KinesioTape and Low Back Pain
LowBack Pain (LBP) is among the most known challenges facing physicaltherapists. This is because it represents over 50% of the referralsregarding outpatient clinic for physical therapy [1-3]. On the otherhand, Non-specificLBP (NSLBP) refers to LBP of not known pathology. It establishesabout 85% to 95% of the entire cases. Itis often created spontaneously, and could be disabling and painful[4-7].
Thereis no clear estimation in Saudi Arabia for the patients’ percentagethat suffers from the LBP, and is referred to the clinic for physicaltherapy. However, LBP impacts on significant number of Saudi Arabiansand the approximated prevalence is from 18.8% to 26.3% [8-10]. Inaddition, LBP o work rate is probably a huge problem among theteachers (63.8%) , physical therapists (33%),nurses(65.7%) , and dentist (73.5) .
Thereare a number of treatment strategies to treat chronic NSLBP. Theyconsist of pharmacological therapy , insufficient bed rest, lackof education, and alteration of activity [17, 18]. However, they aresometimes insufficient, and thus additional therapeutic modalitiesare needed for example electrotherapy , manual therapy ,exercise therapy , and behavioral cognitive therapy .Nonetheless,there is slight to moderate evidence that regards effectiveness ofthese interventions of physical therapy interventions. These alsolead to uncertainty and controversy within the allied and medicalhealth professions [23-25].
Oflate, new approach is considered to be alternative to treating LBP,which is known as the Kinesio Taping (KT) [27-30]. In the 1970s,Kenzo Kase developed KT [27-29]. It is a latex-free and adhesive, andis stretchable to approximated 120-140% of its initial length. 100%of cotton fibers allow for the fast drying and evaporation withouthaving to restrict the range of motion [27-31]. KT application isprojected to induce the following functions of therapy: (1) improvemuscles function (2) activation of blood and nymph circulation (3)Pain system deactivation (4) support the joint function and (5) thesegmental influence [30, 32].
Fewof published clinical trials offered preliminary evidence on the KT’sbeneficial effectiveness in treatment of chronic NSLBP [27, 29, 31,33, 34, and 35]. However, other studies [36, 37] showed that KT lacksevidence and produced minimal effect in the investigated outcomemeasurements varieties. These are involved but unlimited to the pain,functional disability, flexibility of lumbar spine, and the muscularstrength. The purpose of this study therefore, was to detect theeffectiveness of KT application techniques in reduction of pain,functional disability, and trunk flexion range improvement of motion(ROM), especially in patients with chronic NSLBP.
Thiscontrolled trialshowedmajorimprovementsin painintensityand functional disabilityand with the substantialimprovementin trunkflexion ROM after two-week post- intervention.These improveddifferencespersistedforashort-term follow-up (four weeks),in favor of thegroupcomparedwith placebogroup.
Thecurrent study results are in consistent with the previous researchesthat investigated KT use in chronic LBP. One of the studies demonstratedamajorreductionin VAS (p < 0.05), andODI (P < 0.05) after taping application, and withno in between group differences. TheODI of the experimental group however, undergo greater changes. Withanotherstudy handled by Castro-Sanchezet al, it demonstratedKT with smaller effects between controland experimental groupson painand functional disability, which maintainedfour-weekafterthe KTintervention.In addition, Lemos et al., observeda substantialincreasein thetrunkflexion ROM, after applicationof KinesioFascia Correction on the fingertip-to-floor measurement,butnot a mustin healthysubject.However,thiscould be explainedby normalvaluesof trunkflexion ROM, which is at baseline forallthe participants,(mean6.07 ± 1.2 cm).
Theresultsof thisstudyhowever, contradictedwith the findingof Parreira et al., . However,thesimilaritybetween thetwo studiesinregard to thetechniqueof tapingapplication(I-shapedstripes),theauthorsneverreportedsignificantKT effects on painor disability,after the 4-weekinterventionor12 weeksfollow-up.Inaddition, theresultscontradictedwith the findingsof Chen et al, . Hefailedto demonstratea significantKT effect (functionalfascial taping) on the averagepainVAS andfunctionaldisabilityby usingODI after 2-weeksinterventionorintermediate-term follow-up, 12-weeksafter taping.
TheKT Discrepancy results in comparison to the placebo taping may beattributed to the differences in taping application, for example,I-strip taping , Y- strip , star taping [29, 48], KinesioFascia Correction , and the Functional Fascial Taping .Additionally, there is huge variability in assessment tools like PainVAS [29,35,48,50], NRPS , functional disability using the ODI[29,48,50] or RMDQ [29,35,36,48]. In addition, there is assessment oftrunk flexion ROM that uses modified Schober test , flexi meter and finger to tape measurements . Moreover, these studiesare identified by small sample size , visibility [48, 49] andshort-term effect [29, 35, and 49].
Thoughthese studies attempt to prove the KT application efficacy, they failto explain the KT acts mechanism on musculoskeletal conditions. Someinvestigators however, have attempted to speculate and formulatecertain theories that try to explain underlying mechanisms forKT effects on reduction of pain. Meant for this, Slupik et al., 2007 suggested that KT effects could be due to an increasedrecruitment of the motor units muscles. However, other authors havesuggested that KT reduces pain since sensory modalities operatewithin the cross-modal, intermodal, and the interconnecting networks.. KT acts by stimulation of the Golgi receptors to initiate thewhole process[35, 52]. Thisleads to increasein theflow of bloodandlymph in thetapearea.This then dramatically relievespainand thus increasesROM andimprovesdisability[27, 30, 53, and 54]. Inaddition, KT effect lifts the skin thus creates space between theskin and underlying flesh.
Fromthisstudy,allthe avenuesthat make theresearchvulnerableto biasnessare avoidedthrough allthe methodological approaches.Theinabilityto blindparticipantsandtherapists however, are considered to be the limitationof thisstudy.Moreover,thescopeof thecurrentstudycoversonly theKT application, which may not be theoriginalrepresentationof today’sclinical practice.Itwould be interesting toconductKT studies as an adjunctto the treatmentsas recommendedby the clinical practiceguidelines [65, 66].
Participantswith chronic NSLBP demonstrated significant improvement in pain,disability and trunk flexion ROM after the KT application. However,theseeffectsmay begenerallysmallto be considered clinically worthwhile and marinated for a short-term(4-week), after taping application.