Posted in Ella's blog posts

Sports performance, placebo effects and kinesio-tape

Author: Ella Ward, date published: 29/08/13

Kinesio tape

Kinesio®-tape (KT) is widely used by athletes despite its unexplained performance benefits and clinical evidence of its futility (Kamper & Williams, 2013; Stedge et al., 2012). There are anecdotal reports ranging from improvements in circulation to greater strength, but researchers suggest these improvements in performance are due to a placebo effect, not from the KT itself (Stedge et al., 2012). This blog explores the issues associated with KT tape and associated limitations of research, as well as the psychological concepts of the placebo effect.

A method commonly employed by researchers to measure the efficacy of KT is the improper application of KT. For example, in a study by Ayter and colleagues in 2011, researchers used a treatment (proper application of KT) and a placebo group (sticking plaster without stretch) to assess the effect of KT on patellofemoral pain syndrome. Researchers did observe increases in pain, proprioception, balance and muscle strength with both the placebo and treatment groups (Aytar et al., 2011). However, as no control group was employed in this study, we are unable to determine whether the improvements observed were due to a placebo effect, the effect of taping alone or from the KT (Beedie, 2007). In addition, more research is needed in the field in competitive environments, rather than in a laboratory environment for KT to be accepted as therapeutic intervention in sport and performance (Beedie, 2007).

Despite the vast amount of research in the area of placebos, the phenomenon has remained largely unchallenged in the area of sport and performance (Stedge et al., 2012). In many studies, like the one above, researchers aim to investigate the efficacy of KT as a placebo assuming the outcome is a result of a placebo effect. However, if we are directly observing its effect, studies would be best served by measuring what actually causes it and explaining how and why this effect is observed in this situation, not just assuming a placebo effect has occurred. It is also important to note that care must be taken when measuring and observing the placebo effect due to psychosocial influences, as both belief and expectancy have been acknowledged as determining factors in the efficacy of placebo effects (Beedie, 2007; Benedetti et al., 2005). As these factors are not accounted for in many of the studies investigating the efficacy of KT, it may be beneficial to also conduct questionnaires and interviews in conjunction with clinical trials to generate an understanding of one’s psychosocial expectations and beliefs.

One’s belief influences the outcome in the belief of receiving a beneficial treatment (Beedie, 2007). However it is difficult to measure, quantify and determine the strength of one’s belief of its effects on athletic performance. For example, would a recreational athlete with the same belief as an elite athlete show a greater improvement in performance? And if the athlete was Usian Bolt, could he physiologically improve his performance anymore or is it at the “limit” of belief and placebo effect?

In comparison, expectancy refers to how an individual’s behaviour is influenced by the expectation of how they are meant to feel (Aktas & Baltaci, 2011). If we can elicit a placebo effect by verbally persuading someone of how they are expected to feel, it would also be of interest to examine the effect of reversing expectancy and whether this results in decrements in performance. Expectancy in KT application may also be associated with Pavlov’s theory of classical conditioning (Benedetti et al., 2005). However, the majority of studies look at the immediate effect after its application, not the effect of repeated trials on the efficacy of KT (Aytar et al., 2011; Stedge et al., 2012).

Overall, KT and the placebo effect are relevant in sport and performance, as psychologists can manipulate this intervention to enhance athletic performance; avoiding more intrusive, unethical and expensive treatment methods. However, sport practitioners and psychologists need to be confident that KT is actually beneficial for their athletes in order to recommend it as a therapeutic intervention, and convincing empirical evidence is not available yet. Therefore, practitioners need to make an informed appraisal, taking into consideration the individual’s specific psychosocial context. As it is a harmless intervention, and there potential for performance improvement, there is no harm in using Kinesio-tape.

Now after reading this, please vote on this pole:

Reference list:

Image sourced from Flickr creative commons; http://www.flickr.com/photos/zenmama/8653547400/

Aktas, G., & Baltaci, G. (2011). Does kinesiotaping increase knee muscles strength and functional performance? Isokinetics & Exercise Science, 19(3), 149-155.

