# Kinesio Taping vs. Neuromuscular Electrical Stimulation: Which Is Better for Reducing Ankle Sprain Swelling?

> A comparative review of the effectiveness of Kinesio Taping and Neuromuscular Electrical Stimulation in managing acute ankle sprain edema.

## Introduction
Evidence-Based Physical Therapy (EBP) integrates research evidence, clinical expertise, and patient preferences to optimize care. In November 2025, an international course held at the University of A Coruña, Spain, brought together over 30 students and 9 teachers from six universities across Finland, Spain, the Czech Republic, France, and Portugal to explore EBP across various physiotherapy fields. This article presents findings from the trauma theme group regarding the management of ankle sprains.

## The Challenge of Ankle Sprains
Ankle sprains are among the most common sports injuries, often resulting in pain, swelling, and restricted movement. Effective management of swelling during the acute phase is critical, as persistent edema can hinder muscle activation and joint mobility, potentially leading to chronic instability.

## Clinical Interventions: KT and NMES
Physiotherapists frequently utilize two primary modalities for edema reduction:
*   **Kinesio Taping (KT):** An elastic therapeutic tape designed to lift the skin, theoretically improving lymphatic and venous drainage while reducing pressure on pain receptors.
*   **Neuromuscular Electrical Stimulation (NMES):** Uses electrical impulses to induce rhythmic muscle contractions, stimulating the muscle pump mechanism to enhance fluid flow.

Despite their popularity, clinical evidence regarding their effectiveness in reducing acute ankle swelling remains inconsistent.

## Methodology
The research team conducted a structured literature review and applied the PEDro Scale for critical appraisal. The PICO criteria were defined as:
*   **P (Patients):** Adults (18–60) with acute ankle sprains.
*   **I (Intervention):** Kinesio Taping (applied over medial and lateral surfaces).
*   **C (Comparison):** Neuromuscular Electrical Stimulation (NMES).
*   **O (Outcome):** Reduction in ankle swelling.

The review focused on randomized controlled trials (RCTs) sourced from the PubMed database.

## Findings and Critical Appraisal
Using the PEDro Scale, the studies reviewed scored between 5 and 6, indicating moderate methodological quality with limitations such as small sample sizes and lack of blinding.

*   **Nunes et al. (2015):** Found that KT did not reduce swelling at 3 or 15 days post-application compared to control taping.
*   **Man et al. (2007):** Compared KT and NMES in 31 athletes; both interventions showed small, non-significant decreases in ankle volume with no significant difference between groups.
*   **Mazloum et al. (2023):** Concluded that NMES did not effectively reduce edema or improve function in the early phase post-sprain.
*   **Wainwright et al. (2019):** Reported only minor, short-term reduction in edema with NMES, which did not translate to better pain or functional outcomes.

## Conclusion
Current evidence suggests that neither Kinesio Taping nor NMES provides significant additional benefits over standard care (rest, compression, elevation, and active mobilization) for acute ankle sprains. While these modalities are safe, their impact on swelling is not clinically meaningful. 

Clinicians are encouraged to prioritize established strategies like early mobilization and compression. Future research should focus on larger, well-controlled studies with longer intervention periods and potential combined treatment protocols.

## Authors
*   **Kateřina Josefusová**, physiotherapy student, Charles University
*   **Lukáš Rylich**, physiotherapy student, Charles University
*   **Dayen M’Zebla**, physiotherapy student, l’institut de formation en Masso Kinésithérapie (IFMK) de référence Ile de France
*   **Emma González González**, physiotherapy student, University A Coruna
*   **Dagmar Pavlu**, PT, Assoc. Prof., Charles University, Czech Republic
*   **Ivana Vláčilová**, PhD, PT, Charles University, Czech Republic
*   **Marja Äijö**, PT, PhD, Principal Lecturer of gerontology and rehabilitation, Savonia University of Applied Sciences, Finland
*   **Veronica Robles García**, PhD, PT, OT, Associate Professor, University of A Coruña, Spain
*   **Zeltia Naia Entonado**, PhD, PT, University of A Coruña, Spain
*   **María Vilanova Pereira**, PhD, PT, University of A Coruña, Spain
*   **Adrien Pallot**, PT, MSc, Lecturer at École D´Assas, France
*   **Aurel Bellaïche**, PT, Lecturer at CEERRF, France

## References
1. Mazloum, V., Akbari, H., & Gholampour, A. (2023). The comparison of the effects of neuromuscular electrical stimulation and Kinesio Taping on ankle swelling in athletes with lateral ankle sprain. *Journal of experimental orthopaedics*, 10(1), 63. https://doi.org/10.1186/s40634-023-00624-w
2. Wainwright, T. W., Burgess, L. C., & Middleton, R. G. (2019). Does Neuromuscular Electrical Stimulation Improve Recovery Following Acute Ankle Sprain? A Pilot Randomised Controlled Trial. *Clinical medicine insights. Arthritis and musculoskeletal disorders*, 12, 1179544119849024. https://doi.org/10.1177/1179544119849024
3. Man, I. O., Morrissey, M. C., & Cywinski, J. K. (2007). Effect of neuromuscular electrical stimulation on ankle swelling in the early period after ankle sprain. *Physical therapy*, 87(1), 53–65. https://doi.org/10.2522/ptj.20050244
4. Nunes, G. S., Vargas, V. Z., Wageck, B., Hauphental, D. P., da Luz, C. M., & de Noronha, M. (2015). Kinesio Taping does not decrease swelling in acute, lateral ankle sprain of athletes: A randomised trial. *Journal of Physiotherapy*, 61(1), 28-33. https://doi.org/10.1016/j.jphys.2014.11.002