Accepted Manuscript

The effects of kinesio taping on the color intensity of superficial skin hematomas: A
pilot study

Vercelli Stefano, Colombo Claudio, Tolosa Francesca, Moriondo Andrea, Bravini

Elisabetta, Ferriero Giorgio, Sartorio Francesco

PII: S1466-853X(16)30050-5
DOI: 10.1016/j.ptsp.2016.06.005
Reference: YPTSP 735

To appear in: Physical Therapy in Sport

Received Date: 8 May 2015

Revised Date: 12 April 2016
Accepted Date: 14 June 2016

Please cite this article as: Stefano, V., Claudio, C., Francesca, T., Andrea, M., Elisabetta, B., Giorgio, F.,
Francesco, S., The effects of kinesio taping on the color intensity of superficial skin hematomas: A pilot
study, Physical Therapy in Sports (2016), doi: 10.1016/j.ptsp.2016.06.005.

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 ACCEPTED MANUSCRIPT
The effects of kinesio taping on the color intensity of superficial skin hematomas: A pilot

study

Vercelli Stefano1 PhD, PT

Colombo Claudio2, PT

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Tolosa Francesca3, PT

Moriondo Andrea4, PhD

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Bravini Elisabetta5, PhDs, PT

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Ferriero Giorgio1, PhD, MD

Sartorio Francesco1, MSc, PT

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Unit of Occupational Rehabilitation and Ergonomics, Salvatore Maugeri Foundation - IRCCS,
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Veruno (NO), Italy.

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Private practice, Verbania, Italy.
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Private practice, Oleggio (NO), Italy.
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Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
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School in Advanced Sciences and Technology in Rehabilitation Medicine and Sport, Tor Vergata
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University, Rome, Italy.

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Address correspondence to:

Stefano Vercelli, PhD.

Fondazione “Salvatore Maugeri”, IRCCS.

Istituto Scientifico di Veruno, Servizio di Fisiatria Occupazionale ed Ergonomia.

Via per Revislate 13, I-28010, Veruno (NO), Italy.

e-mail: stefano.vercelli@fsm.it

Tel: ++390322884799

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Fax: ++390322830294

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ABSTRACT

Objectives: To analyze the effects of kinesio taping (KT) -applied with three different strains that

induced or not the formation of skin creases (called convolutions)- on color intensity of post-

surgical superficial hematomas. Design: Single-blind paired study. Setting: Rehabilitation clinic.

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Participants: A convenience sample of 13 inpatients with post-surgical superficial hematomas.

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Interventions: The tape was applied for 24 consecutive hours. Three tails of KT were randomly

applied with different degrees of strain: paper-off (Spo); no strain (S0); and maximal longitudinal

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stretch (Smax). We expected to obtain correct formation of convolutions with S0, some

convolutions with Spo, and no convolutions with Smax. Main Outcome Measures: The change in

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color intensity of hematomas, measured by means of polar coordinates CIE L*a*b* using a
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validated and standardized digital images system. Results: Applying KT to hematomas did not
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significantly change the color intensity in the central area under the tape (p>0.05). There was a

significant treatment effect (p<0.05) under the edges of the tape, independently of the formation of
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convolutions (p>0.05). Conclusions: The changes observed along the edges of the tape could be
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related to the formation of a pressure gradient between the KT and the adjacent area, but were not

dependent on the formation of skin convolutions.

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Keywords: physical therapy; bruise; tape; hematoma.

