Effect of Kinesio Tape Versus Diaphragmatic Breathing Exercise In Post COVID-19
Condition: Post COVID-19 Condition
MeSH terms: COVID-19
Study type: Interventional

Summary: 
      According to WHO, current evidence suggests some people experience a variety of long-term
      effects after they recover from their initial illness. These effects are collectively known
      as post COVID-19 condition or "long COVID. While most people who develop COVID-19 fully
      recover, some people develop effects like fatigue, breathlessness, functional activities and
      cognitive dysfunction. At present, there is no specific medication therapy for people with
      post COVID-19 condition.
    

Detailed description: 
      Lungs are the main organs affected by the virus so many respiratory complications occur, like
      increasing breathing effort marked by the usage of auxiliary respiratory muscle and
      paradoxical breathing pattern. However, when a patient with the corona virus become negative,
      the symptoms during Covid-19 infection do not immediately disappear, these symptoms can even
      continue for months. A study on Long Covid stated that, about 87.4% of people reported
      feeling at least one persistent symptom and the most common was chronic fatigue and shortness
      of breath. Physiotherapy rehabilitation, such as breathing exercises and chest physiotherapy,
      can be effective adjuvant therapies in COVID-19 patients. Different therapies are suggested
      to treat Covid-19 complications as Pursed lip breathing exercise which is effective in
      improving respiratory rate and reducing dyspnea in Covid-19 patients.

      Cognitive Behavior Therapy (CBT) has a great impact in promoting the physical and
      psychological health of patients during COVID-19.

      A series of recent studies has indicated that, a telerehabilitation program consisting of
      1-week respiratory exercises was found to be effective, safe, and feasible in Covid-19
      patients with mild to moderate symptomatology. A recent study by Cascella et al. concluded
      that, breathing exercises and chest therapy can be used to help post COVID-19 patients regain
      their normal breathing capacity.

      kinesio tape helps with neuromusculoskeletal rehabilitation by activating cutaneous
      mechanoreceptors, which interact with deeper tissues via continuous sensory and mechanical
      stimuli in the skin, forming a neural arc and proper motor response. In patients with COPD,
      Kinesio tape combined with deep breathing exercises significantly improved pulmonary
      function, perceived severity of dyspnea, and fatigue, and had a positive effect on functional
      capacity.

      Desai et al. concluded in their study that, kinesio tape applied to the diaphragm has a good
      prognosis for diaphragm muscle weakness. It improved maximum inspiratory pressure and
      diaphragmatic excursion range.

      60 Patients will be assignment randomly into three groups: Group A: 20 patients will receive
      pursed lip breathing and cognitive-behavioral therapy in addition to kinesio tape.

      Group B: 20 patients will receive pursed lip breathing and cognitive-behavioral therapy in
      addition to diaphragmatic breathing exercise.

      Group C: 20 patients will receive pursed lip breathing and cognitive-behavioral therapy.
    

Intervention name(s): Pursed lip breathing; Cognitive Behavior Therapy; Diaphragmatic breathing exercise; Kinesio tape
Intervention type(s): Other; Other; Other; Other
Intervention description(s): The position for every patient will be long sitting, and then he will be instructed to breathe in through the nose for 2 seconds. Purse the lips as if about to blow out the candles on a cake. Breathe out very slowly through pursed lips for 4 to 6 seconds, and then repeat for 5 to 10 minutes. The intervention will be done two days a week, through six weeks for all participants by a physiotherapist.; A structured, 6-session psycho-therapeutic intervention, occurring once weekly, will be performed According to the CBT session structure provided by Cully and Teten, with some modifications, Each session will be approximately 1 hour.; The patient will lie in supine position, and then he will be asked to rest for 5 min and lay on their back on a flat surface with pillows under their head and knees for support. One hand will be placed on the abdomen and the other on the upper part of the chest wall. When inhaling, the hand on the abdomen will move upward, while the other hand will remain as still as possible. When exhaling, the hand on the abdomen will move downwards, while the other hand will remain as still as possible again. Breathing will be performed quickly, deeply and without causing tiredness. The breaths should be inhaled through the nose and exhaled through the mouth.
The diaphragmatic breathing exercise will consist of three sets of 10 repetitions, with 30 seconds of rest between each set; The position for every patient will be sitting during application of the tape. The diaphragm muscle will be covered with kinesio tape both anteriorly and posteriorly along the subcostal region. Anteriorly, the base point of an "I" shaped kinesio tape will be applied on xiphoid process with 50_75% tension on the linea Alba and the tails of the tape were applied toward subcostal curvature. Posteriorly, a second "I" shaped Kinesio Tape will be applied from the back The base point of the tape will be applied on the projection of 12th Thoracic vertebra with 50 _75% tension and the tails will be applied toward the ribs.
Other intervention name(s): (CBT)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Kinesio tape; Diaphragmatic breathing exercise; Post COVID-19; six-minute walk test; Oxygen Saturation; Fatigue Severity Scale; Quality of life