Document Type : Original Articles
Authors
1 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
2 Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
3 Orthopedic & Rehabilitation Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
4 Occupational Medicine Department, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Abstract
Background: Chronic non-specific low back pain (NS-LBP) is a prevalent musculoskeletal condition affecting athletes. While core muscle strengthening is effective in managing NS-LBP, the role of the diaphragm in spinal stability is often overlooked. Kinesio taping may enhance muscle function; however, its efficacy when combined with diaphragm strengthening exercises has not been explored in female athletes with NS-LBP. This study aims to investigate the effects of adding Kinesio taping to diaphragm strengthening exercises on pain, function, core muscle endurance, agility, and balance in this population.
Methods: This protocol describes a single-blind randomized controlled trial that will recruit 32 female recreational athletes aged 30–50 years with chronic NS-LBP. Participants will be randomly assigned to one of two groups: diaphragm-strengthening exercises with Kinesio taping (experimental group) or diaphragm-strengthening exercises alone (control group). The intervention will be conducted over 4 weeks. Outcome measures will include: pain (Numerical Rating Scale), function (Oswestry Disability Index and Athlete Disability Index), core muscle endurance (Prone Bridge Test, Side Bridge Test, Unilateral Hip Bridge Endurance Test, Feet Elevated Side Support Test), balance (Single Leg Stance Test, Y Balance Test), and agility (Illinois Agility Test). Assessments will be performed at baseline, post-intervention, and at 2-week follow-up.
Results: The study will provide evidence on the effectiveness of combining Kinesio taping with diaphragm strengthening exercises in female athletes with NS-LBP.
Conclusion: Findings may guide clinical practice by determining whether this combined approach yields superior outcomes compared to diaphragm exercises alone.
Highlights
Keywords
- Rathinaraj LA, Irani A, Sharma SK, Ng B, Sreeja M. Forced Expiratory Volume in the first second [FEV1] in patients with chronic low back pain. Journal of Research in Medical and Dental Science. 2017;5(1):27-32.
- Mousavi SJ, Akbari ME, Mehdian H, Mobini B, Montazeri A, Akbarnia B, et al. Low back pain in Iran: a growing need to adapt and implement evidence-based practice in developing countries. Spine. 2011;36(10):E638-E46.
- Farahbakhsh F, Rostami M, Noormohammadpour P, Mehraki Zade A, Hassanmirazaei B, Faghih Jouibari M, et al. Prevalence of low back pain among athletes: A systematic review. Journal of back and musculoskeletal rehabilitation. 2018;31(5):901-16.
- Finta R. Effects of Diaphragm Strengthening on Severity of Pain and Functional Parameters in Patients with Chronic Nonspecific Low Back Pain: szte; 2019.
- Puntumetakul R, Chalermsan R, Hlaing SS, Tapanya W, Saiklang P, Boucaut R. The effect of core stabilization exercise on lumbar joint position sense in patients with subacute non-specific low back pain: a randomized controlled trial. Journal of physical therapy science. 2018;30(11):1390-5.
- Moon HJ, Choi KH, Kim DH, Kim HJ, Cho YK, Lee KH, et al. Effect of lumbar stabilization and dynamic lumbar strengthening exercises in patients with chronic low back pain. Annals of rehabilitation medicine. 2013;37(1):110-7.
- Calvo-Lobo C, Almazán-Polo J, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Palomo-López P, Rodríguez-Sanz D, et al. Ultrasonography comparison of diaphragm thickness and excursion between athletes with and without lumbopelvic pain. Physical Therapy in Sport. 2019;37:128-37.
- Finta R, Nagy E, Bender T. The effect of diaphragm training on lumbar stabilizer muscles: a new concept for improving segmental stability in the case of low back pain. Journal of pain research. 2018:3031-45.
- Janssens L, Brumagne S, Polspoel K, Troosters T, McConnell A. The effect of inspiratory muscles fatigue on postural control in people with and without recurrent low back pain. Spine (Phila Pa 1976). 2010;35(10):1088-94.
- Cardenas LZ, Santana PV, Caruso P, de Carvalho CRR, de Albuquerque ALP. Diaphragmatic ultrasound correlates with inspiratory muscle strength and pulmonary function in healthy subjects. Ultrasound in medicine & biology. 2018;44(4):786-93.
- Romei M, Mauro AL, D’angelo M, Turconi A, Bresolin N, Pedotti A, et al. Effects of gender and posture on thoraco-abdominal kinematics during quiet breathing in healthy adults. Respiratory physiology & neurobiology. 2010;172(3):184-91.
- Borujeni BG, Yalfani A. Reduction of postural sway in athletes with chronic low back pain through eight weeks of inspiratory muscle training: a randomized controlled trial. Clinical Biomechanics. 2019;69:215-20.
- Smuder AJ, Min K, Hudson MB, Kavazis AN, Kwon O-S, Nelson WB, et al. Endurance exercise attenuates ventilator-induced diaphragm dysfunction. Journal of applied physiology. 2012;112(3):501-10.