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The effects of kinesio taping on the color intensity of superficial skin hematomas: A pilot

study

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ABSTRACT

Objectives: To analyze the effects of kinesio taping (KT) - applied with different degrees of strain

designed to induce or not the formation of skin creases (called convolutions) - on color intensity of

post-surgical superficial hematomas. Design: Single-blind paired study. Setting: Rehabilitation

clinic. Participants: A convenience sample of 13 inpatients with post-surgical superficial

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hematomas. Interventions: A 3-tailed KT technique applied for 24 hours and randomized with

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three different degrees of strain. Main Outcome Measures: The change in color intensity of

hematomas, measured by means of polar coordinates CIE L*a*b* using a validated and

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standardized digital image system. Results: Applying KT to hematomas did not significantly

change the color intensity in the central area under the tape (p>0.05). However, a significant color

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improvement along the edges of the tape was observed (p<0.05), irrespective of the formation of
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skin convolutions caused by KT (p>0.05). Conclusions: A pressure gradient between the KT and
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the adjacent skin is a possible mechanism for the observed differences along the edges of the tape.

The effects were not dependent on the formation of skin convolutions caused by KT.
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Keywords: Physical therapy; Bruise; Tape; Hematoma.

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INTRODUCTION

Over the last decade, the kinesio taping (KT) method has become a popular treatment option in the

field of musculoskeletal and sport injuries. The proposed effects of KT include the improvement of

circulation by increasing the interstitial space between the skin and underlying connective tissues

through the formation of convolutions, i.e. small creases of the patient’s skin created by the

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combination of the tape’s elastic capacity and its application over stretched skin. This is claimed to

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be beneficial in treating conditions such as lymphedema, venous insufficiency, swelling, and

superficial hematomas (Kase, Wallis & Kase, 2003). Studies have been conducted examining the

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effects of KT in relation to improving lymphatic (Tsai, Hung, Yang, Huang & Tsauo, 2009; Smykla

et al., 2013; Bell & Muller, 2013; Pekyavaş, Tunay, Akbayrak, Kaya & Karataş, 2014; Donec &

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Kriščiūnas, 2014) and venous circulation (Aguilar-Ferrándiz, Castro-Sánchez, Matarán-Peñarrocha,
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Guisado-Barrilao, García-Ríos & Moreno-Lorenzo, 2014; Aguilar-Ferrándiz, Castro-Sánchez,
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Matarán-Peñarrocha, García-Muro, Serge & Moreno-Lorenzo, 2013), or reducing acute swelling

after ankle sprains (Nunes, Vargas, Wageck, Hauphental, Luz & de Noronha, 2015). Although there
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is no firm evidence proving the effectiveness of KT on circulation, there appears to be some merit
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in the method warranting further research. To our knowledge, no study has yet investigated the

effects of this application in the presence of hematomas, despite claims by the creators of the
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method and positive clinical observations in this regard. As mentioned above, the key working

mechanism proposed to speed up the absorption of superficial hematomas involves the formation of
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skin convolutions. This is hypothesized to reduce the pressure below the dermis, which in turn

would: 1) increase the carrying capacity of the capillaries enhancing the efficiency of the drainage

system, and 2) reduce the pressure in the mechanoreceptors located below the dermis, decreasing

the nociceptive stimuli (Kase et al., 2003). However, the role of skin convolutions as a working

mechanism in the treatment of hematomas has never been scientifically demonstrated. In fact, KT

applied with stretch to generate convolutions in the skin was no more effective than a simple

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application of the tape without tension to reduce pain intensity and disability in a group of patients

with low back pain (Parreira et al., 2014).

The research question of the present study was whether KT may have an effect on color of

postoperative superficial hematomas. If the hematoma is localized just below the dermis or the

fascia, then a red, purplish-brown, or black ecchymotic area is usually easily visible through the

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skin. Given the close relationship between bleeding and skin ecchymosis, one can assume that a

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decrease in the blackness represents an indirect measure of healing of the hematoma. Accordingly,

it was hypothesized that KT application could be effective in accelerating the reduction of the skin

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color intensity. This hypothesis has been tested by investigating the effects of a three-tailed KT

technique randomized with three different degrees of strain, designed to create or not the skin

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convolutions. A qualitative analysis of the captured images was also conducted in an attempt to
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gain some useful insights into the mechanisms of action of KT.
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MATERIALS AND METHODS

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Research design

This study had a single-blind paired design. The independent variable was the strain level applied to
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KT, while the dependent variable was the color intensity of the hematoma, which was measured

through a standardized and previously validated system for the processing of digital images. The
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study was approved by the XXX’s institutional review board and the local ethics committee of the

Scientific Institute of XXX, and was conducted in compliance with the Declaration of Helsinki.

