|Year : 2019 | Volume
| Issue : 4 | Page : 352-355
Impact of K-Taping on sacroiliac joint pain in women after full-term normal delivery
Shalaka Khobragade, Waqar Naqvi, Shalaka Dhankar, Shyam Jungade
Department of Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical sciences, Wardha, Maharashtra, India
|Date of Submission||15-Nov-2019|
|Date of Decision||28-Nov-2019|
|Date of Acceptance||20-Dec-2019|
|Date of Web Publication||16-Jul-2020|
Dr. Waqar Naqvi
Department of Community Health Physiotherapy, Ravi Nair Physiotherapy College, Sawangi (M), Wardha, Maharashtra
Source of Support: None, Conflict of Interest: None
Background: This study will help to plan the treatment protocol for reducing immediate sacroiliac joint pain with the help of K-tape in women after full term normal delivery and provide better quality of life to get back their activities of daily living more comfortably.Aim and Objectives: Aim of the study is to find out the impact of k-taping in sacroiliac joint pain in women after full term normal delivery. With following objectives 1) To study the impact of kinesiological taping in Sacroiliac joint pain in women after full term normal delivery. 2) To study the quality of life (QOL) in women with sacroiliac joint pain after full term normal delivery. Materials and Methods: study population: women with sacroiliac joint pain after full term normal delivery. Outcome measures- (A) Numeric pain rating scale (NPRS), (B)Roland Morris Disability Questionnaire (RMDQ). Intervention: The intervention period was of 72 hours where K-tape done in experimental group with exercise and only exercise in control group and both the outcome measures were documented. Result: Statistical analysis was done by using descriptive and inferential statistics using student's paired and unpaired t test and software used in the analysis was SPSS 22.0 version and p<0.05 is considered as level of significance. Conclusion: The study concluded that K-taping can be used as an adjunct to exercises in the treatment for solely sacroiliac joint pain reduction but we did not find K-taping as more effective treatment in improving functional disability in females after full term normal delivery with sacroiliac joint pain.
Keywords: Functional disability, K-tape, pelvic floor exercise, postpregnancy
|How to cite this article:|
Khobragade S, Naqvi W, Dhankar S, Jungade S. Impact of K-Taping on sacroiliac joint pain in women after full-term normal delivery. J Datta Meghe Inst Med Sci Univ 2019;14:352-5
|How to cite this URL:|
Khobragade S, Naqvi W, Dhankar S, Jungade S. Impact of K-Taping on sacroiliac joint pain in women after full-term normal delivery. J Datta Meghe Inst Med Sci Univ [serial online] 2019 [cited 2020 Aug 14];14:352-5. Available from: http://www.journaldmims.com/text.asp?2019/14/4/352/289846
| Introduction|| |
In every woman's life, pregnancy is the most significant phase of life in which many physiological modifications occur in women's lives to carry the child in the womb.
In pregnant females who are living a sedentary lifestyle, they have a high risk of low back pain (LBP). LBP is recorded in more than two-thirds of pregnant females as a result of postural adaptation to compensate for an increasing volume of the uterus at some point during pregnancy. LBP impacts between 45% and 75% of females.
It is now usually recognized that approximately 13% of females with constant slight discomfort in the low back area have complaints of pain referring to the buttock, pelvis, and lower extremities and the origin of which is assumed to be related to the sacroiliac joint (SIJ). There are lot of modifications that take place within the female body during pregnancy for the growth of the fetus. The abdominal muscles also get stretched to fit the growing uterus as they stretch, losing their capacity to execute the role of maintaining the body posture, which also causes the lower back to support the majority of the increased weight of the torso, while the center of gravity moves up the uterus and the breast which requires postural compensation for balance and stability.
Laxity of muscle causes and creates intervertebral disc disturbance, disk bulge, and general compression of the lower spine.
Relaxin, as the title indicates, creates room, so the baby has space to move through the birth canal by relaxing the bone in the pelvis. Relaxin also creates unnecessary bodily joint motion, leading to inflammation and pain.
The SIJ is the joint between the sacrum and the ilium bones linked by the powerful ligaments. The joints are strong, transferring the weight from the lower limb to the spine with irregular elevation and depression, resulting in two bodies being interlocked. It is hypomobile in nature as well as stabilizing the joint, European guidelines are published and defined SIJ dysfunction as pain present between the iliac crest and gluteal fold.
