Comparison of Physiotherapy Approaches in Low Back Pain: A Randomized Controlled Trial

Efficacy of kinesio tape added to lumbar stabilization exercises on adult patients with mechanical low back pain: A randomized, single-blind clinical trial

BACKGROUND

Lumbar stabilization exercises (LSEs) are beneficial for chronic mechanical low back pain (CMLBP). However, further research focusing on intervention combinations is recommended. This study examined the effect of kinesio tape (KT) with LSEs on CMLBP adult patients.

METHODS

A randomized blinded clinical trial was conducted. Fifty CMLBP patients of both genders were assigned into one of two groups and received 8 weeks of treatment: group A (control): LSEs only, and group B (experimental): KT with LSEs. The primary outcome was back disability, measured by the Oswestry disability index. Secondary outcomes included pain intensity, trunk extensor endurance, and sagittal spinal alignment, as indicated by the visual analog scale, Sorensen-test, and C7-S1 sagittal vertical axis, respectively. The reported data was analyzed by a two-way MANOVA using an intention-to-treat procedure.

RESULTS

Multivariate tests indicate statistically significant effects for group (F = 4.42, p = 0.005, partial η2 = 0.148), time (F = 219.55, p < 0.001, partial η2 = 0.904), and group-by-time interaction (F = 3.21, p = 0.01, partial η2 = 0.149). Univariate comparisons between groups revealed significant reductions in the experimental group regarding disability (p = 0.029, partial η2 = 0.049) and pain (p = 0.001, partial η2 = 0.102) without a significant difference in the Sorensen test (p = 0.281) or C7-S1 SVA (p = 0.491) results. All within-group comparisons were statistically significant (p < 0.001).

CONCLUSION

The combination of KT and LSEs is an effective CMLBP treatment option. Although patients in both groups displayed significant changes in all outcomes, the combined interventions induced more significant reductions in back disability and pain intensity.

Physiotherapy research on low back pain in the indian context: A bibliometric analysis using the scopus database

BACKGROUND

Low back pain (LBP) is a common musculoskeletal condition that necessitates public health concerns. It also attracts considerable research interest among physiotherapists.

OBJECTIVE

This study conducted a bibliometric analysis to reveal the affinity of Indian physiotherapists toward research on LBP using the Scopus database.

METHODS

An electronic search was performed on December 23, 2020, using specific keywords. The data was downloaded in a Scopus plain text file (.txt) format and were analyzed using R studio (biblioshiny) software.

RESULTS

Two hundred and thirteen articles concerning LBP published from 2003 to 2020 were retrieved from the Scopus database. Among those articles (N= 213), 85.45% (n= 182) were published between 2011 and 2020. An article published by "James SL (2018)" in the Lancet had the highest citation of 1439. The highest collaboration was between India and the United Kingdom, and India and the United States of America jointly accounted for 12.2% (n= 26) of the entire articles (N= 213).

CONCLUSION

Indian physiotherapists have shown an interest through gradually increasing their research output on LBP since 2015. They contributed effectively to various journals and international collaboration. Nevertheless, there is room to improve the quality and quantity of LBP articles in high-quality journals, thereby enhancing the citation count. This study recommends improving the scientific output of Indian physiotherapists on LBP by expanding their international networks.

[Problems and prospects of kinesiotaping use in clinical practice]

Currently the concept of kinesiotaping has become widespread. Kinesiotaping, which was originally implemented in sports medicine, is increasingly used in rehabilitation and various spheres of medicine, such as orthopedics, traumatology, pediatrics, etc. In recent years, the new publications about the kinesiotaping use in neurology and rheumatology have been released, where previously unknown effects, such as improved sensory feedback, have been demonstrated. Great attention is paid to comparative studies of the effects of kinesiotaping and other methods of taping, which have been used for many years. Nevertheless, despite the popularity of this physical therapy and rehabilitation method, the number of scientific studies supporting its use remains insufficient. The effects originally attributed to kinesiotaping are still controversial, and there is insufficient scientific evidence supporting them. It is not reliably determined whether the tape has a tonic or relaxing effect due to the stimulation of the mechanoreceptors and how the taping affects fascial tissue. Its effect on the reduction of pressure in subcutaneous structures, its mechanisms of action on the microcirculatory bloodstream by stimulating exteroceptors and proprioceptors is unclear. The difficulty of kinesiotaping efficacy evaluation consists in the variety of techniques and the necessity to choose the location of the tape applying, its shape, the suitable tension and adhesion time. The article represents the results of the latest scientific researches on the pathogenetic mechanisms of kinesiotaping and efficacy of this technique in various nosologies.