Before inclusion, all subjects signed an informed consent.

Subjects

Subjects were consecutively recruited among those hospitalized in the Rehabilitation Clinic of

XXX, between July 1st and December 31st 2014. Subjects who fulfilled the following criteria were

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eligible for the study: age >18 years; presence of superficial hematomas resulting from surgical

procedures that occurred not more than 4 weeks before, and with a surface area sufficiently large to

enable the application of KT (i.e. at least 10 cm wide and 20 cm long). The exclusion criteria were:

presence of wounds in the target area; use of any other external aids to speed up healing of the

hematoma or that could limit the application of KT (e.g. patches or wound dressings, use of

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compressive stockings); the yellowing of the ecchymotic area, which indicates an advanced stage of

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healing; and the presence of diseases affecting lymphatic or vascular flow.

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Tape application

The method consisted of the application of a KT technique. The tape used was a hypoallergenic,

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non-medicated, waterproof, porous, adhesive, cotton tape, which can be stretched longitudinally up
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to 130-140% of its original length (Cure Tape; Aneid Italia, Rome, Italy).
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Before application, the skin was shaven when necessary, cleaned with alcohol, and dried. Tape ends

were rounded to prevent the square edges from peeling off and to increase the length of application.
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Patients were positioned in such a way that the affected area was elongated to the maximum extent.
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The KT was applied directly on the skin, over the hematoma. The same physical therapist, certified

and extensively trained in the technique, did all applications, so ruling out inter-operator variability
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in performance of the procedure.

A modified technique based on the original “fan” strip application (Kase et al., 2003) was used. A
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common anchor base was applied without tension, followed by the application in a fan-shaped

mode of 3 tails (each one about 1.6 cm wide) randomized with three different degrees of strain:

none (SN), light (SL, about 10-15% of available tension), and full longitudinal stretch (SF).

According to the creators, none to light tension would allow the best results through the correct

formation of skin convolutions, while applying too much tension would decrease the desired results

instead of enhancing them. The consistency of the stretch applied was evaluated by comparing the

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length of the paper backing and tape applied. The location of different strain applied was recorded

for each subject, and the tape was left in situ for 24 consecutive hours.

Standardized digital images system (SDIS)

To standardize light conditions, perpendicularity, and the distance between the skin and the camera,

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a validated digital images system was used to capture pictures (Cheon, Lee & Rah, 2010; Kaartinen,

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Välisuo, Alander & Kuokkanen, 2011; Hallam, McNaught, Thomas & Nduka, 2013). The SDIS

consisted of a cardboard dark chamber (with a base shaped like a truncated octagonal pyramid), a

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LED lighting system, and a digital camera (ST500 digital camera, Samsung Co.Ltd, Seoul, Korea)

(Figure 1). Three LED lights were fixed on the roof of the chamber, which was placed directly on

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the patient’s skin with a dark green sheet arranged to preserve the skin from external light. The
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camera was positioned on the top of the chamber, so that its lens passed through the proper hole.
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Figure 1. The standardized digital system used to capture images.

Procedures

Three consecutive photographs were taken for each subject: at baseline (T0), immediately after KT

was applied, and after 24 hours of use (T1). The second photograph was used only as a reference

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for the exact location of KT. To avoid possible bias due to the pressure marks left on the skin by the

tape shortly after its removal, the third picture was taken half an hour after tape removal.

