Effectiveness of kinesio taping in patients with chronic non-specific low back pain: a systematic review with meta-analysis

Key points

1. 0111 RCTs with 743 total participants were included in this meta-analysis
2. 02KT was not significantly better than no intervention for pain at short-term follow-up (MD=-0.49; 95% CI -1.99 to 1.01)
3. 03KT was not significantly better than placebo for pain (MD=-1.13; 95% CI -2.41 to 0.15) or disability (SMD=-0.14; 95% CI -0.72 to 0.45) at short term
4. 04Adding KT to physical therapy did not improve pain (MD=-0.01; 95% CI -1.39 to 1.36) or disability (SMD=0.14; 95% CI -0.33 to 0.61) over physical therapy alone
5. 05GRADE quality of evidence was rated very low to moderate across all comparisons

How it was conducted

Design

Systematic review with meta-analysis of randomized controlled trials

Search date

Databases searched up to February 26, 2018 (PubMed, EMBASE, PEDro, SciELO, LILACS)

Participants

Adults with chronic non-specific low back pain (symptoms lasting at least 12 weeks); total pooled n=743 across 11 RCTs

Comparisons

KT vs no intervention; KT vs placebo tape; KT combined with exercise or electrotherapy vs exercise or spinal manipulation alone

Primary outcomes

Pain intensity and disability, assessed at short-term (closest to 4 weeks), intermediate-term (closest to 12 weeks), and long-term (closest to 1 year)

Quality assessment

PEDro scale for trial quality (scores 3-9, mean 6.8); GRADE for overall evidence quality

What they found

• KT vs no intervention - pain at short term: MD=-0.49 (95% CI -1.99 to 1.01, p=0.52, n=100); very low quality evidence
• KT vs placebo - pain at short term: MD=-1.13 (95% CI -2.41 to 0.15, p=0.08, n=287 from 4 trials); very low quality evidence
• KT vs placebo - disability at short term: SMD=-0.14 (95% CI -0.72 to 0.45, p=0.65); low quality evidence
• Sensitivity analysis excluding one heterogeneous trial - KT vs placebo pain at short term: MD=-0.59 (95% CI -1.07 to -0.10, p=0.02); small effect, not clinically important
• KT vs placebo - pain at intermediate term: MD=-0.18 (95% CI -0.73 to 0.37, p=0.52, n=100 from 2 trials); low quality evidence
• KT vs placebo - disability at intermediate term: SMD=-0.34 (95% CI -1.42 to 0.75, p=0.54); very low quality evidence
• KT plus physical therapy vs physical therapy alone - pain at short term: MD=-0.01 (95% CI -1.39 to 1.36, p=0.98, n=296 from 5 trials); very low quality evidence
• KT plus physical therapy vs physical therapy alone - disability at short term: SMD=0.14 (95% CI -0.33 to 0.61, p=0.56); very low quality evidence
• PEDro scores ranged from 3 to 9 with a mean of 6.8 (SD=2.0); 7 of 11 trials were considered high quality

Limitations

• Evidence quality ranged from very low to moderate across all comparisons, limiting confidence in the findings
• Most trials only assessed short-term outcomes; only 2 trials followed patients to 12 weeks with no long-term data available
• The number of trials per comparison was small, preventing assessment of publication bias via funnel plots
• Optimal dosage and duration of KT application were not established, with no consensus across included trials

Why it matters

For patients

Patients with chronic low back pain are unlikely to benefit from Kinesio Taping beyond a placebo effect, and should discuss evidence-based alternatives with their physiotherapist.

For clinicians

Clinicians should not recommend Kinesio Taping as a standalone or adjunct treatment for chronic non-specific low back pain given the consistent lack of clinically meaningful benefit across all comparisons.

For readers

This is the first meta-analysis specific to chronic non-specific low back pain, providing the most comprehensive synthesis of KT evidence to date, though the low quality of much of the evidence means conclusions may change as better trials emerge.