In addition to the physical therapy program, taping was applied to 90 patients diagnosed with lumbar disc herniation. 90 patients were randomized into 3 groups. Group 1 received star-shaped taping to the lumbar region in addition to physical therapy, Group 2 received I-shaped taping to the erector spinae muscles in addition to physical therapy, and Group 3 was planned as the control group. In the first evaluation, sociodemographic information and disease duration (months) were questioned. Then, pain, muscle strength and endurance mobility, lumbar proprioception, functional level, and disability were evaluated. Evaluations were performed before treatment, after taping and at the end of the 12th week.
The study included 90 patients aged between 18-65 years who were diagnosed with LDH by magnetic resonance imaging (MRI), had moderate to severe low back pain (Numeric Rating Scale \>4) for at least 6 weeks, and were planned to receive a physical therapy program (10 sessions of hotpack, Transcutaneous electrical nerve stimulation (TENS), and ultrasound every day for 2 weeks). The 90 patients included in the study were randomized into 3 groups using the computer-assisted randomization method. Group 1 received star-shaped taping to the lumbar region in addition to physical therapy (5 times in total every 3 days), Group 2 received I-shaped taping to the erector spinae muscles in addition to physical therapy (5 times in total every 3 days), and Group 3 was planned as the control group. In the first evaluation, sociodemographic information (age, gender, height (m), weight (kg), BMI (kg/m2)) and disease duration (months) were questioned. Then, pain (pain intensity and pressure pain threshold), muscle strength (lumbar extensor muscle strength) and endurance (trunk extensor muscle endurance), mobility (lumbar lordosis angle, joint range of motion), lumbar proprioception, functional level, disability evaluations were performed. Evaluations were performed before treatment, after the taping application and at the end of the 12th week. Post-treatment evaluations were performed the day after the tape was removed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
90
Routine physical therapy program (10 sessions of hotpack, Transcutaneous electrical nerve stimulation (TENS), and ultrasound every day for 2 weeks) was applied. In addition to routine treatment, I taping (a total of 5 times every 3 days) was performed. Two I-shaped kinesio tapings were applied on the paraspinal muscles from the posterior superior iliac spine to the T12 level. 50% tension was applied to the area of the tapes outside the anchor points.
Routine physical therapy program (10 sessions of hotpack, Transcutaneous electrical nerve stimulation (TENS), and ultrasound every day for 2 weeks) was applied. In addition to routine treatment, star taping (a total of 5 times every 3 days) was performed. Four I tapes, one vertical, one horizontal and two at a 45° angle to the vertical tape, were applied to the point of maximum pain in the lumbar region. 25% tension was applied to the midpoint of the tapes except for the ends.
Routine physical therapy program (10 sessions of hotpack, Transcutaneous electrical nerve stimulation (TENS), and ultrasound every day for 2 weeks) was applied. No taping was applied.
Izmir Bakircay University Cigli Training and Research Hospital
Izmir, Turkey (Türkiye)
Pain intensity assessment
Pain intensity was measured using the Pain Intensity Numerical Rating Scale, which is most commonly used in the management of patients with chronic low back pain. The scale has 11 points ranging from no pain = 0 to worst possible pain = 10. Patients were asked to indicate their pain intensity during the "last 24 hours" or "average pain" at rest.
Time frame: Baseline, day after last taping application (week 2), 12 weeks after baseline
Pressure pain threshold assessment
The pressure pain threshold was determined in kg/cm2 using an algometer device. Measurements were made at 4 points, 5 cm lateral to the L3 and L5 spinous processes on the right and left. The patient was informed to give the command 'stop' when the pressure sensitivity became unbearable or turned into pain. The test was stopped as soon as the patient reported pain and the applied force was recorded. 2 measurements were made at 30-second intervals and the average of the measurements was used. If the participant did not report pain at a force equivalent to 100 N/s, the test was stopped and this value was accepted.
Time frame: Baseline, day after last taping application (week 2), 12 weeks after baseline
Muscle strength assessment
Lumbar extensor muscle strength was measured with a hand held dynamometer. Participants were positioned face down on a stretcher with their hands clasped. The base of the dynamometer was fixed to the center of the T4 spine and participants were asked to extend their trunks. The tests were repeated twice with at least a one-minute rest. The higher value was recorded as the result.
Time frame: Baseline, day after last taping application (week 2), 12 weeks after baseline
Endurance assessment
The measurement was made using the Biering-Sorensen test. The participant placed the upper half of his/her body on another examination table at a lower height. The participant was asked to hold his/her body isometrically in a horizontal position with hands clasped behind the head until fatigue or pain was felt. The test was terminated when any part of the participant's upper extremities touched the table. The tests were repeated twice with at least a one-minute rest break. The higher value was recorded as the result.
Time frame: Baseline, day after last taping application (week 2), 12 weeks after baseline
Lumbar lordosis angle assessment
Lumbar lordosis was measured using a digital inclinometer. The participant stood with their feet 15 cm apart and their arms at their sides while looking ahead. In this position, the T12-L1 and S1 spine levels were marked by the physiotherapist. Lumbar lordosis was calculated by placing one end of the inclinometer on T12-L1 and the other on the sacrum.
Time frame: Baseline, day after last taping application (week 2), 12 weeks after baseline
Lumbar joint range of motion assessment
Participants' lumbar flexion, extension and lateral flexion active joint range of motion measurements were evaluated angularly with a universal goniometer.
Time frame: Baseline, day after last taping application (week 2), 12 weeks after baseline
Proprioception assessment
Proprioception was assessed by having the participants attempt to reproduce the target position. Three different target positions were selected. The participants were asked to repeat two different trunk positions from upright posture to 45° and 60° flexion with the eyes looking forward, and one position to 15° extension. Each participant was positioned in 45° lumbar flexion for 10 seconds after a neutral starting position and was asked to remember this position. The participant then returned to the neutral position and was given verbal instructions to reproduce the target position as accurately as possible. The participant reported to the therapist that he had reached the target position as perceived. The participant was asked to maintain the final position for 3 seconds and this position was recorded. The same procedures were repeated for 60° lumbar flexion and 15° lumbar extension. Each trial was repeated three times with a 30-second rest; the mean was then calculated.
Time frame: Baseline, day after last taping application (week 2), 12 weeks after baseline
Functional level assessment
A 30-second stand-up-sit test was performed to determine the functional level. Participants were asked to sit in a back-supported chair without arm support, with their hands crossed on their shoulders. Participants were asked to sit immediately after coming to an upright standing position. A trial test was performed to learn the test. The individual who learned the test was asked to sit down and stand up for 30 seconds and the number of repetitions of the movement was recorded.
Time frame: Baseline, day after last taping application (week 2), 12 weeks after baseline
Disability assessment
The Roland Morris Disability Questionnaire was used to assess disability due to low back pain. The questionnaire consists of 24 items regarding physical activity, rest/sleep, psychosocial outcomes, home management, nutrition, and pain frequency. Higher scores indicate increasing disability.
Time frame: Baseline, day after last taping application (week 2), 12 weeks after baseline
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