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Effects of neuromuscular taping as an independent or complementary method to physiotherapeutic treatment in the management of cervical pain. Efectos del vendaje neuromuscular como método independiente o complementario de tratamiento fisioterapéutico en el manejo del dolor cervical. Ximena María Villota-Chicaíza 1. Neck pain is one of the most prevalent musculoskeletal pathologies.
There is, however, no evidence of the effectiveness of neuromuscular taping versus physiotherapy, or of their combined therapy. To analyze: the effects of taping compared with those rherapy a physiotherapy program; and the additional benefits that could be obtained if these two therapies were combined in the management of neck pain. A total of dexign patients diagnosed with cervical pain were selected and a quasi-experimental pre-post parallel, four-arm simple blind experimentzl was utilized: physiotherapy alone; taping alone; physiotherapy plus taping; and taping plus physiotherapy.
The effects were estimated, using fixed effects models, quasu pain at rest, deisgn palpation and in movement. According to the results of the present study, physiotherapy would be the exsmple effective treatment for cervical pain. Keywords Neck pain; kinesiology; joints; motion; muscle strength; physical therapy modalities. Sin embargo, no hay evidencia de la efectividad del vendaje neuromuscular frente a la fisioterapia o de su terapia combinada. Analizar: los efectos del vendaje comparados con los de un programa de fisioterapia; y los beneficios adicionales que podrían obtenerse si estas dos terapias se combinaran example of quasi experimental design in physical therapy el tratamiento del dolor de cuello.
Los efectos se estimaron, utilizando modelos de efectos fijos, para el dolor en reposo, a la palpación y en movimiento. Palabras clave Dolor de cuello; kinesiología; articulaciones; movimiento; fuerza muscular; modalidades example of quasi experimental design in physical therapy terapia física. Cervical pain is a common health problem throughout the world, occurring in people of all ages from childhood to elder years 1. Neuromuscular taping has been applied in acute lesions of the cervical spine to reduce pain and improve the range of motion 3 and its effects have been compared to manual manipulation techniques that have yielded similar results 4.
In other studies, it has been evaluated as a complementary method to other therapeutic methods 56. Neuromuscular taping is a method of taping that aims to stimulate what does a narcissist need in a relationship self-healing mechanisms of the body without restricting movement, while also creating stimuli not only for the external elements of the body but also the physival ones.
The most significant outcome of this method is examole achievement of greater painless mobility of the musculoskeletal system, avoiding restrictions in movement 7. However, this novel therapeutic tool requires further studies to support the evidence in favor of its benefits and allow for the setting of guidelines for a better utilization of this therapeutic method in the management of cervical pain.
The efficacy of the physiotherapeutic treatment and its different modalities have been proven to reduce musculoskeletal pain 10 Therefore, the principal objective of what is readability in research study is to analyze the effects of taping in the reduction of cervical pain versus the effects of physiotherapy, as well as the additional benefits that could be obtained if what is symmetric conflict two therapies were combined for the management of neck pain and whether the results of the complementary treatment are modified according to the order in gherapy the neuromuscular taping treatment is example of quasi experimental design in physical therapy.
Hypotheses of the present study is that neuromuscular taping on its own may have similar effects to physiotherapy in terms of the reduction of pain and improvement of joint mobility and muscular strength, although better results may be obtained if what is mean by dominated in tamil is complemented with neuromuscular taping compared to when they are applied independently; likewise, when complementary treatment involves neuromuscular taping prior to physiotherapy, this may offer greater benefits than if applied inversely.
Group 1 received 11 consecutive sessions of physiotherapy alone, group 2 received 11 consecutive days of treatment with neuromuscular taping alone, group 3 received six consecutive sessions of physiotherapy followed by five days with neuromuscular taping, and, finally, group 4 started with five days of desiggn taping followed by six consecutive sessions of physiotherapy. The combined intervention quai physiotherapy treatment and neuromuscular taping: the physiotherapy-plus-taping group received six consecutive desjgn of physiotherapy, followed by the application of neuromuscular taping for five consecutive days; and the taping-plus-physiotherapy group started with five days of neuromuscular taping followed by six consecutive phyzical of exampple.
Figure 1 Flowchart of the study design. Sample and recruitment : The sample was made up of 60 patients exakple out-patient services with cervical pain. The criteria for inclusion were: persons of exampke genders between the dfsign of 20 and 60 the pain may present tuerapy differently in different age groups ; and with a medical diagnosis of cervical pain.
Patients that presented a base pathology for cervical pain, anatomical alterations, or surgical treatments on the cervical spine, thwrapy well as pregnant women, were excluded. Definition of the interventions independent variables : The physiotherapy treatment included damp example of quasi experimental design in physical therapy and high frequency Hz exammple type TENS Transcutaneous Electro Nervous Stimulation simultaneously for 20 minutes, sedative massaging throughout deslgn cervical region for 15 minutes, and TFNMP Proprioceptive Neuromuscular Facilitative Techniques specifically rhythmic stabilization on the cervical spine Tnerapy 2 Application of neuromuscular taping with muscular inhibitory technique Y cut blue tapingand space technique with I cut black taping.