- Bigard A-X, Brunet A, Serrurier B, Guezennec C-Y, Monod H. Effects of endurance training at high altitude on diaphragm muscle properties. Pflügers Archiv. 1992;422:239-44.
- Mendez KM, Parsons AW, McCully KK. Measuring Diaphragmatic Endurance And Assessing Respiratory Dysfunction: 347. Medicine & Science in Sports & Exercise. 2021;53(8S):108-9.
- Otadi K, Nakhostin Ansari N, Sharify S, Fakhari Z, Sarafraz H, Aria A, et al. Effects of combining diaphragm training with electrical stimulation on pain, function, and balance in athletes with chronic low back pain: a randomized clinical trial. BMC Sports Science, Medicine and Rehabilitation. 2021;13(1):1-10.
- Morrissey D. Proprioceptive shoulder taping. Journal of bodywork and movement therapies. 2000;4(3):189-94.
- Konishi Y. Tactile stimulation with Kinesiology tape alleviates muscle weakness attributable to attenuation of Ia afferents. Journal of Science and Medicine in Sport. 2013;16(1):45-8.
- Álvarez-Álvarez S, San José F, Rodríguez-Fernández A, Güeita-Rodríguez J, Waller B. Effects of Kinesio® Tape in low back muscle fatigue: randomized, controlled, doubled-blinded clinical trial on healthy subjects. Journal of back and musculoskeletal rehabilitation. 2014;27(2):203-12.
- Paoloni M, Bernetti A, Fratocchi G, Mangone M, Parrinello L, Del Pilar Cooper M, et al. Kinesio Taping applied to lumbar muscles influences clinical and electromyographic characteristics in chronic low back pain patients. Eur J Phys Rehabil Med. 2011;47(2):237-44.
- Yoshida A, Kahanov L. The effect of kinesio taping on lower trunk range of motions. Research in sports medicine. 2007;15(2):103-12.
- Kase K. Clinical therapeutic applications of the Kinesio (! R) taping method. Albuquerque. 2003.
- McKinney J, Velghe J, Fee J, Isserow S, Drezner JA. Defining athletes and exercisers. Elsevier; 2019. p. 532-5.
- Zübeyir S, Nilüfer K, Burcu C, Onur A, Bahar K, Ufuk YS, et al. The effect of kinesiology taping on respiratory muscle strength. Journal of Physical Therapy Science. 2012;24(3):241-4.
- Shafshak TS, Elnemr R. The visual analogue scale versus numerical rating scale in measuring pain severity and predicting disability in low back pain. JCR: Journal of Clinical Rheumatology. 2021;27(7):282-5.
- Noormohammadpour P, Khezri AH, Farahbakhsh F, Mansournia MA, Smuck M, Kordi R. Reliability and validity of athletes disability index questionnaire. Clinical Journal of Sport Medicine. 2018;28(2):159-67.
- Baradaran A, Ebrahimzadeh MH, Birjandinejad A, Kachooei AR. Cross-cultural adaptation, validation, and reliability testing of the modified Oswestry disability questionnaire in Persian population with low back pain. Asian spine journal. 2016;10(2):215.
- Greene PF, Durall CJ, Kernozek TW. Intersession reliability and concurrent validity of isometric endurance tests for the lateral trunk muscles. Journal of sport rehabilitation. 2012;21(2):161-6.
- Durall CJ, Greene PF, Kernozek TW. A comparison of two isometric tests of trunk flexor endurance. The Journal of Strength & Conditioning Research. 2012;26(7):1939-44.
- Juan-Recio C, Prat-Luri A, Galindo A, Manresa-Rocamora A, Barbado D, Vera-Garcia FJ. Is the side bridge test valid and reliable for assessing trunk lateral flexor endurance in recreational female athletes? Biology. 2022;11(7):1043.
- Lehecka BJ, Smith BS, Rundell T, Cappaert TA, Hakansson NA. The reliability and validity of gluteal endurance measures (GEMs). International Journal of Sports Physical Therapy. 2021;16(6):1442.
- Maribo T, Iversen E, Andersen NT, Stengaard-Pedersen K, Schiøttz-Christensen B. Intra-observer and interobserver reliability of One Leg Stand Test as a measure of postural balance in low back pain patients. International Musculoskeletal Medicine. 2009;31(4):172-7.
- Alshehre Y, Alkhathami K, Brizzolara K, Weber M, Wang-Price S. Reliability and Validity of the Y-balance Test in Young Adults with Chronic Low Back Pain. International Journal of Sports Physical Therapy. 2021;16(3):628.
- Hachana Y, Chaabène H, Nabli MA, Attia A, Moualhi J, Farhat N, et al. Test-retest reliability, criterion-related validity, and minimal detectable change of the Illinois agility test in male team sport athletes. J Strength Cond Res. 2013;27(10):2752-9.
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