .Novernhc=r 1999

change in vertical jump height. One may theorize
that patellar taping as part o f a rehabilitation pro-
gram may assist in the activation o f the quadriceps t o
facilitate strength gains. However, a study assessing
knee kinetics before and after a training program us-
ing patellar taping as part o f a comprehensive reha-
bilitation program is needed before this conclusion
can be drawn.
ACKNOWLEDGMENTS
We thank Dr Mark Abel for making the motion
analysis laboratory at Kluge Childrens Rehabilitation
Center available for o u r use. We are also indebted to
Robert Abramsyzk, lab engineer, for his technical as-
sistance.
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