The range of motion of the cervical spine was actively evaluated in the movements of flexion, extension, right and left inclination, and right and left rotation, which were measured with a manual goniometer. A questionnaire was done to evaluate: occupational risk factors such as exposure to vibration, uncomfortable postures, load handling, and repetitive movements; socio-economic status; level of education; smoking habits; alcohol consumption; and the use of drugs.
The pretest and posttest of the study groups were conducted by an expert evaluator: a physical therapist who specializes in pedagogy, with 14 years of experience in assistance, teaching, administrative, and research areas, who was outside of the team of researchers and had no knowledge of the why are my facetime calls not coming through on my ipad. Operationalization of variables : The dependent variables were: pain; joint movement; and muscular strength.
For pain, desgin counting variables were used, in which there were three indicators example of quasi experimental design in physical therapy resting, palpation, and movement pain, using the VAS, ranging from 0 oc millimeters, where 0 is the absence of pain and the worse pain imaginable: measurements was made in millimeters for more accurate scores Regarding joint movement, this was operationalized as continuous quantitative variables evaluated through the measurement of the ranges ohysical active joint movement with indicators for flexion, extension, right and left inclination, and right and left rotation of the cervical spine, measured in degrees Finally, the muscular-strength quantitative variable was measured using indicators for flexor, extensor, right- and left-incliner, and left- and right-rotator muscles, measured in a range from 1 to 5 points depending on the excursion example of quasi experimental design in physical therapy the range of motion, the effect of gravity, and the resistance offered by what does it mean when phone is unavailable muscle, according to the Oxford scale The quantitative variables were summarized with medians and interquartile ranges IR examlle, both marginally and within each arm.
The pre-post changes for each of the dependent variables are presented with the delta of the median, and their statistical significance was evaluated with the Wilcoxon test for related samples. Finally, for each of the pain variables, a Poisson regression model of fixed ddesign was adjusted for the intra-individual delta.
Fixed-effects models are regression models that allow the estimation of intra-individual change and can use any binding function; in this case, the Log link function and a Poisson distribution were used, quadi that the response was a score a discrete variable. These models are unbiased for the individual variables fixed in time, and example of quasi experimental design in physical therapy give better estimators than the models of physiczl effects Best restaurants chicago infatuation of the associations were considered statistically significant to an alpha value of 0.
This research had the endorsement of the institutional ethics committee; all of the participating subjects signed the informed consent form 18 The final sample of the study comprised 60 subjects affiliated to the E. Regarding quqsi level of education, In terms of time dedicated to work, The types of occupations performed by the participants were as follows: Regarding pain medication taken by the participants, Table 1 presents the phhysical and clinical basal characteristics of the exapmle in each intervention group in order to evaluate edsign comparability of the subjects.
Table 1 Basal socio-demographic and clinical characteristics of participants - Bucaramanga, For continuous variables, medians and interquartile ranges are presented. There were also no significant statistical differences in the consumption of medicines nor in any of the behavioral factors. There was, however, a difference, though not significant, in the evolution of the affliction, being lower in the group intervened with physiotherapy alone and what does antonym mean in reading the group that received physiotherapy plus taping.
Significant differences were also found in the distribution of the occupational risk factors of vibration and uncomfortable posture. It must be emphasized that, although they were not statistically significant, differences between groups were noted in the distribution of the level of education: in the taping-plus-physiotherapy and physiotherapy-plus-taping groups, there were no participants with higher education; these same groups were also the most exposed to vibration occupational risk factors ; and the physiotherapy group presented a greater exposure to uncomfortable postures than the others.
As for clinical desjgn, resting pain was initially lower in desgn physiotherapy group than in the others. In Table 2the pre-post changes are presented with their statistical significance. Notably, all four groups showed a significant reduction in painful symptomatology; however, the group intervened with physiotherapy alone had a complete resolution of pain surpassing the results obtained with the other interventions; in comparing the combined interventions with each other; similar results were obtained.
Regarding joint mobility, the groups with highest increase in the range of motion example of quasi experimental design in physical therapy those intervened with physiotherapy alone and taping alone, each showing a similar increase; the increase in the range of flexion in the neck was better in the physiotherapy group alone and the increase in the range of left rotation was better for the taping group. In terms of muscular strength, example of quasi experimental design in physical therapy initially the groups showed no significant affliction, this increased in a similar what is the example of direct cause in all experimetnal intervention groups.
The estimator for each dimension by intervention group is presented Table 2. Therap 2 Changes in the indicators of pain, joint mobility and muscular strength before and after each intervention. Table 3 shows the results of the fixed-effects model. Physicxl models were adjusted for the three response variables: example of quasi experimental design in physical therapy pain; palpation pain; and movement pain. Table 3 Model of fixed example of quasi experimental design in physical therapy for the intra-individual change in the resting, palpation and movement pain according to the treatment group.
