KINESIO TAPPING AND NON SPECIFIC LOW BACK PAIN 13
KinesioTapping and Non Specific Low Back Pain
KinesioTapping and Non Specific Low Back Pain
Theimportance of the health of an individual cannot be underestimated asfar as the overall health of the nation is concerned. It goes withoutsaying that health has a bearing on the productivity of a particularnation, particularly given that only healthy people have the capacityto participate or take part in economic activities. Recent timeshave, essentially, seen an increase in the investment that differentpolicymakers and governments make with regard to the health sectorparticularly in research and development, all with the aim of comingup with the most effective and least costly techniques. Perhaps oneof the most prevalent ailments in the contemporary human society ismuscle and skeletal pain, particularly in the back and on the knees.While immense research has been done regarding this condition, one ofthe most explored techniques for managing the condition remains theuse of Kinesio tape.
Developedmore than 25 years ago by Dr. Kenzo Kase in Japan, the therapeutictaping technique has been used as an alternative to athletic tapingso as to support the joints, muscles and fascia. Of particular noteis the fact that KT allows for unrestricted or unlimited range ofmotion (ROM) and has also been theorized as resulting in thereduction of the time required for recovery from injury throughlowering inflammation and pain. The design of Kinesio taping allowsit to mimic the right weight and thickness of skin, not to mentionthe fact that it incorporates a 30%-40% elasticity over the restinglength thereby coming withdistinctive properties. Similarly, thetape incorporates and adhesive that is purely heat-activated acrylicand is latex-free. The pure cotton fibers enable fast drying andevaporation, which ensures that patients may still wear the take whenin the shower or pool without necessarily reapplying it. This makesthe KT treatment more economical as it can be worn for 3 to 5 days.Typically, the tape is applied around and over muscles so as to avertthe possibility of over-contraction. The elimination of inflammationand pain comes off through enhanced blood and lymphatic circulationwithout the restriction of the ROM pertaining to the affected part.The technique eliminates irritation and pressure pertaining to theneuro-sensory receptors that may create pain. On the same note, thetape is known to reduce inflammation at the affected areas throughlifting the skin microscopically, thereby enhancing the drainage oflymphatic. Underlining its effectiveness is the fact that itstimulates and deforms large-fiber cutaneous mechanoreceptors thatmay hinder nociceptive impulses pertaining to the spinal column andlower the pain via an ascending pathway.
Effectof Kinesio Taping versus no treatment
Stillin determining how effective kinesio tape was, it is necessary todetermine whether there is any difference between its application andthe application of no other intervention. In HYung (2010), 20patients suffering from chronic lower back pain were taken through anon-random control trial aimed at comparing Y-shaped and I-shapedtaping. The results showed that the endurance and strength inextension increased, while the same could not be said in the case offlexion. Of particular note is the fact that both kinesio techniquesand the use of I-shaped taping improved in more or less the same way.
AlBahel et al (2013), on the other hand, noted that kinesio tapingresults in significant variations in the extension and trunk flexion,as well as VAS and RMDQ both before and after the intervention or theuse of KT. In this study, 20 patients between the ages 25-45suffering from chronic NSLBP participated in the single-blinded RCTthat had a pre and post intervention design. In the study, erectorspine Y-shape KT was compared with having no intervention, with theformer being administered 3 times a week for 4 weeks where theeffects on pain, disability and ROM were measured.
Asmuch as there is no significant variation in the lateral flexion orextension, Yoshida & Kahanov (2007) underlined the fact that KTwhen applied over the lower trunk may enhance the active lower trunkflexion ROM. This was confirmed in a study where 30 healthy subjectsparticipated in a randomized crossover pre- and post-test repeateddesign, where KT (y-shape) was compared to no-KT with the mainmeasure being ROM.
Similarresults were obtained by Merion et al (2010) when the application ofthe y-shaped muscle tape over the lumbar spinal segment coupled withthe application of the x-shaped muscle tape over the ischiocruralmuscle group were seen to enhance extensibility as determined in thesit and reach tests.
