Determine the Effect of Kinessio Taping Use after Mc Kenzie

Exercise to Decrease the Scale of Back Pain in Low Back Pain Non

Specific Cases

Reni Aprinawaty Sirait

, Rahmad Aldy

, Isidorus Jehaman

, Sabirin Berampu

, Raynald Ignasius

Ginting

, and Miftahul Zannah

Faculty of Public Health, Institut Kesehatan Medistra Lubuk Pakam, Indonesia

Faculty of Nursing and Physiotherapy, Institut Kesehatan Medistra Lubuk Pakam, Indonesia

Keywords: Kinessio Taping use After McKenzie Exercise Against Decrease in Waist Pain.

Abstract: Lower back pain is disease that affects the quality of life and productivity of a person. The purpose of this

study was to determine the effect of Kinessio Taping use after McKenzie Exercise to decrease the scale of

back pain in low back pain nonspecific cases. This research method was a quasi-experimental design with

pre-test and post-test respondents were 16 people consisting of two treatment groups with each group totaling

6 people. Statistical test results obtained p-value <0.05 (0.001 <0.05) means that there was an is Influence of

Kinessio Taping Usage after Mc.Kenzi Against Pain Scale Reduction in Low Back Pain Case Non Specific.

The results of this study should be used as one method that can be used for handling cases of non-specific low

back pain so it can help the pain experienced by the sufferer.

1 INTRODUCTION

Non-specific Low Back Pain is a clinical syndorome

that is often found in the community. Complaints are

accompanied by pain around the lower back. Almost

the entire population of the world has complained of

Low Back Pain during his lifetime (Ruhaya, 2018).

Spasms caused by low back pain nonspecific

cause sufferers to feel pain, even prolonged spasm

will cause vasoconstriction of blood vessels which

causes ischemia, so that patients limit movement

because it will cause pain. Muscle experiencing

spasmedan is not moved and results in decreased

functional activity in patients (Mulyaningtyas,2016).

Data from the World Health Organization (WHO)

states that 150 types of musculoskeletal disorders are

suffered by hundreds of millions of people that cause

long-lasting pain and inflammation as well as

disability or functional limitations, causing

psychological and social disorders of sufferers,

namely Non-Specific Low Back Pain complaints that

are complaints most commonly found among other

complaints of pain (Putu Restu, 2019).

Date in the World states that every individual in

his lifetime must experience complaints of Non

Specific Low Back Pain, the prevalence is 70-80%

and the prevalence is 15-45% per year (Putu Restu,

2019) while 50-80% of workers worldwide have ever

experience Low Back Pain and result in decreased

human productivity (Tanderi, 2017). The prevalence

of Non-Specific Low Back Pain cases was found as

many as 500,000 and in 5 years the incidence rate

increased by 59% with the number of sufferers being

aged 18-56 years by 85%.

Date from the hospital. Grandmed, Lubuk Pakam

showed that cases of Non-Specific Low Back Pain

have increased from year to year. In 2017 a total of

3,567 people or 33% of the total while in 2018

increased by about 35%, and in January to March

2019 the number of visits was 305 people with an

average of 100 people every month, Poly

Physiotherapy Hospital Grandmed Medistra, 2019.

To overcome the problem of cases of non-specific

low back pain, non-specific low back pain complaints

are by providing Mc.kenzie exercise and

KinessioTaping intervention. Treatment performed

by physiotherapists in Non-Specific Low Back Pain

complaints includes mobilization, exercise therapy

(Mc kenzie) joint and muscle manipulation

(stretching and strengthening), diathermy (SWD or

MWD), TENS, Ultrasound, Traction, and Kinessio

Tapping.

172

Sirait, R., Aldy, R., Jehaman, I., Berampu, S., Ginting, R. and Zannah, M.

Determine the Effect of Kinessio Taping Use after McKenzie Exercise to Decrease the Scale of Back Pain in Low Back Pain Non Speciﬁc Cases.

DOI: 10.5220/0009468701720179

In Proceedings of the International Conference on Health Informatics and Medical Application Technology (ICHIMAT 2019), pages 172-179

ISBN: 978-989-758-460-2

Another method that can be given to overcome the

problem of muscle tension in patients with acute-

stage Low Back Pain Specific acute stage can be done

with Mc.Kenzi and Kinessio Taping exercises that

combine the back extension movement and

Tapping.Therefore researchers want to prove whether

there is an Effect of Giving Kinessio Taping After Mc

Kenzie Exercise Against Lower Lower Back Pain in

Patients with Non-Specific Low Back Pain.

