Neuromuscular Taping (NMT) Effects on Pain, Edema, and Proprioceptive Cognitive Strategies in knee arthroplasty

Total knee replacement arthroplasty (TKA) is a widely used surgical intervention for treating chronic knee pain and disability, particularly in aging populations with rising obesity rates. Despite its effectiveness, TKA presents postoperative challenges, including functional limitations, lymphatic congestion, and chronic pain, which can hinder rehabilitation outcomes.

This article reviews current literature on TKA, emphasizing increasing surgery rates and the need for enhanced functional recovery strategies integrating cost effective treatment modalities such as NeuroMuscular Taping.

Bandholm highlighted the need for improved functional recovery after major joint replacement, although patient-reported outcomes are generally positive post-surgery, performance-based functioning shows limitations, with low postoperative activity levels. Chronic pain has been stated to affect 5 to 20% of patients, strongly impacting rehabilitation and outcomes.

A recent systematic review identified over 11,000 studies on post-TKA modalities, but optimal rehabilitation strategies remain unclear. Complications following TKA, such as deep vein thrombosis, pulmonary embolism, implant dislocation, site infections, amputation, and surgical edema, remain concerning. Effective edema management is crucial for rehabilitation success but can be resource-intensive.

Recent advances in lymphedema treatment, including NeuroMuscular Taping (NMT), show promise in enhancing lymphatic system function and reducing edema. NMT has emerged as a potential low-cost rehabilitation treatment for postoperative edema and pain. However, its effectiveness in TKA recovery requires further study. Specific NMT treatment could support temporary post-surgical lymphatic system insufficiency, enhancing faster lympha conduction despite reduced patient mobility. Over recent years, NMT has been effective in rehabilitating neurological and orthopedic conditions. In systemic sclerosis patients with Raynaud's phenomenon, NMT reduces pain, improves mobility, reducing disability and may increase microvascular circulation.

Postoperative rehabilitation difficulties include severe joint stiffness, edema, hematoma, acute pain, and chronic pain, which hinder patient collaboration with self-exercise and mobility. Therapists often face swelling and pain, increasing stiffness in the operated knee and delaying rehabilitation.

In a recent study, Albizzati Erica, aimed to investigate the effects of decompressive NMT on swelling, pain, range of motion, and cognitive attentional processes in TKA patients. Her single blinded study showed how decompression NMT applications, applied from the 2°day post surgery, gave significant reduction in pain and edema, while patient compliance was also significantly improved offering benefits in TKA recovery.

Conclusions

Correct application of a specific NMT protocol is aimed to provide faster track processes for improving post-surgical rehabilitation for an increasing joint prosthetic population. It has shown to significantly reduce edema and pain, hypothesizing the effects of decompressive tape application (NMT) on cognitive-attentional processing of stimuli. NMT seems to impact the cortex, facilitating attention to the limb and building a better body image, encouraging continuous feedback while enhancing freedom of movement, crucial for cognitive understanding of the world that surrounds.

References

• Albizzati Erica, Claudio Trotti, David Blow, Forte Fabiana. NeuroMuscular Taping (NMT) and Neuroplasticity: NMT reduces pain, edema and influences proprioceptive cognitive strategies during total knee arthroplasty rehabilitation. Journal of Physiotherapy & Physical Rehabilitation, 2(6), 120-126). DOI: 10.5281/zenodo.3934948
• Mark-Christensen T, Thorborg K, Kallemose T, Bandholm T. Physical rehabilitation versus no physical rehabilitation after total hip and knee arthroplasties: Protocol for a pragmatic, randomized, controlled, superiority trial (The DRAW1 trial). F1000Res. 2021 Feb 25;10:146. doi: 10.12688/f1000research.50814.2. PMID: 34316356; PMCID: PMC8276181.
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• Kristianto H, Waluyo A, Yunir E, Gayatri D, Blow D. Neuromuscular taping application opportunities in nursing: a?literature review. Central European Journal of Nursing and Midwifery. 2020;11(3):143-151. doi:?10.15452/cejnm.2020.11.0018.
• Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM. Insall Award paper. Why are total knee arthroplasties failing today? Clin Orthop Relat Res. 2002 Nov;(404):7-13. doi: 10.1097/00003086-200211000-00003. PMID: 12439231..
• Costantino C, Pedrini MF, Licari O. Neuromuscular taping versus sham therapy on muscular strength and motor performance in multiple sclerosis patients. Disabil Rehabil. 2016;38(3):277-81. doi: 10.3109/09638288.2015.1038365. Epub 2015 Apr 20. PMID: 25893397.
• Parisi S, Celletti C, Scarati M, Priora M, Laganà A, Peroni CL, Camerota F, La Torre G, Blow D, Fusaro E. Neuromuscular taping enhances hand function in patients with systemic sclerosis: a pilot study. Clin Ter. 2017 Nov-Dec;168(6):e371-e375. doi: 10.7417/T.2017.2036. PMID: 29209686.
• Iciar M. Dávila Castrodad et al. (2019). Optimal rehabilitation strategies following total knee arthroplasty: A narrative review. World Journal of Orthopedics, 10(7), 256-270).

Keywords: #Totalkneereplacement, #arthroplasty, #rehabilitation, complications, #NeuroMuscularTaping, #NMT, #edema, #pain, #cognitive attentional processes

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