There are several possible effects of pregnancy on the SIJ. The ligaments that stabilize the joint stretches to allow the baby to be delivered and return to normal after birth if they remain loose, the joint laxity may allow sufficient repetitive new movements to cause pain at the joint.
Many studies found that 26% of women in the postpartum had reported SIJ pain. SIJ pain was higher in full-term normal delivery (FTND) than lower cesarean segment. Symptoms of the posterior pelvis girdle and sacroiliac unilateral joint called sacroiliac one-sided joint. PPGP often begins during the 18th week of pregnancy and often peaks between the 24th week and 36th week or begins soon after pregnancy. Lumbopelvic pain associated with pregnancy may continue in the postpartum period. The pain generally get reduces in the postpartum period of the first 6 months, but it has also been suggested that it can continue for up to 3 years of postpartum. Its incidence was recorded to be 35% for the first 1 month after postpartum.
Kinesio tape was created by Kenzo Kase, mixing kinesiology with chiropractic techniques, centered on unique elastic strips that replicate natural skin density and elasticity. The strip elasticity is longitudinal, while the waved adhesive allows normal mechanical functioning of the skin. There are no latex, medication, or chemical ingredients in Kinesio tape. It is made up of 100% cotton fiber; it is sensitive to temperature, and it is water resistant.
It is also believed to promote and improved lymphatic drainage as an impact of stimulated reactivation, proprioceptive training, decreased pain, reinforcement of right structure of motion, and decrease of muscle imbalance.
Taping a muscle immediately improves joint stability, but can also boost proprioceptive signals that are considered significant in regulating the muscle tone, helping to guarantee stabilization.
| Materials and Methods|| |
A study was conducted in the Department of Community Health Physiotherapy, Ravi Nair Physiotherapy College (RNPC), Sawangi (M), Wardha. Ethical approval was obtained from the institutional ethical committee of the university with (Ref. No. DMIMS (DU)/IEC/Jun-2019/8016). Treatment was given to each of the participants for 3 days.
Inclusion criteria were women with FTND. (Amniotic hook, forceps, scissors, speculum, sutures, vacuum, hemostat.), age group 20–45 years of women, Positive pelvic pain provocation test and march test must reproduce a familiar pain in the woman, with regard to the location and quality, and exclusion criteria were women with cesarean section or any complicated surgery, participants not willing or unable to provide informed consent, history/signs or symptoms indicative serious cause of pain that may be inflammatory, infective, traumatic, neoplastic, degenerative, and metabolic. History of chronic LBP that requires surgery.
K-tape, Roland Morris Disability Questionnaire (RMDQ), Numeric Pain Rating Scale (NPRS).
A total of 75 postpartum women, who were registered in the Department of Obstetrics and Gynecology (OBGY), were recruited consecutively. All the said participants had first undergone a comprehensive interview and complete physical examination, at the OBGY's inpatient and outpatient department at Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi by the principal investigator (PI). The aim of the interview was to collect the data of general and medical history, pain location using a pain drawing, and pain intensity by NPRS. Although the disability was assessed using RMDQ were distributed to postpartum women to fill in, they were assisted by PI if they required any help. Inquiries were also made regarding information about the history of lumbopelvic pain during recent pregnancy period (yes/no), and history of LBP not related to recent pregnancy (yes/no).
Sacroiliac joint diagnostic tests
Posterior pain provocation test and march test were performed on each participant for the diagnosis of SIJ pain.
Posterior pain provocation test
For posterior pain provocation test-
The participant was in the supine lying position. While testing, one hip was flexed to 90 degrees. Using one hand to palpate the SIJ, the examiner thrusting down through the hip and knee on the text side. Pain in the SIJ on thrusting was considered as a positive test.
While testing for the march test, the participant was in standing and examiner palpate posterior superior iliac spine. The participant was then asked to stand on the one leg while pulling the opposite knee toward the chest if the SIJ on the side on which the knee was flexed (ipsilateral side) moves minimally or up indicates the test positive for the diagnosis of SIJ dysfunction.