2 RESEARCH METHODS

This research was conducted at the Grandmed Poly

Physiotherapy Hospital, located at Jl Raya Medan,

No.66, Lubuk Pakam. The research was conducted in

February-July 2019.

This type of research is a quasi-experimental

research design with pre-test and post-test two

groups. With a pre-test and post-test group control

approach. Parallel design is used to compare between

two independent group (group compersion) groups to

compare between two intervention groups (Sugiono,

2016). respondents were divided into two groups and

the control group was only done by Mc Kenzie

Exercise in patients with Non-Specific Low Back

Pain, and the intervention group was the group that

used Kinessio Taping after Mc Kenzie Exercise in

patients with Non-Specific Low Back Pain in Figure

Figure 1: Research Implementation Flow.

Pain measurement was performed using Verbal

Anolog Scale (VAS). VAS has been widely used in

diverse adult populations, including those suffering

from rheumatic diseases. VAS is an instrument used

to assess pain intensity using a line 10 cm long

(Figure 1) with a scale reading of 0-10 cm with a

range of meanings: no pain (0.9 cm), mild pain (1-3

cm) moderate pain (3.1 -7 cm), and severe pain (7.1-

8.9 cm). Pain measurement can be done by the

respondent himself. Determination of VAS score is

done by measuring the distance between the end of

the line on the painless line to the point indicated by

the patient (Klimek, Bergmann, Biedermann, et all,

2017).

Pain measurement in this study was carried out

before and after treatment of pain intensity

measurements in both groups in advance was given

an explanation of the handling of Kinessio Taping

and Mc Kenzie Exercise to determine the scale of

pain. Measurement data will be tested by Paired

Sample t-test and independent t-test. The flow of this

research can be seen in Figure 2.

Figure 2: Visual Analogue Scale.

Information:

1-3 : Mild pain

4-6 : Moderate pain

7-9 : Severe pain

1 : heavy pain

2.1 Kinessio Taping

The Kinessio Taping method is a technique

developed by Dr. Kenzo Kaze in Japan in the 1973

era, where this technique uses elastic tape that is

applied directly to the skin. Kinesio taping is a

therapeutic modality that is based on a natural healing

approach with the help of giving elastic plasters

(Fredik, 2016, Ismaningsih, Selviani, I. 2018).

Kinessio taping is an elastic adhesive that can be

pulled with a pull of 130-140 of its actual length,

which aims to facilitate the work of muscles (Soriano

et al, 2013). Kinessio Taping is a modality based on

the body's own healing process, the method in

Kinessio Taping shows its effects through the activity

of the neurological system and the circulatory system.

The basis of this method is the Kinessio Taping

science as a treatment that can be combined with

other treatments. Kinessio Taping functions include

Determine the Effect of Kinessio Taping Use after McKenzie Exercise to Decrease the Scale of Back Pain in Low Back Pain Non Speciﬁc

Cases

173

activation of the endogenous analgesic system,

eliminating disruption to the flow of fluids in the

body, correction of joint problems, reducing pain

through suppression (Kim T, Melita P., 2017). The

flow of this research can be seen in Figure 3.

Figure 3: Kinessio Taping

2.2 Methods Mc Kenzie Exercise

The McKenzie Exercise Method consists of 4

exercises namely the first exercise until the fourth

exercise are extension exercises, the last 2 exercises

are flexion exercises. As an initial application,

training is only given until the fourth exercise.

Exercise I Position the patient facedown with the

head facing one side and the arms at the sides. The

patient is asked to inhale then exhale regularly until

the patient feels relaxed. Hold the position for 2

minutes. The flow of this research can be seen in

Figure 4.

Figure 4: Exercise I.

Exercise II, both position the patient facedown

with the hand position like a push up, then do the

movement pressing the mat / floor with the waist of

the body raised up and elbows bent 90º, try to pelvic

and both legs remain attached to the floor, hold for 5

seconds and do as much 10 times. The flow of this

research can be seen in Figure 5.

Figure 5: Exercise II

Exercise III, position the patient face down, hands

up in a position like push-ups, then hand movements

press the mat / floor until the elbows are in a straight

position and the body is raised upward until the waist

aches, try to pelvic and both legs remain attached to

the mat / floor. Hold it for 5 seconds and do it 10

times. The flow of this research can be seen in Figure

Figure 6: Exercise III

Exercise IV, position the patient upright, legs

slightly open and hands placed on his waist, then bend

his body back as far as the patient can. Hold the

position for 5 seconds and do it 10 times. The flow of

this research can be seen in Figure 7.

Figure 7: Exercise IV

To get optimal results from Mc Kenzie Exercise

therapy there are a number of things that must be

considered, including:

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

174

 The preparation of this exercise starts from the

movements that are easiest for the patient, then is

increased according to the patient's abilities.

