The Effect of Kinesio Taping With Cervical Spondylosis
Condition: Cervical Spondylosis
MeSH terms: Spondylosis
Study type: Interventional

Summary: 
      The investigators aimed to evaluate the effect of kinesio tape application on the sense of
      proprioception in patients with cervical spondylosis.This research aims to determine the
      relationship between the sense of cervical proprioception and neck pain intensity, neck
      disability and quality of life, and to determine the relationship between cervical spinal MRI
      findings and cervical proprioception. Studies conducted to date are limited to the evaluation
      of patients who underwent kinesio tape for neck pain in terms of joint range of motion, pain,
      and disability. In a study examining the relationship between cervical kinesio-tape
      application and cervical proprioception sense; The patient group consists of the young
      population and the patient evaluation was made immediately after the end of the treatment.
      The aim of this study is to evaluate the relationship of kinesio tape applied to the elderly
      patient group with cervical spondylosis, where the cervical proprioception sense is more
      affected, with cervical proprioception sense in the mid-term and to examine its relationship
      with cervical spinal MRI phenotypes. The possible relationship between proprioceptive sensory
      deficit and joint degeneration is based on a combination of neuromuscular control dysfunction
      and periarticular degeneration. Thus, the investigators aimed to improve the proprioceptive
      sense, reduce pain and increase functionality in the elderly patient group with kinesio-tape
      in the study.
    

Detailed description: 
      Cervical spondylosis is the aging of the cervical spine as a result of degeneration of the
      intervertebral discs. In this process, shortening of the disc distance in the cervical spine,
      thickening of the ligaments, development of ligamentous and segmental instability, arthrosis
      and loss of lordosis in the facet joints are observed. Degenerative disc changes are often
      seen as bulging, protrusion, extrusion, and sequestration. Cervical discs are thicker
      anteriorly than posteriorly, resulting in normal lordosis. In the degenerative process, first
      of all, the height decreases in the anterior of the disc and loss of lordosis occurs. The
      process progresses with aging and causes axial neck pain and/or disc herniations due to
      degenerative changes, intraspinal canal and foraminal stenosis, secondary radiculopathy or
      myelopathy symptoms.

      Although there is no complete consensus about the pathophysiological mechanism that causes
      cervical degenerative disc disease, several hypotheses have been developed. Although
      spondylosis is seen as a normal part of aging according to the current approach, certain
      occupations, repetitive movements and traumas can accelerate the process. Only a single
      factor has no chance to trigger the degenerative process. In other words, many factors of the
      normal aging process affect cervical spondylolysis. Although age-related degeneration is the
      primary cause, cervical disc injuries may affect this degenerative process in younger
      patients.

      Degeneration in the cervical spine may only present with neck pain if there is no compression
      on the spinal cord or nerve root. This degeneration causes radicular pain in the occipital
      region, posterior neck, shoulder or arm due to inflammation due to extrinsic compression in
      the nerve root. Patients with cervical spondylosis usually present with complaints of pain,
      tingling, numbness, and weakness in the upper extremities, resulting in significant
      disability and functional limitations.

      Proprioception is a sense of bodily movement position that includes a sense of joint position
      and a sense of movement (kinesthesia). Proprioceptive information reaches the central nervous
      system via the afferent pathway, which contributes to movement and postural neuromuscular
      control. The cervical muscles have an abundant muscle spindle density reflecting a rich
      proprioceptive system, which contributes to enhanced sensorimotor function and therefore
      plays an important role in maintaining effective motor control and static and dynamic
      postures.

      Studies have shown that sense of cervical position is vital in maintaining joint stability
      under static and dynamic conditions, and impaired proprioception may predispose to the
      development of pain. Cervical proprioception is measured by joint position error in degrees.
      In cervical spondylosis, impaired cervical proprioception is the result of position
      sensitivity being affected primarily by impairment in the muscles, joints, or capsules and
      secondarily by changes in afferent proprioceptive adjustment and integration. Impaired
      position sense impairs both neuronal and muscular control of normal cervical joint function,
      resulting in unbalanced muscle strength and placing the joint at risk for trauma.

