The Effects of Flossing Band and Kinesio Taping on Nondominant Knee Joint Muscle Strength, Power and Endurance in Young Adult Males

Participants

The sample size for this study was determined during the research design phase using the G-Power 3.1.3 software. A repeated measures design was employed, incorporating three conditions: no intervention, application of a flossing band, and application of kinesiology taping. The parameters set for sample size calculation were as follows: effect size (f) = 0.25, significance level (α) = 0.05, statistical power (1-β) = 0.80, and correlation among repeated measures (r) = 0.80. Based on the G-Power analysis, a minimum of 10 participants was required to ensure sufficient statistical power. However, considering potential attrition during the study, a total of 12 participants were recruited.

The participants were undergraduate students enrolled at G University, selected based on the following inclusion criteria: no history of orthopedic knee surgery within the past six months, no neurological disorders affecting the lumbar spine or lower extremities, and no allergic reactions to kinesiology tape. Prior to participation, all individuals received a comprehensive explanation of the study’s objectives and procedures and provided written informed consent voluntarily.

During the experimental phase, two participants withdrew due to personal reasons, resulting in a final sample of 10 participants included in the analysis. The physical characteristics of the participants are presented in <Table 1>.

Table 1.

Physical characteristics of subjects

Study design

This study aims to compare and evaluate the effects of no treatment, Kinesio taping, and flossing bands on muscular function when applied to the non-dominant leg during knee joint exercises. Prior to the intervention, pre-assessments were conducted to evaluate the bilateral muscle strength of 10 participants, and the leg with the lower strength values was designated as the non-dominant side. Based on these assessments, six participants were classified with a left-sided dominance, while four exhibited right-sided dominance. The difference in strength between the dominant and non-dominant sides ranged from 5% to 11% for the knee extensors and from 6% to 10% for the knee flexors. The flexor-to-extensor strength ratio was observed to be 35–45% on the left side and 38–48% on the right side <Table 2>. Participants were randomly assigned to different intervention conditions and exercise sequences using a lottery-based allocation method (drawing lots labeled A, B, C, D, E, and F). The knee joint exercise program was administered as a single-session intervention, incorporating modifications and refinements of previous studies that applied flossing bands. The exercises were performed at a low intensity utilizing body weight, with a perceived exertion level of 9–11 <17, 18> will be replaced with more recent studies. The program consisted of three exercises—Standing knee flexion & extension, and Squats—each performed for 15 repetitions across two sets, with a 2-minute rest interval between sets. The total exercise duration was 20 minutes <Table 3>. Following the completion of the exercise session, muscular function was assessed using isokinetic dynamometer. To account for neuromuscular recovery and to ensure accurate strength assessment under different intervention conditions, a 7-day washout period was implemented between each condition [19]. The experimental procedure is illustrated in <Figure 1>.

Table 2.

Subject’s knee extension/flexion pre-test values (unit: N·m)

Table 3.

Exercise program

Figure 1.

Experimental procedure.

Flossing band application and exercise method

In this study, a green (Level 1) flossing band manufactured by Sanctband was used for the application of the flossing intervention. The band measured 5 cm in width and 2 m in length and was composed of latex material. The application method was modified based on the study by Konrad et al. [15] and was implemented as follows. The flossing band was applied in a proximal direction, starting from the distal region of the thigh on the non-dominant leg (5 cm above the knee). The band was wrapped with a 50% overlap to ensure even compression and was stretched to 50% of its original length (Stretch Ratio 1.5) to maintain consistent pressure. Care was taken to ensure uniform tension throughout the wrapping process, and the band was secured after covering approximately half the length of the thigh <Figure 2>. Following the application of the flossing band, participants maintained proper body alignment while performing the exercises outlined in Table 3. If a participant reported pain exceeding 7 on the Visual Analog Scale (VAS) or exhibited adverse reactions such as numbness, cyanosis, or sensory abnormalities, the flossing band was immediately removed, and the experiment was discontinued [20]. Furthermore, the application duration of the flossing band was strictly limited to 5–7 minutes. After band removal, participants engaged in light movement for one minute to facilitate lower limb blood circulation recovery.

Figure 2.

Flossing band application and exercise method.