 When doing exercises as far as possible straight

crooked movements performed by patients

slowly, rhythmically and in control.

 Each type of movement is done at least 5 (five)

times and the best movements are performed 15

times.

 Exercise in a lying position should be done on the

floor using a rather hard mattress.

 Exercise is done as much as the patient is able, not

to be too tired.

 Must notify the person concerned if the exercise

carried out adds to the pain, even if necessary the

exercise must be stopped (Agung, 2019).

3 RESULTS AND DISCUSSION

3.1 Characteristics of Respondents

Distribution of respondent data In the control group

based on the age of Non-Specific Low Back Pain

patients at most aged 30-40 were 7 people (43.8%)

and in the intervention group were 7 people (43.80%),

ages 41-50 in the group control were 8 people

(50.0%) and in the intervention group were 8 people

(50.0%), while the number of respondents based on

age 51-60 in the control group as many as 1 person

(6.3%) (Table 1).

Table 1: Respondents distribution based on age

characteristics.

Characteristics

Respondents

Control group

Intervention

Group

n % n %

30-40 7 43,8 7 43,8

41-50 8 50,0 8 50,0

51-60 1 6,3 1 6,3

Total 16 100 16 100

It is suspected that with increasing age a person is

more at risk for contracting stiffness in the muscle

area, especially in the muscles in the lumbar region, a

muscle that is often performed in activities for

individuals who sit for long periods of time, bend for

long periods or often bend when working , lifting

heavy objects, standing, sleeping and lying down

badly. Prolonged postural stress causes overstretch of

the ligaments and other soft tissues that maintain the

vertebra. When the joint between the two bones is in

a position that results in overstretch and fatigue in the

soft tissue around the joint, pain often results (Ellen Z

Hilleggas, 2016).

Based on Table 2, the number of respondents

based on male gender in the control group was 10

people (62.5%) and in the intervention group as many

as 11 people (68.8%) while the number of female

respondents in the control group was as many as 6

people (37.5%) and in the intervention group were 5

people (31.3%).

Table 2: Distribution of respondents based on sex

characteristics.

Characteristic

of Responden

Control

Group

Intervention

Group

n % n %

Man 10 62,5 11 68,8

Woman 6 37,5 5 31,3

Total 16 100 16 100

3.2 Average before and after

Administration of Mckenzie Exercise in

Patients with Non-specific Low Back

Pain

Based on data collection conducted at the

physiotherapy clinic of Grandmed Lubuk Pakam

Hospital on Non-Specific Low Back Pain, the results

of data processing before and after the administration

of Mc Kenzie Exercise in this study can be seen in

Table 3 below.

Based on Table 3, it can be seen that there is a

difference between the Mean results before and after

the administration of Mc Kenzie Exercise, namely the

Mean before 6.19 with SD 1.047 and the Mean results

after giving Mc Kenzie Exercise Mean 4.50 with SD

1.033 While the difference differences in the mean

results before and after the administration of Kinessio

Taping after Mc Kenzie exercise, the mean before

6.63 with SD 1.147 and the mean results after giving

Kinessio Taping after Mc Kenzie Exercise 3.94 with

SD 0.929

Table 3. Average before and after administration of Kinesio

taping after Mc Kenzie Exercise

Category`

Kinesio Taping

and Mc Kenzie

Exercise

Mckenzie

Exercise

Mean

Std

Deviation

Mean

Std

Deviation

Before 6,63 1,147 6,19 1,047

After 4,50 1,033 4,50 1,033

Determine the Effect of Kinessio Taping Use after McKenzie Exercise to Decrease the Scale of Back Pain in Low Back Pain Non Speciﬁc

Cases

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3.3 Difference before and after

Administration of Kinesio Taping and

Mckenzie Exercise in Patients with

Non-specific Low Back Pain

Based on the data processing that has been done in

statistical tests using the paried t-test, the results of

the data processing of the mean difference before and

after the administration of Mc Kenzie Exercise can be

seen in Table 4, below. Statistical test results obtained

mean 1.688 with SD 0.602 and p-value α < (0.001

<0.05), it can be concluded that there is a significant

effect between before and after administration of Mc

Kenzie Exercise in patients with Non-Specific

Chronic Low Back Pain.

Table 4. Difference Before and after administration of

Kinesio Taping after Mckenzie Exercise.

