The Effect of Different Kinesio Taping Techniques Applied to Patients With Chronic Low Back Pain on the Thoracolumbar Fascia

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 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).

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

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).

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 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.

Postural endurance was assessed using the Spinal Mouse device during a standardized static loading task. Participants were asked to hold a weight equivalent to 5% of their body weight with both hands at shoulder level, arms parallel to the floor, for 30 seconds while maintaining an upright posture. Immediately after the task, spinal posture was re-measured using the Spinal Mouse. Changes in spinal alignment angles before and after the endurance task were calculated numerically by the software and used as indicators of postural endurance (competence).

The Sorensen test will be performed to assess endurance of the trunk extensor muscles. Participants will lie in a prone position with the pelvis, hips, and knees supported on the examination table, while the upper body extends beyond the edge of the table. The lower extremities will be stabilized by straps or manual fixation. Participants will be instructed to maintain the upper body in a horizontal position with arms crossed over the chest. The test will end when the participant is unable to maintain the horizontal position or reports fatigue. Endurance time will be recorded in seconds (Baltacı et al., 2006).

Trunk flexor endurance will be assessed using a standardized static trunk flexion test. Participants will sit on the examination table with the trunk flexed to approximately 60 degrees, hips and knees flexed, and feet secured. Arms will be crossed over the chest. Participants will be instructed to maintain this position without support for as long as possible. The test will be terminated when the participant is unable to maintain the target position or reports exhaustion. The duration will be measured in seconds using a stopwatch (Bliss & Teeple, 2005).