The Effect of Kinesio Taping With Cervical Spondylosis

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.

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.

Eligibility Criteria:
Inclusion Criteria:

* Being over 50 and under 70
* Moderate to severe neck pain and limitation in neck movements according to the Visual Analogue Scale, which has been present for at least 3 months
* Presence of cervical degeneration radiologically
* being literate
* Giving consent by agreeing to participate in the study
* Having an MRI registered in the system in the last 1 (one) year

Exclusion Criteria:

* Being under 50 and over 70
* Neck pain that has been present for less than 3 months
* Patients with positive Spurling test and radiculopathy
* Patients with nerve root compression and stenosis in the evaluation with cervical MRI within the last 1 year
* History of neurological disease, history of neck trauma, cervical myelopathy, any inflammatory arthritis, tumor, infection involving the cervical spine, and vertebrobasilar artery insufficiency
* Cervical spinal surgery history
* Vestibular disorder
* vision problems
* cognitive impairment
* polyneuropathy
* B12 and vitamin D deficiency (Patients with abnormal values for B12 and vitamin D in the last three months through the hospital examination result system will not be included in the study)
* No known diagnosis of psychotic disorder
* Active skin infection, cellulitis, open wounds, presence of cancerous tissue, extreme obesity and allergy to adhesives containing polyacrylate
* not being literate
* Patients who received physical therapy, injection, manual therapy, kinesio-tape treatment from the neck region in the last 3 months.