Effect Of Kinesiology Tape On Pain, Posture, Balance And Respiration In Ankylosing Spondylitis
Phase: NA
Conditions: Ankylosing Spondylitis
Sponsor: Bursa Yuksek Ihtisas Training and Research Hospital

 
 
BURSA YUKSEK IHTISAS TRAINING AND RESEARCH HOSPITAL 
RESEARCH PROTOCOL 
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                                                                                                                                      Date: 07/03/2023       
                   
1. RESEARCH TITLE: 
 
Effect of kinesiology tape on pain, posture, balance and 
respiration in ankylosing spondylitis: a randomized 
controlled trial
 
 
2. RATIONALE AND 
JUSTIFICATION OF 
THE RESEARCH:  
 
    
Ankylosing Spondylitis (AS) is a chronic inflammatory 
disease characterized by inflammation, especially in the 
enthesis regions and surrounding bone tissue of the 
spine. 
 
Fusion in adjacent vertebral segments in AS leads to 
reduced 
axial 
movement 
and 
mechanical 
stiffness(1). 
 
Secondary to spinal deformities such as decreased 
lumbar lordosis, increased thoracic kyphosis, and 
loss of cervical lordosis, patients with AS may 
develop hip flexion contracture, resulting in 
compensatory knee flexion(2). 
 
The increase in spinal kyphosis causes the center of 
gravity to shift forward and downward. It is 
suggested that hip and knee flexion, along with 
plantar flexion, occur to compensate for this shift 
and keep the center of gravity within the base of 
support(3). 
 
Furthermore, due to increased spinal kyphosis, 
patients find it difficult to look forward, leading to 
limitations in daily living activities such as driving, 
personal care, and social communication(4). 
 
Pulmonary involvement in AS is typically 
asymptomatic and includes anomalies of the 
thoracic cage and lung parenchyma. Reduced lung 
volumes are one of the most important findings of 
this disease. 
Chest wall rigidity in these patients is caused by 
bony 
ankylosis 
in 
the 
sternomanubrial, 
sternoclavicular, costovertebral joints, and thoracic 
vertebrae. Progressive chest wall deformities, such 
as kyphosis, are subsequently added to this clinical 
picture. In later stages of the disease, all these 
involvements result in reduced chest wall movement 
and increased respiratory problems(7).

 
 
BURSA YUKSEK IHTISAS TRAINING AND RESEARCH HOSPITAL 
RESEARCH PROTOCOL 
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 
Non-pharmacological 
approaches, 
such 
as 
education, exercise, and physical therapy, are 
considered important cornerstones of AS treatment, 
alongside pharmacological treatments. 
 
Kinesio Tape (KT) lifts the skin, increasing the area 
of the skin and subcutaneous tissue, thereby 
enhancing 
circulation 
and 
movement. 
Consequently, it reduces inflammation in the area 
and accelerates circulation and tissue healing. 
 
The second mechanism involves stimulating 
mechanical receptors on the skin, sending impulses 
to the central nervous system via tactile stimulation. 
It has been reported that the resulting impulse 
provides stimulation/inhibition and neuromuscular 
re-education(5). 
 
Moreover, it is argued that the activated gate control 
mechanism due to these sensory stimuli, along with 
the release of fascia through space enlargement, 
increased circulation, and mechanical support, 
reduces pain(6). 
In light of all this information, it is hypothesized that a 
non-pharmacological approach using a home exercise 
program (HEP) (spinal extensor strengthening, posture, 
and balance exercises) and the Kinesio Taping 
technique in AS patients may achieve reduced pain 
symptoms, correction of postural deformities, and an 
increase in respiratory capacity. 
 
REFERENCES 
1.  Vergara ME, O'Shea FD, Inman RD, Gage WH. 
Postural control is altered in patients with ankylosing 
spondylitis. Clinical biomechanics. 2012;27(4):334 40.
2.  Aydog E, Depedibi R, Bal A, Eksioglu E, Unlu E, 
Cakci A. Dynamic postural balance in ankylosing 
spondylitis patients. Rheumatology. 2006;45(4):445 8.
3.  Sawacha Z, Carraro E, Del Din S, Guiotto A, 
Bonaldo L, Punzi L, et al. Biomechanical assessment 
of balance and posture in subjects with ankylosing 
spondylitis. 
Journal 
of 
neuroengineering 
and 
rehabilitation. 
2012;9(1):1-11.
4.  Uçkun A, Sezer İ. Ankilozan spondilit ve denge. 
Eurasian Journal of Medicine. 2017;49(3):207-10

 
 
BURSA YUKSEK IHTISAS TRAINING AND RESEARCH HOSPITAL 
RESEARCH PROTOCOL 
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5.  Kase K, Wallis J, Kase T. Clinical therapeutic 
application of the kinesio taping method. Tokyo, 
Japan: Ken Ikai Co Ltd; 2003 
6.  Kalichman L, Vered E, Volchek L. Relieving 
symptoms of meralgia paresthetica using kinesio 
taping: A pilot study. Arch Phys Med Rehab 
2010;91:1137-9. 
7.   Fisher LR, Crawley MID, Holgate ST. Relation 
between chest expansion, pulmonary function, and 
exercise tolerance in patients with ankylosing 
spondylitis. Ann Rheum Dis 1990; 49: 921-5.
 
