Effect Of Instrument-Assisted Soft Tissue Mobilisation and Kinesio Taping on Pain, Kinesiophobia, Pain Catastrophizing, Functional Disability in Patients with Chronic Non Specific Neck Pain.

Over the past 10 years, technology has advanced at a quick pace, significantly altering people’s lifestyles, particularly those of young adults who lead physically inactive lifestyles1. Neck pain is a widespread musculoskeletal issue, impacting around 288.7 million people globally. In 2017 it led to an estimated 28.6 million years of disability making it a prominent cause of global impairment. Addressing this prevalent concern is vital for enhancing public health worldwide.In office workers, the estimated 1-year prevalence of neck pain was 45.5%; among healthcare professionals, it varied from 45.8% to 54.7%2. In 2010 neck pain ranked fourth in terms of years lived with disability, according to the global burden of illnesses. With the world’s population ageing, these figures could get worse in the future3.Based on the high-quality data that is currently available, persons who lead sedentary lifestyles are more likely to experience neck pain4.Recently, excessive use of computers and mobile phones, especially by young people, has increased the occurrence of neck pain. About two out of every three people will at some point in their life undergo at least a single episode of neck discomfort1.A significant percentage of people never entirely heal from neck pain, yet only 6.3% of neck pain sufferers classify their condition as chronic.Moreover, pain that has persisted for at least three of the preceding six months is classified as chronic or persistent pain5. Studies indicate that between 50% and 85% of people who suffer discomfort are likely to have recurrent episodes of neck pain, which can lead to disability and chronic neck pain (CNP). According to reports, neck pain is more common overall in early adulthood than it is in children and adolescents5. Females are more impacted than males, and the prevalence increases in middle age. Prolonged cervical flexion and repetitive labor are risk factors. A minimal degree of incapacity is caused by mechanical neck pain. Compared to non-obese people, obese people may be more susceptible to neck pain for a variety of reasons, such as increased systemic inflammation, harmful structural changes, increased mechanical stress and ground reaction force, decreased muscle strength, more psychological problems, and greater disability related to kinesiophobia6.The fourth-ranking condition that causes disability is chronic neck pain. The major objectives of treatment are to improve the quality of life for patients with chronic neck pain, assure independence in everyday activities, and develop joint range of motion (ROM), muscle strength, endurance, and coordination. There are numerous established approaches of treating it. Physiotherapists choose exercise therapy since it is the most successful treatment option, although it does involve the patient’s active participation. In order to improve functions and lessen inflammation, pain, and muscle spasm brought on by nerve root irritation, passive treatment methods such as electrotherapy, hot-cold pack applications, manual therapy techniques, cervical traction, and neck collar are used 12

|The significant correlations have been shown between neck pain and psychosocial variables that affect pain perception, such as catastrophizing, stress, anxiety, and depression7.Inappropriate pain cognitions, such as (kinesiophobic)movement apprehension pain catastrophizing, and hypervigilance, are also common in CNP patients. According to studies, the best factors that predict persistent musculoskeletal pain over a six-month period are fear and movement avoidance. Prolonged pain and impairment are also thought to be caused by pain catastrophizing, the fear-avoidance beliefs factor, and movement avoidance as a result of reluctance to risk of pain or harm.Because of this, when working with patients who have long-term disabilities, healthcare professionals should take psychological variables into account and recognize their importance8.

The methods for treating neck discomfort include applying heat, receiving manual treatment, engaging in physical activity, etc. A recent addition to the toolkit of physiotherapists is kinesio taping. Kinesio tape supports and stabilises muscles and joints without limiting range of motion, aiding in the body’s natural healing process. 4.Kinesio taping technique (KT) has gained popularity in addition to all of these therapeutic modalities, particularly for musculoskeletal issues. The KT was created by Kenzo Kase, but earlier the usage was less compared usage of it has increased recently.The following are some of the hypotheses put up regarding the effects of KT: pain inhibition; blood circulation stimulation; oedema reduction through increased lymph circulation; and joint position correction by the provision of muscular relaxation, support, and stability to muscles and joints without restricting range of motion12.The application of the tape was done in the following shapes: I, Y, X, Octopus, Donut, and Star. Utilizing it improves muscular function and reduces pain by activating cutaneous mechanoreceptors on skin tissues as well as blood and lymph circulation. This is achieved through the pain gate theory16.By reducing excessive muscle tension and enhancing joint function, these actions enable the damaged fascia and muscles to recover to normal functioning.In addition to being sticky, kinesiotape is thin, air permeable, and water resistant.Because of its skin-like adhesion qualities, it applies steady shear to the skin and can be left on for three to four days without needing to be removed. 13

Another treatment has proved to be effective in treatment of chronic mechanical neck pain is Instrument-assisted soft tissue mobilisation (IASTM).It has become a common therapeutic modality for myofascial limitation, used in conjunction with traditional treatments for chronic pain. Numerous IASTM instruments, including hawk grips, graston, adhesion breakers, functional and kinetic treatment, and fascial abrasion technique, each have their unique method of treatment and design, including the material and form of the instruments19.IASTM is carried out with the use of tools made especially to mobilize soft tissue (such as scar tissue and myofascial adhesion) in order to lessen discomfort and enhance function and range of motion. By using these tools, the tissue can be treated in a targeted location and with a deeper penetration17. The goal of IASTM therapy is to encourage collagen secondary to fibroblast recruited healing by resorbing excess fibroses and so promoting the restart of connective tissues. Thus, scar tissues, adhesion, and fascial restrictions are loosened and disintegrated18.

   |Various treatment approaches are available for the treatment of  chronic non specific neck pain recently IASTM and K Tape addition along with routine physiotherapy has given better results.IASTM helps in releasing the soft tissue while K tape helps to support and stabilize the soft tissue and joint. Studies done previously  where IASTM and K tape are compared with conventional treatment, Manual therapy, Mulligan mobilization, McKenzie mobilization have proved to be beneficial in treatment of neck pain, trapeizitis and trigger points. But most of these studies done have seen immediate effect or short term effect i.e 48 hours or  one week .Most of these(IASTM and K Tape) studies have failed to asses the sustained effect of these treatment technique. Studies done on K tape have not mentioned precise stretch of tape on soft tissue. And these chronic neck pain studies have not addressed other components of chronic pain such as kinesophobia and catastrophizing they have only considered pain severity, function and disability. Also studies are lacking where they have compared between IASTM and K tape in chronic non specific neck pain, but done in chronic low back pain, where they have proved both groups were improved equally and the limitations of this study was that the effects were  not observed after certain period of time. Both of these treatment technique are effective in treatment of fascia and also K tape helps to treat tissue bellow fascia but still studies are lacking.

As the studies lack in so many areas there arises a strong need to conduct a study which aims to compare The effect of IASTM and K tape on pain , kinesophobia, pain catastrophizing, functional disability in patient with non specific chronic neck pain.