Assessment and outcome measures

The primary outcome measure was the difference in skin color intensity (blackness) between KT

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application and control areas, measured by means of a free software program (ImageJ,

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downloadable at: http://imagej.nih.gov/ij/) operating on the digital images. The assessor was

blinded to the degree of strain applied. First, mean values of the three basic colors (Red, Green,

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Blue, RGB) were obtained from each area of interest. As RGB is an ordinal scale with irregular

intervals, values were then converted into a continuous scale represented by the polar coordinates

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CIE L*a*b* (L*: luminance; a*: green and red balance; and b*: blue and yellow balance.
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Conversions were operated with the software program Easy RGB, available at: www.easyrgb.com).
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CIE L*a*b* is a color space system of the International Commission on Illumination where each of

the three values increases by 1 unit as the color appears brighter, more reddish, and more yellowish,
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respectively. This procedure has been used for the colorimetric analysis of scars (Cheon et al.,
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2010; Hallam et al., 2013). The chromatic difference was calculated using geometric coordinates

with this formula: ∆L*a*b*=√[(L*1–L*2)2+(a*1– a*2)2+(b*1 – b*2)2], where 1 and 2 represented

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the mean values for the two areas compared.

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Statistical analysis

All statistical analyses were performed using SPSS ver. 19.0 (SPSS Statistics for Windows, IBM

Corp., Armonk, NY, USA). Significance level was set at α=0.05.

Color homogeneity at baseline: the analysis of color homogeneity before treatment was a necessary

pre-requisite. To this end, mean CIE L*a*b* values of pictures at T0 were calculated over an area

of 14768 pixels for each tail. To locate precisely the area on which the three KT tails were applied,

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the second picture was used as a reference. Mean values were paired and analyzed with Student's t

test.

Treatment effect: treatment effect analysis was performed over an area of 14768 pixels from the

middle of each tail. A fourth non-treated surrounding area was used as a control for spontaneous

healing. Mean differences of before-after treatment values (∆L*a*b*) were paired and compared

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using ANOVA with a Bonferroni post-hoc correction (Figure 2).

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Figure 2. The figure shows how areas were selected at T0 (left) and T1 (right) to compare color
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intensity changes (∆) for the treated (KT1, KT2, KT3, representing the three different degrees of
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strain applied) and control (non-KT) areas.

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A posteriori analysis: a qualitative visual inspection of pictures at T1 indicated that along the edges
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the blackness was reduced with respect to the central area of the tail. For this reason, two
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convenient areas of 2252 pixels were selected after an x4 digital zoom: one from the edges, and one

from the center of all tails. Mean ∆L*a*b* values (before-after treatment) were then grouped for

location (edge vs. central area) and compared using Student's t test (Figure 3).

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Figure 3. The figure shows how areas were selected at T0 (left) and T1 (right) to compare color

intensity changes (∆) between the edges and centers of the tails.

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If any treatment effect was detected, a Student’s t test was finally used to compare the mean ∆L*a*b*

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values (edge vs. central area) between the three degrees of strain of KT. This analysis was used to test
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the possible effect of skin convolutions (Figure 4).
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Figure 4. The figure shows how areas were selected at T1 from the edge (1) and the center (2) of each
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KT tail, applied with different degrees of strain.

RESULTS

A total of 29 patients were eligible. Sixteen were excluded because they did not grant consent.

Thirteen white Caucasian subjects consented to participate in the study. The demographic

characteristics of the sample are showed in Table 1. Adherence to the treatment was complete, and

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all subjects were evaluated after the 24h application of KT. No allergic reactions after the removal

of the tape were observed.

Mean: 70±13.5 (1SD)

Age, years
Range: 51-80

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Male: n=6
Gender

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Female: n = 7

Total Hip Replacement

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(osteoarthritis) n = 7
Surgery
Total Knee Replacement

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(osteoarthritis) n = 6
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Days from the
Mean: 7.3±1.1 (1SD)
surgical
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Range: 6-9
intervention
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Table 1. Demographic characteristics of the participants (n=13).