Category Mean

Std

Deviation

value

Before

and After

Kenzie

Exercise

1,688

0,602

11,211

0,001

3.4 Difference before and after

Administration of Kinesio Taping

after Mckenzie Exercise in Patients

with Non-specific Low Back Pain

Based on the data processing that has been done in

statistical tests using the paried t-test, the results of

the processing of the difference in data before and

after giving Kinessio Taping after Mc Kenzie

Exercise can be seen in Table 5 below

Statistical test results obtained mean 2.688 with

SD 0.704 and p-value α < (0,000 <0.05), it can be

concluded that there is a significant effect between

before and after administration of Kinessio Taping

after Mc Kenzie Exercise in patients with non-

specific Low Back Pain.

Table 5. Difference before and after administration of

Kinesio taping after Mckenzie Exercise

Category Mean

Std

Deviation

value

Before and

After

Kinessio

Taping After

Mc Kenzie

Exercise

2,688

0,704

15,276

0,000

3.5 Difference in Giving Mckenzie Exercise

and Giving Kinesio Taping after Mc

Kenzie Exercise

Based on data processing that has been done in

statistical tests using the independent t-test, the results

of the data processing difference in Mc Kenzie

Exercise and Kinessio Taping after Mc Kenzie

Exercise can be seen in Table 6 below.

Statistical test results obtained mean 1.688 with

SD 0.602 and p-value α < (0.001<0.05) Mc Kenzie

Exercise, it can be concluded that there is an influence

between before and after administration of Mc Kenzie

Exercise in patients with Non-Specific Low back

pain. Statistical test results obtained mean 2.688 with

SD 0.704 and p-value α < (0,000 <0.05), it can be

concluded that there is a significant effect between

before and after administration of Kinessio Taping

after Mc Kenzie Exercise in patients with Non-

Specific Low Back Pain.

Table 6. Difference in giving Mckenzie Exercise and

Giving Kinesio taping after Mc Kenzie Exercise

Mc Kenzie

Exercise Group

Kinessio Taping

After Mc Kenzie

Exercise

Mean

Difference

Sig (2-

tailed)

1,000 0,000

The conclusion above can be concluded that the

hypothesis of this study is accepted, namely: "There

is an Effect of Giving Kinessio Taping After Mc

Kenzie Exercise Against Lower Lower Back Pain in

Patients with Non-Specific Low Back Pain".

3.6 Effect of before and after Mc Kenzie

Exercise (Control Group) on the Pain

Scale Reduction in Non-specific Low

Back Pain

Based on the results of the study before the Mc Kenzi

Exercise was carried out it was known that the

average pain value of 6.19 with SD 1.047. Whereas

after giving Mc. Kenzie is known to have an average

pain value of 4.50 with an SD of 1.033.

The statistical test results obtained p value α <

(0,000 <0.05), it can be concluded there is the

influence of Mc Kenzie on the pain scale reduction in

cases of non-specific low back pain. The results of

this study are in accordance with research conducted

by Pope, (2014) McKenzi Exercise is an exercise

therapy that uses body movements, especially

towards extensions. Where in the case of non-specific

LBP spasms occur due to suppression of the posterior

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longitudinal ligaments which are very sensitive

because they contain afferent nerves type A δ and C,

so the patient is ill when bending (Mulyaningtyas

Trikusuma Wardani, 2016, Maciej C., Truszczyńska-

Baszak, Kowalczyk, 2018).

Mc Kenzie Exercise Pain Reduction Mechanism

is an exercise therapy that uses body movements,

especially towards extension. Where in the case of

non-specific LBP spasms occur due to suppression of

the posterior longitudinal ligaments which are very

sensitive because they contain afferent nerves type A

δ and C, so the patient is ill when bending

(Mulyaningtyas Trikusuma Wardani, 2016, Basil J.,

MK Franklin S., 2019). By giving Mc Kenzie

Exercise exercises that use body movement towards

extension and the patient's active role will restore

mobility and lumbar function by relieving stress that

will restore the nucleus pulposus back to the anterior,

so that inflammation that occurs in the posterior

longitudinal ligament decreases and pain in the

lumbar will decrease and can provide a sense of

comfort and there is improvement in posture and

eliminate imbalance muscles (Ellen Z Hilleggas,

2016, Vahid M., Mansour S., Amirhossein B., et all,

2017).

The researchers' assumption is that by doing Mc

Kenzie's exercise that uses body movements towards

extension and the patient's active role will restore

lumbar mobility and function by relieving stress that

will return the nucleus pulposus back to the anterior,

so that inflammation in the posterior longitudinal

ligament decreases and pain in the lumbar will

decrease and can provide comfort and there is

improved posture and eliminating muscle imbalance.