Lee& Yoo (2011) and Lee & Yoo (2013) agree in their randomlycontrolled test where they compared KT and the application of notaping. In the 2011 study, 56 healthy individuals took part in therandom controlled trial where the first group had anterior pelvictilt taping compared to no taping. It is noted that the subgroup thathad KT indicated a significant increase in the anterior pelvicinclination after the application of the tapes. In fact, the increasewas maintained in spite of the periodic slump position, somethingthat the subgroup that did not have KT never showed.
InLee & Yoo (2013), a 20 years old female with Cobbs angle L1-IS of68°, pain in both the sacroiliac joints and buttock areas, as wellas a sacral horizontal angle of 45° had PPTT applied for 2 weeks,with the expected outcomes revolving around pain, motion palpitationand pelvic inclination. It was noted that the PPTT intervention hadpositive effects on the inclination of the pelvis and the sacralhorizontal angle, resulting in positive effects on the sacroiliacjoint dysfunction, as well as medial buttock pain.
AsKang et al (2013) notes, the postural taping may alter the activityof the back extensor muscle, as well as the rating of perceivedexertion, and the lumbo-pelvic-hip complex kinematics in physicaltherapists who have chronic low back pain in the course oftransferring the patients. In the 2013 study, 19 male physicaltherapists suffering from CLBP took part in the study where posturaltaping was compared to no taping. The study results demonstrated thatKT intervention would have favorable effects on the horizontal angleof the sac and the inclination of the pelvis, which positivelyaffects the sacroiliac joint dysfunction, as well as the medialbuttock pain.
Onthe same note, Hwang-Bo & Lee (2011) applied KT on a 36-year oldmale physical therapist in a case report pertaining to one patientand compared it to no exercise, with the measurements being ROM,disability and pain. It was noted that the application of KT resultedin the decrease of VAS and ODI, while ROM increased. Further, it maybe noted KT can be applied in the treatment and prevention ofoccupational lower back pain in varied other professions that revolvearound the lifting of heavy objects.
Effectof Kinesio Taping versus sham taping.
Indetermining the effectiveness of Kinesio Taping, it has becomeimperative that it be compared with sham taping. According to Chen etal, (2012), sham taping, which involves that involves the use of notension was found to be less effective in lowering worst back paincompared to Kinesio taping. Indeed, Kinesio taping was found toimmediately enhance the range of motion immediately after it wasapplied to the joints and back. However, it is noteworthy that thestudies found no considerable variation as far as pain and theoverall disability scores are concerned. Of particular note is thefact that functional facial taping, which is a component of kinesiotaping reduced the worst pain in patients that had non-specific andnon-acute low back pain in the course of the treatment phase.
Aclosely similar verdict was reached by Parreira et al (2014) andLemos et al (2014) in a study that compared the effectiveness ofKinesio taping and that of sham taping. The main question in thestudy was whether kinesio taping, when applied on individuals withchronic back pain in line with the treatment manual so as to generateskin convulsions, would reduce disability and pain more compared to asimple application that is deficient of convolutions. In this study,it was determined that the difference in their effectiveness was notstatistically significant, in which case Kinesio taping could not besaid to be more effective than the simple application.
Thiswas the same case with Castro-Sanchez et al, (2012), who determinedthat the differences in reduction of sham taping and kinesio tapingwere too minute to be considered as significantly worthwhile. In thisstudy, a total of 60 patients between the age of 18-65 years oldsuffering from CNSLBP participated in random controlled trials withhidden allocation, intention-to-treat analysis and assessor binding.This study compared KT that was star-shaped over the painful areaagainst sham taping where the strip transverse across the painfularea with the main measurement being muscle endurance, ROM,kinesiophobia, pain and disability. Within one week, KT had loweredthe pain and disability at statistically insignificant levels, whileat the 4 weeks follow-up, there was significant trunk muscleendurance increase and pain reduction, although the same was not thecase for disability.
