Effects of Mc Connell Versus Kinesio Taping; Combined With Hip and Knee Strengthening in Patients With Patellofemoral Pain Syndrome

Overview

Patellofemoral pain (PFP) is a common musculoskeletal-related condition that is characterized by insidious onset of poorly defined pain, localized to the anterior retro-patellar and/or peripatellar region of the knee. The onset of symptoms can be slow or acutely develop with a worsening of pain accompanying lower-limb loading activities (e.g. squatting, prolonged sitting, ascending/descending stairs, jumping, or running). This randomized controlled trial compares the effects of McConnell taping and Kinesio taping, each combined with a standardized hip and knee strengthening exercise program, in patients with Patellofemoral Pain Syndrome (PFPS). A total of 34 participants (17 per group), aged 26-44 years, will be randomly allocated into two groups. Both groups will undergo a 4-week intervention, consisting of supervised sessions on alternate days. Outcomes will be assessed at baseline and after the intervention. Group A will receive conventional physical therapy, hip and knee strengthening exercises, and McConnell taping. The intervention includes TENS, heating pad application, progressive strengthening exercises, functional training, stretching, and rigid McConnell taping applied before each session to provide medial patellar glide and improve patellar alignment. Group B will receive the same conventional physical therapy and strengthening program but with Kinesio taping. Elastic Kinesio tape will be applied using standardized I-strip and Y-strip techniques to facilitate patellar alignment, improve proprioception, and provide neuromuscular support. The tape may remain in place for 1-2 days, if tolerated. The primary outcomes include pain (Numeric Pain Rating Scale), range of motion (universal goniometer), and functional disability (KOOS-Patellofemoral questionnaire), measured at baseline and after the 4-week intervention.

This study is a randomized controlled trial (RCT) designed to compare the effectiveness of McConnell taping and Kinesio taping, when each is combined with a standardized hip and knee strengthening exercise program, in patients with Patellofemoral Pain Syndrome (PFPS). The trial aims to determine which taping technique provides greater improvements in pain, range of motion (ROM), and functional disability when used as an adjunct to exercise therapy. Participants will be recruited using a purposive sampling technique and randomly allocated into two intervention groups through the coin toss method. The study includes 34 participants, with 17 participants in each group, following adjustment for a 10% attrition rate. Adults aged 26-44 years, of either gender, meeting the inclusion criteria for PFPS will be enrolled. Outcome measures will be recorded at baseline and after completion of the 4-week intervention period. Participants allocated to Group A will receive conventional physical therapy, a structured hip and knee strengthening exercise program, and McConnell taping. Conventional physical therapy consists of Transcutaneous Electrical Nerve Stimulation (TENS) with a frequency of 50-100 Hz and a continuous cycle, combined with the application of a heating pad for 15 minutes before exercise. Additional treatment components include isometric and isotonic strengthening exercises for the hip and knee musculature, functional training, and stretching exercises prescribed according to the individual patient's needs. McConnell taping is performed using rigid, non-elastic tape applied over a protective adhesive underlay to minimize skin irritation. The tape is anchored from the lateral femoral condyle toward the medial posterior aspect of the knee to produce a medial glide of the patella, thereby improving patellar alignment and correcting maltracking during movement. Because of its rigid nature, the tape is applied before each treatment session and replaced during every supervised visit. The objective of McConnell taping is to reduce mechanical stress on the patellofemoral joint, improve knee biomechanics, decrease pain, and facilitate more effective performance of strengthening exercises. Participants in Group B will receive the same conventional physical therapy and identical strengthening program as Group A, ensuring that the only difference between groups is the taping technique. Instead of rigid taping, participants will receive Kinesio taping, which utilizes elastic therapeutic tape designed to provide dynamic support while allowing normal joint movement. The Kinesio taping technique consists of an I-strip applied over the tibial tuberosity without tension and a Y-strip positioned around the patella. The medial strip is applied with 25-40% stretch, whereas the lateral strip is applied with 75-100% mechanical stretch to provide stabilization and facilitate patellar alignment. Unlike McConnell tape, Kinesio tape may remain in place for 1-2 days, provided it is well tolerated, although participants will be instructed to remove the tape before going to bed. The elastic properties of Kinesio tape are intended to enhance proprioception, provide neuromuscular support, reduce pain, and improve movement without significantly restricting joint mobility. Both intervention groups will participate in the same progressive hip and knee strengthening program, delivered over 4 weeks, with three supervised sessions per week, resulting in 12 treatment sessions. Each session will last approximately 30-40 minutes. The exercise protocol has been standardized to ensure consistency across groups while allowing the study to evaluate the independent effects of the two taping techniques. During Week 1, participants will perform isometric hip strengthening exercises including gluteal squeezes, heel presses, hip adduction squeezes, hip abduction presses, seated isometric hip flexion, and clamshell exercises. Each exercise will be completed in three sets of ten repetitions with a ten-second hold, followed by stretching according to patient requirements. The assigned taping technique will be applied before the exercise session. In Week 2, the program progresses to quadriceps sets, hamstring sets, wall sits, and knee extension holds, maintaining three sets of ten repetitions with ten-second holds. Stretching continues as needed, and taping is again applied before each treatment session. During Week 3, exercises advance to include lateral step-ups, squats limited to 0-45° of knee flexion, glute bridges, hip abduction raises, and clamshells performed using a light resistance band. Participants complete three sets of 10-12 repetitions, with stretching and taping continuing throughout the treatment period. In Week 4, resistance is further progressed through clamshells with resistance bands, wall slides, side-stepping with therabands, lateral step-ups, and banded glute bridges using light-to-moderate resistance. Stretching remains individualized, and the assigned taping intervention is applied before each supervised exercise session.