Bilateral Asymmetrical Limb Proprioceptive Neuromuscular Facilitation Effects on Pain, Multifidus Activity, Range of Motion, and Disability in Low Back Pain: A Randomized Controlled Trial

OBJECTIVE

The purpose of this study was to determine the effects of bilateral asymmetrical limb proprioceptive neuromuscular facilitation (PNF) pattern exercises on lumbar multifidus (LM) activity, pain, disability, and lumbar range of motions (ROMs) compared to Swiss ball exercises in patients with chronic low back pain (CLBP).

METHODS

A randomized controlled trial was conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan, between March 2020 and January 2021. A sample size of 150 patients with CLBP was randomized into 2 groups. Participants in the intervention group (n = 75) received bilateral asymmetrical limb PNF, while the comparison group (n = 75) received Swiss ball exercises. The scores of the visual analog scale, Oswestry Disability Index, Modified-Modified Schober's test, and percentage of the maximum voluntary contractions of LM (%MVC LM) through surface electromyography were recorded before and after 15 sessions of exercises. The Wilcoxon signed rank and Mann-Whitney U tests were employed for within-group and between-group comparisons of all outcomes, respectively. The considered level of significance was 0.05. The trial was registered with ClinicalTrials.gov (NCT04206137).

RESULTS

Pain (in sitting, standing, and walking), disability on the Oswestry Disability Index, and left side %MVC LM were significantly improved (P < .001) in the PNF group compared to the comparison group except for right side %MVC LM and ROMs on the Modified-Modified Schober's test (P > .05).

CONCLUSION

Bilateral asymmetrical limb PNF exercises showed improvement in pain, disability, and LM activity of patients with CLBP more than those who used Swiss ball exercises.

The efficacy of kinesio taping as an adjunct to physical therapy for chronic low back pain for at least two weeks: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND:

Kinesio taping (KT) is a relatively new treatment method for chronic low back pain (CLBP). The effectiveness of KT as an adjunct to physical therapy (PT) for CLBP remains controversial.

OBJECTIVE:

The aim of this updated meta-analysis was to critically examine and evaluate the evidence of recent randomized controlled trials regarding the effectiveness of KT as an adjunct to PT for CLBP for at least 2 weeks.

METHODS:

This systematic review and meta-analysis was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library were searched in September 2020 by two independent reviewers. The risk of bias was assessed using the Cochrane Collaboration's tool. Data analysis was performed with Review Manager Software.

RESULTS:

Twelve randomized controlled trials with a total of 676 patients were included in our study. Mean improvements were significantly higher in the KT+PT group than the PT group for pain score (SMD, 0.73 [95% CI, 0.37–1.08], P < .00001) and disability (SMD, 1.01 [95% CI, 0.42–1.59], P = .0007). Of 12 studies based on the pain score, 7 reported KT+PT patients to have significantly less pain at latest follow-up when compared with PA patients (P < .05). Of 11 studies based on the disability, 8 reported KT+PT patients to have significantly better improvements at latest follow-up when compared with PA patients (P < .05).

CONCLUSION:

Kinesio taping combined with physical therapy provided better therapeutic effects regarding pain reduction and disability improvement compared with physical therapy alone in individuals with chronic low back pain. Limitation: 1. Included studies and sample sizes were small and most studies were with moderate evidence level; 2. several important outcomes such as range of motion and distance walked were lack; 3. heterogeneity among the included studies was unavoidable.

Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021

Low back pain (LBP) remains a musculoskeletal condition with an adverse societal impact. Globally, LBP is highly prevalent and a leading cause of disability. This is an update to the 2012 Academy of Orthopaedic Physical Therapy (AOPT), formerly the Orthopaedic Section of the American Physical Therapy Association (APTA), clinical practice guideline (CPG) for LBP. The overall objective of this update was to provide recommendations on interventions delivered by physical therapists or studied in care settings that included physical therapy providers. It also focused on synthesizing new evidence, with the purpose of making recommendations for specific nonpharmacologic treatments. J Orthop Sports Phys Ther 2021;51(11):CPG1-CPG60. doi:10.2519/jospt.2021.0304.

Effect of kinesio taping on low back pain during pregnancy: a systematic review and meta-analysis

BACKGROUND

Low back pain during pregnancy affects the normal daily activities of pregnant women to a certain extent. Current studies have shown that Kinesio Taping (KT) may be a treatment for low back pain during pregnancy, but there is still a lack of key evidence. The purpose of this study is to evaluate the efficacy and safety of KT in the treatment of low back pain during pregnancy.

METHODS

PubMed, Web of Science, The Cochrane Library, Scopus, Embase, Wanfang Data, CNKI, and VIP databases were searched to collect randomized controlled trials (RCTs) of the efficacy of KT intervention on low back pain in women during pregnancy. The retrieval time limit is from the establishment of the database to April 2021. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Meta-analysis was performed using RevMan5.3 software.

RESULTS

A total of 7 RCTs were included, including 444 patients. Meta-analysis results showed that: Compared with the control group, KT intervention could significantly improve low back pain and dysfunction, VAS score (- 1.62, 95%CI - 2.08 to - 1.16, P < 0.00001, I2 = 77%), RMDQ score (- 1.00, 95%CI - 1.54 to - 0.46, P = 0.0003, I2 = 80%); The results of the meta-analysis of the subgroup showed that compared with the control group, the KT intervention was less than or equal to 1 week, and the waist pain and dysfunction were improved, with statistically significant differences. The difference in the improvement of low back pain was statistically significant after KT intervention for more than 1 week, but there was no statistically significant difference in RMDQ score (- 1.25, 95%CI - 2.66 to 0.15, P = 0.08, I2 =77%). Compared with the control group, KT intervention improved low back pain in the second and third trimesters, and the difference was statistically significant.

CONCLUSION

KT has a positive effect on the improvement of low back pain during pregnancy, KT intervention can significantly improve pregnant women's low back pain and dysfunction problems, improve the quality of life. It is suggested that future research should focus on the prevention and treatment of low back pain during pregnancy to provide more research data for improving women's health.

The effect of elastic therapeutic taping and rigid taping on pain, functionality, and tissue temperature in lumbar radiculopathy: a randomized controlled study

PURPOSE

To compare the therapeutic effects of different taping materials and techniques on pain, functionality, and tissue temperature in patients with lumbar radiculopathy. Methods: Patients with lumbar radiculopathy were included in the study (n = 51). Patients were randomly divided into three groups, which were the elastic taping (n = 17), rigid taping (n = 17), and placebo taping groups (n = 17). All patients were enrolled in a physiotherapy and rehabilitation program that included thermotherapy, electrotherapy, and exercise five times a week for 2 weeks. The pain was measured before and after treatment using the Visual Analogue Scale. Functionality and quality of life were measured using the Oswestry Low Back Pain Disability Questionnaire and Roland-Morris Disability Questionnaire. The tissue temperature of the treated area in the lumbar region was measured by digital electronic infra-red thermography. Results: After the treatment, pain, functionality, and quality of life were improved in all groups (p < 0.05). Elastic taping was more effective in decreasing pain and increasing functionality than placebo taping (p < 0.05), but no difference was observed between placebo taping and rigid tapping. Local tissue temperature did not change before and after treatment in the elastic taping group (p > 0.05). Tissue temperature increased in the rigid and placebo taping groups (p < 0.05). Conclusion: Taping therapy in patients with lumbar radiculopathy has a positive effect on pain and functional status. Elastic taping can be recommended for clinical use because its effect is superior in some recovery parameters and its ease of use.