InVoglar & Sarabon (2014), 12 healthy individuals took part in arandomized placebo controlled cross-over study, where the tape wasplaced over paravertebral muscles in the experimental study, whilethe placebo condition sham application was carried out transversallyon the lumbar region. It was determined that as much as KT hadpotential beneficial effects on the anticipatory postural adjustmentstiming, the same was recorded in the case of sham taping, in whichcase there is no statistically significant variation.
However,Bae et al, (2013) seem to disagree about the effectiveness of KT incomparison to the sham taping. In their study, a total of 20 patientssuffering from chronic LBP took part in randomly controlled trialswith pre and post phases, where KT and ordinary physical therapy wascompared to ordinary physical therapy and sham tape. The measurementswere disability, pain MRCP and postural control. As much as the twogroups resulted in similarly significant reduction in ODI and VAS, KTwas seen as having positive effects on anticipatory postural control,as well as MRCP.
Effectof Kinesio Taping versus other interventions
Kinesiotaping may also be compared with other interventions particularlyconventional therapies. In a study conducted by Salvat & Salvat(2010) comparing KT with the use of conventional bandages, 33 healthyindividuals participated in experimental double-blind study. Theparticipants were divided into three groups with the first havingkinesio taping, while the second and 3rdgroups had conventional bandages and placebo bandages. It was notedthat there was a significant difference in the results, with theKinesio taping showing higher trunk flexion compared to theconventional taping and the placebo bandages.
However,the results were different as was demonstrated in the case of Enciso(2009), where Kinesiology therapy was compared to the posturaleducation and exercise therapy, with each of them being given 3sessions. In the study, 8 patients aged between 20 and 50 years oldand suffering from chronic NSLBP took part in the single-blindedrandom controlled trial with pre and post-intervention design. KT wascompared to exercise therapy and postural education with the outcomemeasured being pain and disability. It was noted that the two groupsdid not demonstrate any significant variations in the disability(RMDQ and ODI) or even pain (QB) prior or even after theintervention. Of course, the results may have been affected by thefact that the therapies were applied on an extremely small sample (8patients), which may not have been sufficient to make properconclusions.
Effectof Kinesio Taping plus other interventions versus other interventionsalone
Ithas been well acknowledged over time that different therapies andstrategies of intervention may be combined and applied to anindividual so as to enhance the healing process. In instances wherekinesiology therapy is applied to conventional therapy, it is thecase that the results are much better than when the conventionaltherapy is applied alone.
AsAsthana et al (2013) notes, the combination of KT and conventionaltherapy was seen as more effective in enhancing RMQ and VAS comparedto the application of conventional therapy alone. This wasdemonstrated in a study where 30 patients between the ages 20 and 50were subjected to randomly controlled trials where conventionaltherapy and KT were compared to conventional therapy alone in a oneweek session. The main outcomes that were being measured were pain,ROM and disability, with the combination of KT and conventionaltherapies showing significant improvement on pain and disabilitycompared to the conventional therapy alone. However, it may often becontested whether the combination always results in better results.
Indeed,Kachanathu et al (2013) disagreed from the notion that the resultswould be better when the therapies are combined. In a study where 40patients suffering from NSLBP were subjected to a combination of KTand conventional physical therapy and compared to another group thatonly had conventional physical therapy, it was noted that the twogroups demonstrated significant variations as far as the trunkextension and flexion, as well as RMDQ and VAS were concerned.However, there was no difference between the two groups, which meansthat either the conventional physical therapy has similareffectiveness on pain, disability and ROM as the KT or that KT doesnot have any significant implications on pain.
Similarresults were obtained in Paoloni et al (2011) where KT was combinedwith Exercise and compared to Exercise alone and KT alone. In thisstudy, 39 patients aged between 30 and 80 years old and sufferingfrom chronic lower back pain participated in single blinded randomlycontrolled trials and pre-test/posttests. It was noted that as muchas the three groups demonstrated significant reductions in pain,there was no significant variation between KT and other exercises.
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