Effectiveness of Kinesio Taping in Patients With Chronic Nonspecific Low Back Pain: A Systematic Review With Meta-analysis.

STUDY DESIGN: Systematic review. OBJECTIVE: To investigate the effects of Kinesio Taping (KT) in patients with nonspecific low back pain. SUMMARY OF BACKGROUND DATA: KT is widely used in patients with low back pain. METHODS: We conducted searches on PubMed, EMBASE, PEDro, SciELO, and LILACS up to February 26, 2018. We included only randomized controlled trials (RCTs) in adults with chronic nonspecific low back pain that compared KT to no intervention or placebo as well as RCTs that compared KT combined with exercise against exercise alone. The methodological quality and statistical reporting of the eligible trials were measured by the 11-item PEDro scale. The quality of the evidence was assessed using the GRADE classification. We considered pain intensity and disability as the primary outcomes. Whenever possible, the data were pooled through meta-analysis. RESULTS: We identified 11 RCTs for this systematic review (pooled n = 743). Two clinical trials (pooled n = 100) compared KT to no intervention at the short-term follow-up. Four studies compared KT to placebo (pooled n = 287) at short-term follow-up and two trials (pooled n = 100) compared KT to placebo at intermediate-term follow-up. Five trials (pooled n = 296) compared KT combined with exercises or electrotherapy to exercises or spinal manipulation alone. No statistically significant difference was found for most comparisons. CONCLUSION: Very low to moderate quality evidence shows that KT was no better than any other intervention for most the outcomes assessed in patients with chronic nonspecific low back pain. We found no evidence to support the use of KT in clinical practice for patients with chronic nonspecific low back pain. LEVEL OF EVIDENCE: 1.

Análise biomecânica do tronco e pelve em exercícios do método pilates: revisão sistemática / Análisis biomecánico del tronco y de la pelvis en ejercicios del método pilates: revisión sistemática / Biomechanical analysis of the trunk and pelvis during pilates method exercises: systematic review

RESUMO O método pilates é atualmente utilizado na reabilitação e na prática de atividade física. Alguns estudos investigaram sua eficácia no tratamento de condições específicas, mas informações sobre a avaliação biomecânica durante a realização dos exercícios ainda são escassas. Portanto, o objetivo deste estudo foi realizar uma revisão sistemática de estudos observacionais com avaliação biomecânica durante os exercícios baseados no método pilates. A busca foi realizada nas bases de dados Embase, CINAHL, Web of Science, SPORTDiscus e PubMed. Alguns dos termos relacionados à biomecânica e pilates, como "cinemática" e "eletromiografia", foram interligados por or/and. A análise da qualidade metodológica e da captação do sinal eletromiográfico foi baseada nas diretrizes do STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) e dos Standards for Reporting EMG Data do ISEK, respectivamente. Dos 14 estudos incluídos na revisão sistemática, apenas um utilizou o desenho de estudo transversal do tipo caso e controle. Exercícios de pilates realizados no solo e os músculos multífidos foram os mais avaliados, utilizando principalmente a avaliação eletromiográfica. Os resultados dos estudos permitiram observar que os músculos multífidos foram os mais ativados em alguns exercícios do método pilates e que a ativação muscular é dependente da posição do praticante e da posição das molas. Os 14 estudos publicados possuem qualidade metodológica satisfatória, mas a maioria deles possui descrição incompleta dos registros eletromiográficos. Assim, podemos sugerir que a mudança de posicionamento do praticante/molas e a escolha dos exercícios interferem diretamente na ativação muscular durante a realização de exercícios.