Kinesio tape Application method

In this study, the application of Kinesio taping was modified based on the methodology proposed by Kenzo et al. [21]. The tape used was 3NS tape (5 cm in width, 140% elasticity) manufactured by TS Corporation. Kinesio taping was applied to the quadriceps femoris and hamstring muscles, with the specific application methods detailed as follows. For the quadriceps femoris, taping was applied to the vastus medialis, vastus lateralis, and rectus femoris muscles. The application was performed while the participant was seated with the knee flexed at 90°. Using an I-shaped tape strip (25 cm in length), the tape was affixed starting from the superior region of the knee and extended proximally along the thigh. The tape was applied with an elongation of 25–30%. For the hamstrings, taping was applied to the biceps femoris and semitendinosus muscles. Participants were positioned in a prone position with the knee slightly flexed during the application. An I-shaped tape strip (30 cm in length) was used, starting from the distal region of the thigh (popliteal area) and extending proximally toward the gluteal region. The tape was applied with an elongation of 25–30%, and care was taken to prevent the formation of wrinkles during application <Figure 3>. Following the application of Kinesio taping, participants performed the same exercise program as in the flossing band condition. If participants exhibited symptoms such as pruritus, erythema, or inflammation during the exercise session, the tape was immediately removed [16].

Figure 3.

Kinesio tape Application method.

Assessment of muscle function using an isokinetic dynamometer

Muscle function assessment was conducted using an isokinetic dynamometer, following methodologies described in previous studies [22]. The evaluation parameters included muscle strength (60°/sec), muscle power (180°/sec), and muscle endurance (240°/sec). For the isokinetic measurements, participants were positioned on the assessment chair with the hip joint flexed to 90°. The rotational axis of the knee joint was aligned with that of the dynamometer. To minimize compensatory movements, participants were secured using a lumbar belt, pelvic belt, and medial malleolus strap <Figure 4>. After completing the weekly knee joint exercise interventions, muscle function of the non-dominant leg was assessed. Measurements included three repetitions at an angular velocity of 60°/sec and 180°/sec, and 26 repetitions at 240°/sec, to evaluate the strength, power, and endurance of the quadriceps femoris and hamstring muscles. A 30-second rest period was provided between each test [23].

Figure 4.

Assessment method of muscle function using an isokinetic dynamometer.

Statistical analysis

In this study, statistical analyses were conducted using IBM SPSS Statistics 26 for Windows. Descriptive statistics were calculated for all variables, including the mean and standard deviation. To analyze differences in muscular function following the application of flossing bands and Kinesio taping during knee joint exercise interventions, a one-way repeated measures analysis of variance (ANOVA) was performed. Additionally, to account for potential issues related to multiple comparisons due to repeated measures, a post hoc analysis was conducted using the Bonferroni correction to adjust for Type I error. The level of statistical significance for all analyses was set at α = .05.

Comparison of knee muscle strength by intervention method

As shown in <Table 4>, there were no statistically significant differences in quadriceps strength among the three conditions—no intervention, kinesio taping, and flossing bands (p = 0.05). However, a statistically significant difference was observed in hamstring strength (p < 0.05). Post hoc analysis revealed no significant difference between the no-intervention and kinesio taping conditions (p > 0.05).

Table 4.

Comparison of knee muscle strength by intervention method (unit: N·m)

Comparison of knee muscle power by intervention method

As shown in <Table 5>, significant differences in muscle power were observed among the three conditions—no intervention, kinesio taping, and flossing bands—for both the quadriceps and hamstrings (p < 0.001). Post hoc analysis indicated that there were no significant differences between the no-intervention and kinesio taping conditions (p > 0.05). However, the flossing band intervention resulted in significantly greater muscle power in both the quadriceps and hamstrings compared to the other two conditions (p < 0.05).

Table 5.

Comparison of knee muscle power by intervention method (unit: N·m)

Comparison of Knee Muscle Endurance by Intervention Method

As shown in <Table 6>, significant differences in muscle endurance were observed among the three conditions—no intervention, kinesio taping, and flossing bands—for both the quadriceps (p < 0.05) and hamstrings (p < 0.005). Post hoc analysis revealed no significant differences in quadriceps endurance among the three conditions (p > 0.05). However, for hamstring endurance, no significant difference was found between the kinesio taping and flossing band conditions (p > 0.05). Nevertheless, both interventions resulted in significantly greater hamstring endurance compared to the no-intervention condition (p < 0.05).

Table 6.

Comparison of knee muscle endurance by intervention method (unit: N·m)

