This study aims to evaluate the effects of functional thoracolumbar fascia kinesiology taping on fascia thickness, pain, and functional disability in individuals with nonspecific chronic low back pain. The study is planned as a randomized controlled trial and will include a total of 30 individuals aged 18-65 years who have been diagnosed with nonspecific mechanical chronic low back pain. Participants will be randomly assigned to two groups: the Functional Fascial Taping Group will receive kinesiology tape applied to the thoracolumbar fascia using a fascia correction technique, while the Muscle Technique Taping Group will receive traditional muscle taping applied to the paravertebral muscles. Interventions will be performed twice a week for two weeks. Assessments will be performed before and after treatment; pain intensity will be measured using the Visual Analog Scale, pressure pain threshold will be measured using an algometer, functional disability will be measured using the Oswestry Low Back Pain Disability Index, and thoracolumbar fascia thickness will be measured using ultrasonography. The findings are expected to contribute to clinical practice by providing evidence-based data on the effectiveness of different kinesiology taping techniques in chronic low back pain.
Age: Be between 18 and 65 years old.
Volunteer status: Be willing to participate in the study and sign an informed consent form.
A pain episode lasting longer than 6 weeks or
A history of recurrent low back pain (episodes lasting longer than 24 hours with at least one pain-free period of one month before/after the episode).
Specific Spinal Pathologies: The presence of a specific cause for back pain (e.g., structural abnormalities such as herniation, stenosis, spondylolisthesis).
History of Major Trauma: A history of serious trauma to the back region.
Systemic Diseases: Systemic diseases that may affect the outcome, such as rheumatological diseases or diabetes.
History of Cancer: Any cancer diagnosis or history.
Parallel
Functional Fascial Taping Group
Other interventionThe treatment program for the Functional Fascial Taping Group is as follows: Participants in this group will undergo a targeted fascial correction technique applied to the thoracolumbar fascia. In practice, "I" and "Y" strips cut from 5 cm x 5 m kinesiology tape will be used, and the tapes will be applied to the right and left thoracolumbar fascia with an oscillatory (oscillating) tension in the range of 10-50%. The protocol will be repeated for a total of 2 weeks (4 sessions), twice a week, and the tapes will be replaced at each session. The primary goal is to reduce pain and improve function by directly affecting the biomechanics of the fascial tissue. Patients in the stabilization exercises group will perform cervical stabilization exercises consisting of 3 levels with gradually increasing difficulty. The exercises will be taught to patients level by level by a physical therapist over 6 weeks. Stretching exercises will be performed before each exercise session.
Muscle Technique Taping Group
Other interventionIn this group, the more traditional approach of muscle taping will be adopted. The application will be performed using three "I"-shaped strips of tape. The first two strips will be placed completely tension-free (0%) on the paravertebral muscles while the patient is leaning forward and performing a slight rotation. The third tape will be applied transversally with 25% tension, parallel to the ground, over the sacroiliac joints. This protocol will also be applied twice a week for two weeks, with the aim of providing muscle support and increasing stabilization.
Damascus Banding Group
Other interventionThe taping applied in this group will not aim to correct any muscles or fascia, will be performed without applying therapeutic tension (0% tension), and will not produce a standard clinical effect. At the end of the study, all participants will be informed that they can access known effective taping approaches upon request.
Traditional treatment
Other interventionPatients in the stabilization exercise group will be given cervical stabilization exercises consisting of 3 levels with gradually increasing difficulty. The exercises will be taught to patients level by level by a physical therapist over 6 weeks. Patients will perform the exercises for a total of 6 weeks. Patients will be asked to perform stretching exercises before each exercise session.
Pain intensity
The Visual Analog Scale (VAS) will be used to measure participants' pain intensity. Participants are asked to indicate their current state by placing a line or dot on a 10-centimeter straight line, where both ends are defined by the parameter to be measured in the individual. Pain intensity in the individual is calculated in this way. For example, the parameters to be evaluated are determined at one end of the drawn 10-centimeter straight line (0 = no pain, 10 = unbearable pain).
The thoracolumbar fascia thickness/ULTRASOUND
The thoracolumbar fascia thickness will be measured using the Versana Primer R2 VS GE (China, 2022) ultrasound with a 4.0-13.0 MHz, 38.4 mm probe and a scanning protocol performed at the L3 level of the lumbar spine. Measurements will be performed by an experienced physician doctor in musculoskeletal ultrasound. Measurements will be performed bilaterally in the standard manner, with the patient lying comfortably in the prone position. Measurements will be performed using ultrasound B-mode and a depth setting of 30 mm. Sufficient gel will be used to avoid probe compression on the skin to ensure accurate measurements. To prevent TLF thickness differences from affecting the results, measurements will be taken at 3 separate points and averaged. As recommended by Pirri et al., the probe will be placed perpendicularly, and short and long axis images will be obtained. Images will be recorded and measurements will be taken (Pirri et al., 2024).
LOW BACK PAIN DISABILITY
The Oswestry Back Pain Disability Questionnaire will be used to obtain information about how much back (or leg) pain affects a person's daily activities. The questionnaire consists of 10 sections. The patient is asked to mark the most appropriate answer for themselves. The score is calculated, and the resulting percentage values are interpreted according to the values given below (Yi, 2008); 0% - 20% - minimal disability 20% - 40% - moderate disability 40% - 60% - severe disability 60% - 80% - disabled 80% - 100% - bedridden
Posture
Spinal posture was assessed using a computer-assisted wireless Spinal Mouse device (Spinal Mouse System, Idiag, Fehraltorf, Switzerland). The device was guided manually along the spinous processes from C7 to S3 while the participant stood in a relaxed upright position. The Spinal Mouse records sagittal spinal curvature and calculates numerical values for thoracic kyphosis, lumbar lordosis, and overall spinal inclination. All postural alignment parameters were automatically transferred to the computer software and expressed as angular values (degrees).
Lateral Bridge Testt
The lateral bridge test will be used to evaluate lateral core muscle endurance. Participants will be instructed to lie on their right side, supporting their body on the forearm and feet, with the body aligned in a straight line. The non-supporting arm will rest along the body. Participants will be asked to maintain this position for as long as possible. The test will be terminated when proper alignment is lost or when the pelvis contacts the examination surface. The duration the position is held will be recorded in seconds (Bliss \& Teeple, 2005).
Spinal Mobility:
Spinal mobility was evaluated with the same Spinal Mouse system by assessing trunk flexion posture. Participants were instructed to perform maximal trunk flexion from the standing position, and the device was rolled along the spine during the movement. The Spinal Mouse quantitatively measured segmental and total spinal range of motion by calculating angular changes between adjacent vertebral segments. The system provides cumulative numerical values for spinal flexion mobility in degrees. Spinal mobility measurements were recorded at baseline and at the 6-week follow-up.
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