THE EFFECTS AND MECHANISMS OF KINESIOLOGICAL TAPING IN PEOPLE WITH LOWER BACK PAIN

Abstract

KinesioSTaping (KT) is increasingly used to treat low back pain (LBP). LBP is a common disorder with high lifetime incidence and recurrence which is complicated by variable treatment effects and unclear mechanisms. The overarching aim of this thesis was to determine whether biomechanical tissue responses could be identified and then used to determine subgroups of responders or nonSresponders to KT. Changes in thoracolumbar fascial thickness, structure and shear strain are associated with LBP. Methodological development was required and delivered a reliable, valid, inSvivo measurement technique to enable quantification of lumbar soft tissue biomechanics. ThreeSdimensional ultrasound videos with known orientation and position were recorded from the thoracolumbar tissues while participants performed range of movement tasks. Surface electromyography and kinematic data were collected. An automated algorithm using crossScorrelation to track contiguous tissue layers across sequential frames was developed and applied to process videos. A rapid systematic review was conducted and confirmed the lack of KT efficacy, in contrast with observed popularity. The first observation study indicated that normal subjects had some tissue layer specific changes in movement with KT application. Subsequent studies of participants with LBP showed reduced superficial tissue movement compared to controls, but MANOVA showed that KT did not change either group’s overall soft tissue biomechanics. Interestingly, overall soft tissue biomechanics responded differently among the small subgroup of participants with LBP who reported immediate, albeit minor, pain relief. This thesis shows that there are some effects of a common KT procedure on the lumbar soft tissues which are not yet robustly proven enough to be clinically applicable. Future study is warranted on those whose condition immediately benefits from receiving KT application to reveal if this mechanism can be developed and used to improve the immediate treatment response for those with LBP. Further, the dynamic tissue measurement method developed in this project should be considered as a transferable tool which has the potential to be applied to study effects and mechanisms of the other therapeutic modalities.