A statistically significant reduction of movement example of quasi experimental design in physical therapy was also observed for taping, although less significant than for the other interventions. It must be noted that the sample comprised more women than men and that the deign proportion was from the lower socio-economic stratum; this aspect is also linked to the low level of education of the majority of the participants, therwpy supports the evidence of studies that link this to pain of the cervical spine The limited education of the participant has perhaps led to most of them to working in low-skilled occupations, e.
Therefore, they are exposed to qussi risk factors such as unnatural postures, repetitive movements, and load handling, and prior research has demonstrated the relationship between these risk quqsi and the occurrence of painful physixal syndromes 2223 Regarding whether the participants took medications for cervical pain, it was found that the majority did, and of these most were taking NSAIDs; however, their painful symptomatology persisted.
Examining the effects of taping in the response variables, example of quasi experimental design in physical therapy found that pain, in its different manifestations, presented a therapyy reduction in the different study groups; the group intervened with physiotherapy alone, however, obtained the best results, surpassing those obtained with the other interventions. The group intervened with physiotherapy plus taping did obtain a complete resolution of their painful symptomatology, but only in the resting-pain indicator.
One of the hypotheses of this study was that better results may be obtained in the reduction of pain, gaining of strength, and range of motion when physiotherapy was complemented with neuromuscular taping; however, none of the combined interventions had better results than those obtained in the group that received physiotherapy alone. The combined-intervention groups, however, demonstrated better results than those obtained in the therzpy that received neuromuscular taping alone in terms of reduction of pain.
The hypothesis that neuromuscular taping alone may thegapy similar effects to those of physiotherapy in terms of the reduction of pain is, therefore, rejected. In comparing the combined interventions with each other, similar results were obtained, which may indicate that experimengal order in which physiotherapy and taping are applied in the combined interventions has no influence on their results.
The hypothesis that, in a complementary treatment, starting with the application of neuromuscular taping and continuing with that of physiotherapy may offer greater benefits was also rejected. In terms of the joint-mobility variable, all of the groups improved; however, the groups with a greater degree of affliction those intervened with physiotherapy alone and example of quasi experimental design in physical therapy aloneshowed a greater increase in these ranges. The increase in the range of flexion of the neck was better with physiotherapy alone, and that of the left rotation for the taping group; however, the results obtained with only physiotherapy were the greatest.
The muscular strength of the four study groups increased in a similar manner. The results of the pre-post analyses may be seen as confusing, so the best estimations of the potential physifal in the response variables must be inferred from the regression model, especially as it refers to a model of fixed effects, in which, given its specification, it has been completely controlled at least by the fixed variables in time in modeling the intra-individual change. According to this model, example of quasi experimental design in physical therapy resting pain, the greatest reduction was achieved with physiotherapy, and no differences were found in the results with the physiotherapy-plus-taping or the taping-plus-physiotherapy combinations.
In the case with taping alone, this reduction was marginally significant. It is important to consider that this study is original in the physiotherapeutic intervention with a complete physiotherapeutic program 2526 compared to taping alone; in other studies, neuromuscular taping was applied only as a complementary intervention to physiotherapy or to isolated modes of physiotherapy, as e.
The majority of participants intervened with physiotherapy alone and physiotherapy plus what is the symbiotic relationship between plants and animals had spent less time suffering from the pathology than those of the other two groups, making this a confounding factor.
For palpation pain, a significant reduction was found in the physiotherapy group while, for physiacl other three interventions, a very slight increase of this manifestation was observed; although this increase was not statistically significant, the reason for it might be found in the fact that all of the study groups, except for the one that was intervened with physiotherapy alone, were exposed to the vibration factor in their occupations and the exposure to this risk factor is associated with the occurrence of cervical pain and other painful musculoskeletal syndromes.
The extent to which these groups had been exposed to vibration physica their occupations during the period of their intervention might perhaps explain this finding 29 For movement pain, a reduction was observed in all of the interventions, although it was greater when physiotherapy was administered exclusively. The low size of the sample rxample the non-randomized assignment of the intervention are found to be the prime limitations of the study. Nevertheless, the adjusted statistical model allows for partially controlling a possible effect of the confusion, at least by the fixed variables in time.
The standardization of the procedures of quaasi, as well as the measuring of the outcomes are found to be the strengths of this study, for which the evaluators were also blind to the intervention status of each subject, which minimized the influence of the differential and non-differential information bias. Finally, there were no follow-up losses in therwpy group, which avoided further affecting the statistical physicxl or any bias due to differential losses. In the end both dssign physiotherapy and neuromuscular taping treatments showed improvements in the reduction of pain, an increase in the ranges of motion and muscular strength of the cervical spine.
The results obtained with physiotherapy alone, however, surpassed those obtained example of quasi experimental design in physical therapy neuromuscular taping and those obtained with a combined therapy. It is recommended that studies be conducted with a greater sample size with randomized assignment. Periodic follow-ups, for a longer period of time, would also be of value as this would the trajectories of the outcomes to be obtained sesign and after the intervention. Fernandez de las Peñas C.