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Color homogeneity at baseline: no significant differences between tails (p>0.05) were observed at

baseline. This confirmed the chromatic homogeneity of the hematomas and allowed further
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analysis.
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Treatment effect: compared to spontaneous healing, the application of KT with different degrees of

strain did not significantly change (p>0.05) the color intensity of skin hematomas under the central

area of each tail (Figure 5).

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Figure 5. Box plot for ∆L*a*b* values (black lines are means, boxes are 25th and 75th percentiles,

whiskers are min and max) from pre/post comparison. SN = no strain; SL = paper-off (light) strain;

SF = full longitudinal stretch.

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A posteriori analysis: a significant treatment effect was observed (p<0.05) when comparing the
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areas under the edges with those under the center of the tape application (Figure 6).
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Figure 6. Box plot of ∆L*a*b* values (black lines are means, boxes are 25th and 75th percentiles,

whiskers are min and max) obtained at T1 comparing the area under the edges with area under the

center of all tails.

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This effect was not dependent (p>0.05) on the degree of strain applied (Figure 7).

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Figure 7. Box plot of ∆L*a*b* values (black lines are means, boxes are 25th and 75th percentiles,

whiskers are min and max) obtained at T1 between edge and central area under different degrees of
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strain applied. SN = no strain; SL = paper-off (light) strain; SF = full longitudinal stretch.

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DISCUSSION

The experimental hypothesis of this study was based on the marked skin color changes observed
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after KT application in patients with superficial hematomas. After 24 hours of treatment, a

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significant reduction in skin color intensity was detected along the edges of the tape, but not under
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the central area of KT tails. A pressure gradient between the KT and the adjacent skin is a possible

mechanism explaining the observed differences. These results were somewhat in conflict with the

clinical observation in which some blackness reduction was apparently visible also under the central

area of tails. This conflict may be explained by a well-known effect of perception called

“Cornsweet effect” (Cornsweet, 1970; Craik 1966; O’Brien 1958). According to this phenomenon,

a very small central area (the ‘central ridge’, characterized by a different color intensity from

adjacent areas) affects the perception of the large whole surrounding area, portions of which are
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distant from the ridge (Figure 8). The region adjacent to the light part of the edge appears lighter,

and the region adjacent to the dark part of the edge appears darker, but in fact the color tone of both

areas is exactly the same. The color difference can be easily made to disappear by blacking out the

region containing the central ridge with a strip uniform in color and brightness: the consequence is

that the two lateral areas are perceived as identical.

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Figure 8. Graphical representation of the Cornsweet effect. The two areas in the upper image have the
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same hue and brightness, but are perceived by the human eye as two different shades of gray, a darker
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(A) and a lighter one (B), due to the presence of the central ‘ridge’, which consists of two rows of pixels

of different shades of gray. When the central ridge is hidden by a black band (lower image) this effect
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is no longer evident.
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Similarly, hiding the area near the edges of tails (which can be considered as the ‘central ridge’

described above), the color intensity of the hematoma after treatment and that of the control area

appears much more similar than before (Figure 9).

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Figure 9. Representation of the Cornsweet effect on an image from a patient. Observing the picture on

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the left (A) one perceives the area under the KT tail as lighter than the surrounding skin. This

perceived difference in chromatic intensity is reduced when the areas near the margins are hidden (B).

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Applying proper strain to KT with formation of skin convolutions is believed to be one of the key

factors for effective treatment (Kase et al., 2003). The convolutions are deemed useful to increase
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the capillary carrying capacity and to improve the efficiency of the drainage system (Tsai et al.,
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2009; Smykla et al., 2013; Bell & Muller, 2013; Pekyavaş et al., 2014; Donec & Kriščiūnas, 2014;
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Aguilar-Ferrándiz etal., 2014; Aguilar-Ferrándiz et al., 2013; Nunes et al., 2015). However, the