- The institutional ethical committee clearance (Ref. No. DMIMS (DU)/IEC/Jun-2019/8016) was obtained from the head of Institute, Datta (M) Institute of Medical Sciences before the start of the study
- Approval from the institutional committee was obtained
- Permission from the gynecology department was taken
- Information was given on the study to be carried out to the target population
- Participatants willing to participate were included according to with respect to selection criteria
- The total number of participants were included 75 with postpartum day 4 to day 7 with a history of LBP and complaining of pelvic girdle pain was selected for this research
- Written informed consent was provided in the Marathi and English to obtained from all the participants and those who voluntarily agreed was included in the study
- After getting consent from the participants, which were divided into two groups by simple random sampling
- The participants were divided into two equal groups consisting of 37 participants in each group
- Group A was provided by Kinesiology taping, breathing exercise, and Kegel's exercise, whereas Group B was provided by breathing exercise and Kegel's exercise.
Ethical clearance was obtained from the Institutional Ethical Committee of RNPC, Sawangi (Meghe), Wardha, on 11th Jan 2019. With ethical clearance no DMIMS(DU)/IEC/2019-20/302.
| Results|| |
A total of 75 participants were taken and they are randomly assigned into the groups received the intended treatment, they were analyzed for the outcomes. Statistical analysis was performed using descriptive and inferential statistics using Student's paired and unpaired t-test, and software used in the analysis was SPSS 22.0 version (Chicago, Illinois, USA) and P < 0.05 is considered as the level of statistical significance [Table 1], [Table 2], [Table 3] and [Graph 1], [Graph 2], [Graph 3].
|Table 2: Comparison of mean difference in Numeric Pain Rating Scale score in two groups|
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|Table 3: Comparison of mean difference in Roland Morris - Disability Questionnaire Score in two groups|
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Mean age in patients of Group A was 25.43 ± 6.19, and in Group B, it was 27.1 ± 6.22.
The mean difference in NPRS score in patients of group A was 3.64 ± 1.00 and in patients of group B, it was 2.59 ± 1.18. Using Student's unpaired t-test statistically significant difference was found in the mean difference in NPRS score pre- and post-treatment (t = 4.11, P = 0.0001).
Mean difference in RMDQ score in patients of Group A was 7.16 ± 1.95 and in patients of Group B, it was 3.32 ± 0.97. Using Student's unpaired t-test statistically significant difference was found in the mean difference in QUID score in Group A and Group B (t = 10.70, P = 0.0001).
| Discussion|| |
In the present study, we did an experimental study, 75 women between the age group of 20-45 years in the Department of Community Health Physiotherapy, RNPC. Participants were selected randomly from the gynecology department (AVBRH). They were further divided into two groups (Group A and Group B) according to the simple random sampling technique.
We analyzed and compared both the groups after treatment, there was a statistical difference in pre- and post-intervention analysis of both the groups; however, the result showed statistically significant improvement in Group A than Group B. because Group A receives K-taping along with breathing exercise and Kegel's exercise. K-Taping relieves pain as including changes in muscle activation, reduction of joint repositioning, and reduction of abnormal muscle tension.
Gangwal Anand et al. conducted research on the effectiveness of k-taping on LBP in immediate postvaginal delivery females. They suggested that k-taping can be used as an adjunct to exercises in treatment for solely LBP, which also supports findings of our study.
The study conducted by Kaplan Seyhmas et al., assessed 65 patients with pregnancy-related LBP and allocated in two groups treatment group received Kinesio taping and paracetamol, the control group only received paracetamol, the study showed the effectiveness of Kinesio taping as a complementary method of treatment to achieve effective control of pregnancy-related LBP.,,,,,,
| Conclusion|| |
The study concluded that Kinesio taping can be used as an adjunct to exercises in the treatment for solely SIJ pain reduction, but we did not find Kinesio taping as a more effective treatment in improving functional disability in females after FTND with SIJ pain.
Acknowledging a dissertation work represents the endless thanks which first goes to a mentor/guide for me. I would like to express my most valuable thanks to Dr. Waqar Naqvi, Professor and HOD, Department of Community Health Physiotherapy for his timely suggestion, guidance, and constant encouragement in the successful completion of my research and thesis work. I would like to express my sincere gratitude to Dr. Vijay Babar, Bio-statistician, DMIMS for helping me in the statistical analysis of result and most valuable thanks to institutional ethical committee for giving the permission for my thesis project.
Financial support and sponsorship
The source of funding was provided by R and D office (research cell) by Datta (M) Institute of Medical Sciences with ref no. DMIMS (DU)/R and D2018-19 on dated April 17, 2018.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]