Author Names
Schmidt, S., Wölfle, N., Schultz, C., Sielmann, D., Huber, R., and Walach, H.
Reviewer Name
Carly Andrake, SPT
Reviewer Affiliation(s)
Duke University School of Medicine, Doctor of Physical Therapy Division
Paper Abstract
Background: Chronic low back pain is the most frequent medical problem and the condition with the most years lived with disability in Western countries. The objective of this study was to assess a new treatment, Medi-Taping, which aims at reducing complaints by treating pelvic obliquity with a combination of manual treatment of trigger points and kinesio taping in a pragmatic RCT with pilot character. Methods: One hundred ten patients were randomized at two study centers either to Medi-Taping or to a standard treatment consisting of patient education and physiotherapy as control. Treatment duration was 3 weeks. Measures were taken at baseline, end of treatment and at follow-up after 2 months. Main outcome criteria were low back pain measured with VAS, the Chronic Pain Grade Scale (CPGS) and the Oswestry Low Back Pain Disability Questionnaire (ODQ). Results: Patients of both groups benefited from the treatment by medium to large effect sizes. All effects were pointing towards the intended direction. While Medi-Taping showed slightly better improvement rates, there were no significant differences for the primary endpoints between groups at the end of treatment (VAS: mean difference in change 0.38, 95-CI [- 0.45; 1.21] p = 0.10; ODQ 2.35 [- 0.77; 5.48] p = 0.14; CPGS – 0.19 [- 0.46; 0.08] p = 0.64) and at follow-up. Health-related quality of life was significantly higher (p = .004) in patients receiving Medi-Taping compared to controls. Conclusions: Medi-Taping, a purported way of correcting pelvic obliquity and chronic tension resulting from it, is a treatment modality similar in effectiveness to complex physiotherapy and patient education.
NIH Risk of Bias Tool
Quality Assessment of Controlled Intervention Studies
- Was the study described as randomized, a randomized trial, a randomized clinical trial, or an RCT?
- Yes
- Was the method of randomization adequate (i.e., use of randomly generated assignment)?
- Yes
- Was the treatment allocation concealed (so that assignments could not be predicted)?
- Yes
- Were study participants and providers blinded to treatment group assignment?
- No
- Were the people assessing the outcomes blinded to the participants’ group assignments?
- Yes
- Were the groups similar at baseline on important characteristics that could affect outcomes (e.g., demographics, risk factors, co-morbid conditions)?
- Yes
- Was the overall drop-out rate from the study at endpoint 20% or lower of the number allocated to treatment?
- No
- Was the differential drop-out rate (between treatment groups) at endpoint 15 percentage points or lower?
- No
- Was there high adherence to the intervention protocols for each treatment group?
- Cannot Determine, Not Reported, or Not Applicable
- Were other interventions avoided or similar in the groups (e.g., similar background treatments)?
- Cannot Determine, Not Reported, or Not Applicable
- Were outcomes assessed using valid and reliable measures, implemented consistently across all study participants?
- Yes
- Did the authors report that the sample size was sufficiently large to be able to detect a difference in the main outcome between groups with at least 80% power?
- No
- Were outcomes reported or subgroups analyzed prespecified (i.e., identified before analyses were conducted)?
- Yes
- Were all randomized participants analyzed in the group to which they were originally assigned, i.e., did they use an intention-to-treat analysis?
- Yes
Key Finding #1
Quality of life improved significantly more in the Medi-Taping group with a small- to medium-sized effect
Key Finding #2
The finger-to-floor distance, which measures functionality, improved significantly more in the Medi-Taping group
Key Finding #3
Changes in pain score (VAS) and function (ODQ) did not improve significantly in the Medi-Taping group
Key Finding #4
Patients in both groups benefitted from treatment
Please provide your summary of the paper
This study looked at the effects of Medi-Taping combined with manual therapy in patients with chronic low back pain. Two groups were created randomly: the experimental group, which received Medi-Taping and manual therapy, and the control group, which received physiotherapy and patient education. This study found that both groups benefitted from the treatment they received, but the Medi-Taping group had slightly better outcomes regarding quality of life and functionality. The finger-to-floor distance showed to be the most sensitive outcome measure, which measures functionality and showed greater improvements in the Medi-Taping group.
Please provide your clinical interpretation of this paper. Include how this study may impact clinical practice and how the results can be implemented.
This study is the first to look at the use of Medi-Taping combined with manual therapy and was designed based on educated guesses and clinical impressions. Additionally, the study could be considered unreliable due to an over-optimistic power calculation. The study only included two centers, which makes the results difficult to generalize. Overall, the Medi-Taping treatment modality seems to have similar results to a physical therapy and patient education program for those with chronic low back pain. Further research should be done with a less over-optimistic powered study.