3. OBJECTIVE OF THE 
RESEARCH:  
 
  The aim of this study is to investigate the effect of 
Kinesio Taping on pain, posture, balance, and 
respiration in ankylosing spondylitis and to demonstrate 
the difference between this technique and routine home 
exercises provided to this group of patients.
 
 
4. EXPECTED BENEFITS 
OF THE RESEARCH:  
 
   Investigation of the efficacy of the KT method on 
pain, posture, balance, and respiration in AS patients. 
 
5. RESEARCH 
METHODOLOGY:  
     Participants: 
Eighty patients aged 18–65, diagnosed with ankylosing 
spondylitis, not in the acute flare period, who applied to the 
Physical Medicine and Rehabilitation (PMR) outpatient 
clinic of Bursa Yuksek Ihtisas Training and Research 
Hospital between April 1, 2023, and January 1, 2024, will 
be included in the study. 
 
Inclusion Criteria: Patients over 18 years old 
diagnosed with ankylosing spondylitis  
 
Exclusion Criteria: Patients with active malignancy, 
active cellulitis and skin infection, open wounds, 
deep vein thrombosis, and patients with vestibular 
and orthopedic pathologies affecting balance. 
Intervention: 
 
Group 2: Will receive only a home exercise program 
(HEP: spinal extensor strengthening, posture, 
balance, and respiratory exercises) for 5 weeks, 5 
days a week, 3 sets of 10 repetitions. 
 
Group 1: Will receive the home exercise program in 
addition to Kinesio Taping applied by a physician to 

 
 
BURSA YUKSEK IHTISAS TRAINING AND RESEARCH HOSPITAL 
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the thoracic, lumbar, and cervical regions in the 
hospital setting. The KT will remain on the patient 
for 5 days and then be removed by the patient. The 
tape will be applied once a week for 5 weeks. 
Outcome Measures: 
At the end of the 5 weeks, the following will be used for 
patient assessment: VAS, Range of Motion (ROM), 
BASMI, BASFI, BASDAI, fingertip-to-floor distance, 
modified Schober test, chest expansion, AS quality of life 
questionnaire, and Berg Balance Scale. 
 
 
6. DATA COLLECTION TOOLS 
 
 Information-Questionnaire Form 
 Self-administered Questionnaire 
 Questionnaire administered under observation 
 Interviewer-administered Questionnaire 
 Observation 
 Laboratory examination 
 Record from archives 
 Other (Specify): ROM measurement with a goniometer will be conducted in the 
outpatient clinic setting. Fingertip-to-floor distance, chest expansion, and modified 
Schober measurement will be taken with a tape measure. 
 
NOTE: Please also submit a detailed list of where the required information/laboratory tests 
will be obtained, along with the pre-authorization letters from the clinics and laboratories. 
 
 
 
 
7. STATISTICAL METHODS FOR 
DATA ANALYSIS:  
 
  Data analysis will be performed using the IBM 
SPSS 22.0 statistical software package. 
  In addition to descriptive statistical methods 
(frequency, percentage, mean, standard deviation, 
median, min-max), the Chi-Square () test will be 
used for comparing qualitative data. 
  The suitability of the data for normal 
distribution 
will 
be 
evaluated 
using 
the 
Kolmogorov-Smirnow and Shapiro-Wilk tests.

 
 
BURSA YUKSEK IHTISAS TRAINING AND RESEARCH HOSPITAL 
RESEARCH PROTOCOL 
Document Code: 
EY. FR. 16 
 
Revision Date:24.03.2023 
Revision No:03 
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  If correlation analysis is performed, the 
Spearman test will be used when the data does not 
show normal distribution, and the Pearson test will 
be used when it does. 
  For intergroup analysis, the Independent T-test 
will be applied if normal distribution is detected, 
and the Kruskal-Wallis test will be applied if 
abnormal distribution is detected. 
  Probability values (P) less than 0.05 will be 
accepted as significant, indicating a difference 
between the groups, while values greater than 0.05 
will be considered non-significant, indicating no 
difference between the groups. 
 
 
8. PLANNED DURATION OF THE RESEARCH: 
 
 Planned Start Date: 01/05/2023 
 Planned End Date: 01/01/2024 
 
9. CONTACT PERSON FOR THE RESEARCH: 
 
 Name Surname: Busra Gokgun 
 Phone: +905384690900 
 Date:07/03/2023