Aytar, A., Ozunlu, N., Surenkok, O., Baltacı, G., Oztop, P., & Karatas, M. (2011). Initial effects of kinesio® taping in patients with patellofemoral pain syndrome: A randomized, double-blind study. Isokinetics & Exercise Science, 19(2), 135-142.

Beedie, C. J. (2007). Placebo effects in competitive sport: Qualitative data. Journal of Sports Science and Medicine, 6, 21-28.

Benedetti, F., Mayberg, H. S., Wager, T. D., Stohler, C. S., & Zubieta, J.-K. (2005). Neurobiological mechanisms of the placebo effect. The Journal of Neuroscience, 25(45), 10390-10402.

Kamper, S. J., & Williams, C. M. (2013). The placebo effect: powerful, powerless or redundant? British Journal of Sports Medicine, 47(1), 6-9.

Stedge, H. L., Kroskie, R. M., & Docherty, C. L. (2012). Kinesio Taping and the circulation and endurance ratio of the gastrocnemius muscle. Journal of Athletic Training, 47(6), 635-642.

Posted in Uncategorized

Placebo’s

A placebo is something of no intrinsic remedial value that is used to appease or reassure another. The placebo effect is related to the perceptions and expectations of the patient; if the substance is viewed as helpful, it can heal, but, if it is viewed as harmful, it can cause negative effects. . The term placebo has been used in medicine since the 18th century and has changed from “an epithet given to any medicine adapted more to please than to benefit the patient” in Quincy’s Lexicon-medicum to Irving Kirsch’s hypothesis that placebo effects are produced by the self-fulfilling effects of response expectancies, in which the belief that one will feel different leads a person to actually feel different.

If you broaden the concept of a placebo beyond pure medical treatment, you can start to include other interventions, such as strapping, dietary supplements, acupuncture and other ergogenic aids as types of placebos. In many cases these interventions have no scientific evidence to prove or dis-prove their effect on the individual and instead the placebo effect may be the cause of change

The brain has control over the body processes affected by most placebos, such as pain, motor fatigue, and fever. These body processes are directly organised by the brain, while other processes usually regulated by the body such as the immune system are also controlled indirectly by the brain through the nervous system. Moerman and Jonas introduced the term  “meaning response” for the meaning that the brain associates with the placebo, which causes a physiological placebo effect as a placebo is an inert substance that does not directly cause anything.

Kirsch, I., 1985. Response expectancy as a determinant of experience and behaviour. American Psychologist 40 (11):1189-1202

Moerman, D.E. and Jonas, W.B. 2002. Deconstructing the placebo effect and finding the meaning response. Ann Intern Med. 136 (6): 471–6

Posted in Coaching

More Rule Changes?

In a post I was reading More Rule Changes? it discussed a number of potential changes to volleyball. These include, servers to land behind the end line, back row attackers must land behind the attack line, eliminate open-hand tip, eliminate overhead serve receive, penalties for a missed serve?, free substitution, no contact with center line, no contact with the net, change in points for a set.

This had me thinking about what changes would actually improve the game of volleyball. Most of the time it is suggested that the rallies are too short and that extending the length of each point will make the game more interesting for spectators. In my experience, new people to the sport are overawed by the speed of the game play, not the number of times the ball crosses the net. I feel like improving the possibility for big kills and fast plays should be the way to go, not slow the game down and make it harder to win a point. Just like in every other sport, the most entertaining part of the game is the end of a point (or when you score a goal). Everybody loves to see a combo run and a massive kill that bounces inside the 3m line. We should find more ways of making that happen.

The reason I believe, that extending the rallies is a priority, is that when they do happen (which is quite rare in elite volleyball) it is because of some spectacular plays on the court. It isn’t the length of the rally that is entertaining, its the skill and athleticism displayed that everyone wants to see.