      Conservative treatment of spondylosis includes transcutaneous electrical nerve stimulation
      (TENS), heat, traction, exercise, postural training, massage, kinesiotaping, and numerous
      manual therapy and mobilization techniques. Recent studies investigating treatment modalities
      for neck pain associated with cervical spondylosis have shown that combined treatments are
      more effective than exercise alone.

      The kinesio-tape technique has been developed with the philosophy that positive results can
      be obtained with a taping method similar to the structural properties and flexibility of
      human skin, without limiting the joint movements of the kinesio tape. Latex-free kinesio-tape
      is composed of 100% cotton and elastic polymer fibers. Dr. According to Kase, muscle
      dysfunction is one of the leading problems originating from the musculoskeletal system. Dr.
      Kase argues that taping the muscle is more effective than immobilizing the joint
      circumference with tape. After injury or overuse, the elastic properties of the muscle
      deteriorate. For this reason, kinesiology tapes are designed to be similar to the elastic
      properties of the muscle, to be adhesive, to have a lifting effect on the skin to which
      kinesiology tapes are applied, and to allow air circulation between the skin and the external
      environment. The technique is based on 3 basic concepts. These are space, motion, and
      cooling. As painful and inflamed muscles swell due to edema, the area where muscles are
      located narrows. When kinesio-taping is applied, the skin and subcutaneous interstitial area
      are increased by lifting the skin, thus increasing circulation and movement. This reduces
      pain and improves performance. The neuromuscular system is retrained. Injuries are prevented,
      circulation is accelerated and tissue healing is ensured.

      The idea that kinesiotaping can regulate proprioception by affecting cutaneous
      mechanoreceptors has been put forward by some researchers. Kinesiolo-tape affects
      mechanoreceptors sensitive to tension, loading, pressure and shear forces by changing the
      length of the skin and superficial fascia and the tension of the muscle fibers. This can lead
      to significant changes in muscle movement and tone. Slow pressure stimulation, particularly
      on connective tissue, alters the effect on mechanoreceptors and may affect gamma motor neuron
      firing and muscle tone regulation. Kinesiotape can be particularly effective in increasing
      proprioceptive ability only in the middle of the movement. In this range, ligament
      mechanoreceptors are inactive, whereas muscle receptors are active. Understanding joint
      movement and position can be effective in the development of proprioception by stimulating
      sensory afferent transmission. Cutaneous afferent stimuli interact with the motor cortex and
      thus affect the muscle excitability of the central nervous system.
    

Intervention name(s): conventional physical therapy; Active Kinesiotaping; Sham Kinesiotaping
Intervention type(s): Other; Other; Other
Intervention description(s): A hotpack will be applied to the neck area for 15 minutes in the prone position of the patients. Conventional type Tens with a frequency of 50 Hz and a pulse duration of <150 microseconds will be applied for 20 minutes, taking the painful area to the center. Ultrasound will be applied to the patients for 5 minutes with a dosage of 1-1.5 watts/cm2. Cervical joint range of motion exercises, stretching exercises for trapezius, scalenia, rhomboid, levator scapulae, pectoral and suboccipital muscles will be applied, then cervical isometric strengthening exercises and stabilization exercises will be carried out in a controlled manner. Conventional physical therapy will be applied by the same physiotherapist 5 days a week for 3 weeks.; For kinesio-tape application, a 20 cm long Y strip and a 15 cm long I strip tape will be prepared. The patient will flex his neck, and the application will be started from the midline of the upper thoracic vertebrae. Initially, 4-5 cm stretching will be applied, and the arms of the Y strip will be adhered to the cervical paravertebral muscles without stretching. I strip will be applied to the painful area with the area correction technique, with maximum stretching in the middle and without stretching the ends. The applications will be made by the same physiatrist with 7 years of clinical experience.; For Sham kinesio-tape application, a 20 cm long Y strip and a 15 cm long I strip tape will be prepared. The patient will flex his neck, the application will be started from the midline of the upper thoracic vertebrae, and the Y and I bands will be applied without stretching. The applications will be made by the same physiatrist with 7 years of clinical experience.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cervical Spondylosis; kinesio-tape; cervical proprioception