results of this study challenge the role of skin convolutions as a possible working mechanism of
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KT. First, no statistically significant differences in colorimetric values were found for any of the

degrees of strain applied to KT (light, full, or without strain). Interestingly, applying too much
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tension was claimed to decrease desired results instead of enhancing them (Kase et al., 2003), but
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this was not confirmed in our study. Second, the reduction of skin blackness observed along the

edges of tape was different from the ‘zebra-stripes’ pattern expected, i.e. with greatest reduction in

color intensity at the point where the skin was hypothetically raised by skin folds, perpendicularly to

the orientation of the tape. Third, the outcome used in this study precludes any possible placebo

effect bias (Vercelli, Ferriero, Bravini & Sartorio, 2013).

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Recently, the role of skin convolutions has been challenged also in a study aimed to measure KT

effects on pain and disability in people with chronic low back pain (Parreira et al., 2014). To date,

this is the first study analyzing the effect of KT on color changes of superficial hematomas. All

methodological steps were taken to ensure the lowest possible risk of bias, and all subjects who

entered the study completed treatment and follow-up assessment, contributing to unbiased treatment

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estimates. The degree of strain applied did not appear to be relevant, but other variables still need to

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be explored such as the disposition of the tape or the duration of treatment. Based on our

experience, for future studies it could be advisable to cut the tape to increase as much as possible

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the number of tails. Further, to avoid problems with tape adhesiveness over time, the best tail width

seems to be about 1 cm, splitting the tape into 5 tails.

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Limitations of this study include the small sample size (a post-hoc analysis revealed that the power
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of the study was about 73%, setting an effect size = 0.4, and ɑ = 0.05), and the limited body areas
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involved, which were restricted to the lower limb and buttocks. Moreover, the prescription of anti-

coagulants or blood thinners to patients involved in the study was not modified. This could limit
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drawing firm conclusions on the effects of KT, but it reflects what actually happens in clinical
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practice. Then, KT was applied following only partially the original ‘fan strip’ technique for

lymphatic and circulatory system drainage. The main difference was that one tail was applied with
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the maximum strain allowed by the tape, which may have attenuated the results. However, this was
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necessary to test the role of skin convolutions. Finally, it should be clearly stated that the
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relationship between the reduction of local color intensity and the actual healing of the hematomas

or the recovery of activity level remains to be explored.

CONCLUSIONS

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After 24 hours of KT application on superficial hematomas, a significant improvement in the skin

color intensity was observed along the edges of the tape, but not under the central area of tails. This

effect is possibly attributable to the creation of a pressure gradient between the edges of KT and the

adjacent area. Further studies are needed to explore the possible working mechanisms of KT, and

also the optimal rationale for its use, by examining the influence of other variables that were not

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considered here such as the direction of tails, or the duration, frequency, and total number of

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applications.

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Disclosure Statement

Conflicts of interest: none

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Funding: none
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Color figures: to be reproduced in color on the Web (free of charge) and in black-and-white in print.
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REFERENCES

1. Kase K, Wallis J, Kase T. Clinical Therapeutic Applications of the Kinesio Taping Method.

Tokyo, Japan: Ken Ikai Co Ltd; 2003.

2. Tsai HJ, Hung HC, Yang JL, Huang CS, Tsauo JY. Could Kinesio tape replace the bandage

in decongestive lymphatic therapy for breast-cancer-related lymphedema? A pilot study.

PT
Support Care Cancer. 2009;17(11):1353-60.

RI
3. Smykla A, Walewicz K, Trybulski R, Halski T, Kucharzewski M, Kucio C, Mikusek W,

Klakla K, Taradaj J. Effect of Kinesiology Taping on breast cancerrelated lymphedema: a

SC
randomized single-blind controlled pilot study. Biomed Res Int. 2013;2013:767106.