RESUMEN La acumulación de la grasa torácica puede contribuir a la reducción de la movilidad torácica (MT) con disminución del volumen pulmonar. También las alteraciones de la MT pueden ocurrir en el envejecimiento, debido a la progresiva calcificación de las articulaciones implicadas en los movimientos respiratorios y a la reducción de los espacios intervertebrales. Este estudio tuvo el objetivo de verificar la influencia de la edad, de las características antropométricas y de la distribución de grasa corporal en conductas de la MT de mujeres, así como verificar cuál de las variables es la más relevante para la MT. Se trata de un estudio transversal, del cual participaron 100 mujeres con edades entre 25 y 75 años y con índice de masa corporal (IMC) entre 18,5 y 55kg/m2. Se midieron las circunferencias del cuello (CC), de la cintura, de las caderas y la relación entre cintura/cadera. Se evaluó la MT a través de la cirtometría torácica en los niveles axilar y xifoides y, tras realizarse las tres mediciones, se determinó la MT por la diferencia entre el valor más grande obtenido en la inspiración y el menor valor en la espiración. Se emplearon los test de correlación y de regresión lineal múltiple. Mediante las correlaciones significativas, los resultados demostraron que la MT disminuye debido al aumento de edad y a la obesidad. La CC tuvo mayor influencia (16,60%) bajo la MT en el nivel axilar y el IMC en el nivel xifoides (18,16%). Se concluyó que la MT redujo con el envejecimiento y la obesidad, y que la acumulación de grasa en el cuello y el aumento del IMC son los factores que más influyen en el comprometimiento de la MT de mujeres.

ABSTRACT The pilates method is currently used in the rehabilitation and practice of physical activity. Some studies have investigated the effectiveness of the pilates method in the treatment of specific conditions, but information about the Biomechanical evaluation during the exercises are still scarce. Therefore, the purpose of this study was to conduct a systematic review of observational studies with biomechanical evaluation during the exercises based on the pilates method. The search was conducted based on data of the EMBASE, CINAHL, Web of Science, SPORTDiscus and PubMed databases. Some of the terms related to Biomechanics and pilates, as "cinematic" and "electromyography", were connected by or/and. The analysis of the methodological quality and electromyographic signal capture was based on the guidelines of STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) and Standards for Reporting EMG Data of ISEK, respectively. Of the 14 studies included in a systematic review, only one cross-sectional study design was used of the case and control type. pilates exercises carried out in the soil and multifidus muscles were the most evaluated, using mainly the electromyographic evaluation. The results of the studies made it possible to observe that the multifidus muscles were the most used in some exercises of the pilates method and muscle activation is dependent upon the position of the practitioner and the position of the springs. The 14 studies published have a satisfactory methodological quality, but most of them have incomplete description of electromyography records. Thus, we can suggest that the change of positioningof the practitioner/springs and the choice of exercises interfere directly in the muscle activation during exercises of the pilates method.

Kinesio taping to generate skin convolutions is not better than sham taping for people with chronic non-specific low back pain: a randomised trial.

QUESTION: For people with chronic low back pain, does Kinesio Taping, applied according to the treatment manual to create skin convolutions, reduce pain and disability more than a simple application without convolutions? DESIGN: Randomised trial with concealed allocation, intention-to-treat analysis and blinded assessment of some outcomes. PARTICIPANTS: 148 participants with chronic non-specific low back pain. INTERVENTION: Experimental group participants received eight sessions (over four weeks) of Kinesio Taping applied according to the Kinesio Taping Method treatment manual (ie, 10 to 15% tension applied in flexion to create skin convolutions in neutral). Control group participants received eight sessions (over four weeks) of Kinesio Taping with no tension, creating no convolutions. OUTCOME MEASURES: The primary outcome measures were pain intensity and disability after the four-week intervention. Secondary outcomes were pain intensity and disability 12 weeks after randomisation, and global perceived effect at both four and 12 weeks after randomisation. RESULTS: Applying Kinesio Tape to create convolutions in the skin did not significantly change its effect on pain (MD-0.4 points, 95% CI-1.3 to 0.4) or disability (MD-0.3 points, 95% CI-1.9 to 1.3) at four weeks. There was a small difference in favour of the experimental group for the secondary outcome of global perceived effect (MD 1.4 points, 95% CI 0.3 to 2.5) at four weeks. No significant between-group differences were observed for the other secondary outcomes. CONCLUSION: Kinesio Taping applied with stretch to generate convolutions in the skin was no more effective than simple application of the tape without tension for the outcomes measured. These results challenge the proposed mechanism of action of this therapy. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-7ggfkv.