3.7 The Influence of before and after

Kinesio Taping and Mc Kenzie Exercise

Intervention Group on Decreasing Pain

Scale in Non-specific Low Back Pain

Based on the results of the study before giving

Kinessio Taping and Mc Kenzie Exercise, the

average pain value was 6.63 with SD 1.147, while

after giving Kinessio Taping and Mc Kenzie Exercise

the average pain value was 3.94 with SD. 0.929.

Statistical test results obtained p value (0.001) <α

(0.05), it can be concluded that there is an influence

before and after administration of Kinessio Taping

and Mc Kenzie Exercise on pain intensity in patients

with Non-Specific Low Back Pain.

Because with the technique of giving Kinessio

Taping it will make the area in the waist refuted and

prevent the onset of low back pain which is closely

related to the way of working, work attitude, and

work position. By paying attention and managing the

causes and triggers, the incidence of work back pain

can be minimized or delayed presence. Several

factors related to lifting and lifting that affect the

onset of work back pain are heavy loads, large loads,

types of loads and so on. One of the tools for handling

low back pain.

The mechanism of the use of pain with the use of

Kinessio Taping self-protective due to work that

prevents injury to muscle tissue while doing

activities. Pain that arises because of the paravertebral

muscle spasm that will suppress the nociceptor nerve

fibers and from there the pain is sent to the Posterior

Horncel (PHC) and sent back to the brain. With

Kinessio Taping, muscle work will be helped so that

spasm in the muscles will be reduced and the pressure

will be reduced so that the pain will also be reduced

(Ellen Z Hilleggas, 2016, Seyda T. C., Derya O. K.,

2019). The researchers' assumption is that the

addition of Kinessio Taping before Mc Kenzie's

intervention can further inhibit or reduce pain, this is

due to a refinement done by Kinessio Taping so that

it is topped and will reduce the emphasis on the

lumbar muscles, therefore it is necessary to use

Kinessio Taping to prevent the occurrence of

Kinessio Taping excessive diototomy.

3.8 Difference in Average Difference before

and after the Administration of the Mc

Kenzie Exercise Intervention with the

Mc Kenzie Exercise and Kinesio Taping

Groups

Test results using independent t-test statistical test

obtained p value α < (0.001 <0.05), so the hypothesis

in this study was accepted, namely: "There is an

Effect of Giving Kinessio Taping after Mc Kenzie

Exercise Against Pain Scale Reduction in low back

pain cases nonspecific in Poly Physiotherapy

Hospital of Granmed Lubuk Pakam ".

The effect produced by the combination of

Kinessio Taping and Mc Kenzie Exercise will be far

more successful compared to therapy that only uses 1

intervention. This is because the process of pain in

non-specific low back pain patients not only comes

from the receptors but because of the bad posture that

occurs in these patients, therefore therapy is needed

to refute or block the muscles around the lumbar in

order to reduce pain (Tanna, Thiyagarajan, Gounde,

2016)

The researchers' assumption is that there are

fundamental differences in the first treatment and the

second treatment, in the first course to reduce tension

in the muscles but cannot refute the muscles around

Determine the Effect of Kinessio Taping Use after McKenzie Exercise to Decrease the Scale of Back Pain in Low Back Pain Non Speciﬁc

Cases

177

the lumbar. While in the second treatment, Kinessio

Taping can intervene in the lumbar so that it cannot

repair bad posture to avoid excessive position.

4 CONCLUSIONS

Based on statistical test results, it can be concluded

that:

 In the control group based on the age of non-

specific low back pain patients at most ages 41-

50 as many as 8 people (50.0%) while in the

intervention group the most were 41-50 aged as

many as 8 people (50.0%). The sex of the

majority of non-specific low back pain patients

is male in the control group (62.5%) while in the

intervention group (68.8%).

 Mean pain intensity in the control group (Mc

Kenzie Exercise): before the mean of 6.19 and

after the mean of 4.50

 Mean pain intensity in the intervention group

(Mc Kenzie Exercise and Kinessio Taping)

before the mean of 6.63 and after the mean of

3.94.

 Difference in mean pain before and after the

control group and intervention group mean

1.045.

 There is an Effect of Giving Kinessio Taping

after Mc Kenzie Exercise on Pain Scale

Reduction in Non-Specific Low Back Pain

Cases in Physiotherapy at Grandmed Lubuk

Pakam Hospital in 2019 (p value = 0.001)

ACKNOWLEDGEMENTS

Thank you sent to:

 To all patients who have agreed to be a research

sample

 Director of the Grandmed Lubuk Pakam

Hospital who has given permission to carry out

this research

 Chancellor of the Medical Institute Medistra

Lubuk Pakam who has provided financial

support and facilities so that research can be

carried out properly and smoothly.

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