4. Bell A, Muller M. Effects of kinesio tape to reduce hand edema in acute stroke. Top Stroke

Rehabil. 2013;20(3):283-8.
U
AN
5. Pekyavaş NÖ, Tunay VB, Akbayrak T, Kaya S, Karataş M. Complex decongestive therapy
M

and taping for patients with postmastectomy lymphedema: a randomized controlled study.

Eur J Oncol Nurs. 2014;18(6):585-90. doi: 10.1016/j.ejon.2014.06.010.

D

6. Donec V, Kriščiūnas A. The effectiveness of Kinesio Taping® after total knee replacement
TE

in early postoperative rehabilitation period. A randomized controlled trial. Eur J Phys

Rehabil Med. 2014;50(4):363-71.

EP

7. Aguilar-Ferrándiz ME, Castro-Sánchez AM, Matarán-Peñarrocha GA, Guisado-Barrilao R,

García-Ríos MC, Moreno-Lorenzo C. A randomized controlled trial of a mixed Kinesio

C
AC

taping-compression technique on venous symptoms, pain, peripheral venous flow, clinical

severity and overall health status in postmenopausal women with chronic venous

insufficiency. Clin Rehabil. 2014;28(1):69-81.

8. Aguilar-Ferrándiz ME, Castro-Sánchez AM, Matarán-Peñarrocha GA, García-Muro F, Serge

T, Moreno-Lorenzo C. Effects of kinesio taping on venous symptoms, bioelectrical activity

of the gastrocnemius muscle, range of ankle motion, and quality of life in postmenopausal

18
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women with chronic venous insufficiency: a randomized controlled trial. Arch Phys Med

Rehabil. 2013;94(12):2315-28.

9. Nunes GS, Vargas VZ, Wageck B, Hauphental DP, Luz CM, de Noronha M. Kinesio Taping

does not decrease swelling in acute, lateral ankle sprain of athletes: a randomised trial. J

Physiother. 2015;61(1):28-33. doi: 10.1016/j.jphys.2014.11.002

PT
10.Parreira Pdo C, Costa Lda C, Takahashi R, Junior LC, Junior MA, Silva TM, Costa LO.

RI
Kinesio Taping to generate skin convolutions is not better than sham taping for people with

chronic non-specific low back pain: a randomised trial. J Physiother. 2014;60(2):90-6. doi:

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10.1016/j.jphys.2014.05.003

11.Cheon YW, Lee WJ, Rah DK. Objective and quantitative evaluation of scar color using the

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L*a*b* color coordinates. J Craniofac Surg. 2010;21(3):679-84.
AN
12.Kaartinen IS, Välisuo PO, Alander JT, Kuokkanen HO. Objective scar assessment-A new
M

method using standardized digital imaging and spectral modelling. Burns 2011;37:74-81.

13.Hallam MJ, McNaught K, Thomas AN, Nduka C. A practical and objective approach to scar
D

colour assessment. J Plast Reconstr Aesthet Surg. 2013;66(10):e271-6.

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14.Cornsweet TN. Visual perception. New York, NY: Academic Press, 1970.

15.Craik KJW. The Nature of Psychology. New York, NY: Cambridge University Press, 1966.
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16.O'Brien V. Contour perception, illusion and reality. J Opt Soc Am. 1958;48:112–119.

17.Vercelli S, Ferriero G, Bravini E, Sartorio F. How much is Kinesio taping a psychological

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crutch? Man Ther. 2013;18(3):e11. doi: 10.1016/j.math.2012.10.008.

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 ACCEPTED MANUSCRIPT
Highlights

Effects of KT on color intensity of superficial hematomas was analyzed.

A significant color improvement along the edges of the tape was observed.

The effects were not dependent on the formation of skin convolutions caused by the KT.

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 ACCEPTED MANUSCRIPT
The study was approved by the Fondazione Salvatore Maugeri’s institutional review board and the
local ethics committee of the Scientific Institute of Veruno (NO), and was conducted in compliance
with the Declaration of Helsinki. Before inclusion, all subjects signed an informed consent.

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