Effects of flossing bands and kinesio taping on muscle strength

Flossing bands induce a hypoxic state by restricting blood flow and increasing metabolic stress, thereby promoting muscle growth and strengthening [24]. This mechanism effectively activates fast-twitch muscle fibers, contributing to rapid strength gains within a short period [25]. In contrast, Kinesio taping enhances muscle activation, provides consistent tension and support to prevent excessive fatigue, and stimulates proprioceptive feedback, which aids in strength development [26]. In this study, the application of flossing bands and Kinesio taping was found to have a significant effect on the strength improvement of the quadriceps and hamstring muscles. Notably, in the hamstring muscles, the flossing band intervention demonstrated greater strength gains compared to both the no-treatment and Kinesio taping conditions. This finding suggests that flossing bands may induce strength gains similar to those observed in high-intensity training, even when applied in low-intensity exercise settings [27]. The non-dominant muscles are more prone to weakening due to lower usage frequency and often exhibit muscle strength imbalances between agonist and antagonist muscle groups. Such imbalances can increase the risk of injury, particularly during landing and directional changes [28]. To address this issue, Karabulut et al. [24] conducted a study applying flossing bands to the non-dominant limb and reported significant improvements in muscle strength and stability, thereby reducing injury risk. Additionally, pre-assessment results in this study indicated a low Hamstring-to-Quadriceps (H/Q) ratio, suggesting that the hamstring (flexor) was relatively weaker than the quadriceps (extensor). Previous studies have reported that, in the presence of muscular imbalances, the relatively weaker muscles tend to exhibit greater adaptive responses to external interventions [29]. This trend was also observed in the present study, where interventions using flossing bands and Kinesio taping had a more pronounced positive effect on hamstring strength improvement.

Effects of flossing bands and kinesio taping on muscle power

Flossing bands restrict blood flow, inducing a hypoxic state and enhancing the activation of fast-twitch muscle fibers, thereby facilitating improvements in muscular power [30, 31]. Kinesio taping, on the other hand, has been suggested to shorten the time required for maximal force production, thereby improving muscle reaction time and contributing to enhanced muscle contraction efficiency [32]. The findings of this study confirm that both flossing bands and Kinesio taping are effective in improving muscular power, with the flossing band intervention yielding the greatest improvements. Plocker et al. [33] reported that flossing band training promotes the secretion of growth hormones, thereby enhancing the explosive capacity of muscle fibers. Additionally, Pisz et al. [34] suggested that flossing bands enhance muscular power and muscle fiber activation during training and are particularly effective in exercises requiring rapid contraction speeds. Meanwhile, Kinesio taping may serve as an intervention strategy that enhances joint stability and muscle activation, thereby contributing to improvements in muscular power [32, 35]. These findings suggest that the two intervention methods may be used complementarily and provide valuable foundational data for the development of training programs aimed at enhancing muscular power.

Effects of flossing bands and kinesio taping on muscle endurance

Flossing bands create a hypoxic environment by restricting blood flow, thereby increasing metabolic stress, which enhances capillary density and oxygen transport capacity [36]. In contrast, Kinesio taping facilitates the removal of metabolic byproducts by improving blood and lymphatic circulation, thereby reducing muscle fatigue and enhancing exercise endurance [32, 37]. The findings of this study demonstrate that both flossing band and Kinesio taping interventions significantly improved the muscular endurance of the quadriceps and hamstring muscles. Notably, in the hamstring muscles, the flossing band intervention resulted in greater improvements in muscular endurance compared to both the no-treatment and Kinesio taping conditions. This study confirmed that both flossing band and Kinesio taping interventions had a significant effect on improving the muscular endurance of the quadriceps and hamstring muscles. Notably, the flossing band intervention resulted in greater improvements in hamstring endurance compared to both the no-treatment and Kinesio taping conditions. Previous studies have reported that relatively weaker muscles exhibit greater adaptive responses to external interventions, which may explain the observed improvements in hamstring strength [38]. Furthermore, the findings suggest that flossing bands may enhance muscular endurance by increasing mitochondrial density within muscle fibers, thereby reducing oxygen consumption while improving endurance capacity [34, 39]. Meanwhile, Kinesio taping serves as an auxiliary tool that contributes to joint stability and muscle endurance enhancement, particularly by increasing resistance to muscle fatigue during prolonged physical activity [40]. This implies that it may play a role in both sustaining muscular endurance improvements and preventing injuries. Both intervention methods contribute to muscular endurance enhancement through distinct physiological mechanisms. Further in-depth studies across various populations and exercise intensities are warranted to determine the optimal conditions for maximizing the effectiveness of these interventions in improving muscular endurance.

This study has several limitations. First, the study population was limited to adult males, which may hinder the generalizability of the findings to other demographic groups, such as females and older adults. Second, the sample size was relatively small (n=10), and the experiment was conducted on a limited cohort, which may restrict the applicability of the results to a larger population. Future research should be conducted with a larger sample size to enhance the reliability of the findings. Third, this study only evaluated short-term effects and did not assess the long-term efficacy of the interventions. Fourth, variables related to the intensity and duration of flossing band application were not considered, indicating the need for a more precise and controlled analysis. Future studies should include participants of diverse age groups and genders, while also ensuring a larger sample size to improve the reproducibility and statistical power of the results. Additionally, further investigation into the combined effects of flossing bands and Kinesio taping is warranted. Long-term follow-up studies are necessary to verify sustained effects, and the development of individualized intervention strategies based on muscle fiber composition should be considered. These efforts will contribute to establishing more effective strength enhancement strategies in both athletic training and rehabilitation settings.