RAJIV GANDHIUNIVERSITY OF HEALTH SCIENCES,

KARNATAKA, BANGALORE
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION

1. Name of the Candidate Mr. PRAMOD DONGARE

CITY COLLEGE OF
And Address
PHYSIOTHERAPY,
(in block letters): MANGALORE

2. Name of the Institute : CITY COLLEGE OF

PHYSIOTHERAPY, MANGALORE

3. Course of study and subject : MASTER OF PHYSIOTHERAPY (MPT)

2 YEARS DEGREE COURSE

PHYSIOTHERAPY IN COMMUNITY
HEALTH

4. Date of Admission to Course: 25 JAN 2023

5. Title of the topic: TO COMPARE EFFECTIVINESS OF

DRY NEEDLING VERSUS
KINESIOTAPING IN COMBINATION
OF TRADITIONAL PHYSIOTHERAPY
PROTOCOL IN PATIENTS WITH
CHRONIC LOW BACK PAIN AMONG 5
TO 6 HOURS OF DESK JOB WORKERS
6. Brief Resume of the Intended Work:

6.1) Introduction and need of the study

Chronic low back pain definition:

Low-back pain is a prevalent global health issue and a significant contributor to work-related
disability, impacting both employee productivity and healthcare expenses. A considerable
proportion, ranging from 60% to 80%, of adults encounter low-back pain at various stages of
their lives1,2,3]. The majority of individuals suffering from this condition attribute it to
mechanical factors. Among the various factors, a herniated lumbar disc stands out as one of the
primary culprits behind chronic low-back pain.

Chronic low-back pain is defined as lasting more than 3 months and is often associated with pain,
muscle spasms, and strength loss. This condition not only leads to social, financial, and health
issues but also involves various psychosocial factors that contribute to its chronicity4,5].
Psychological aspects, including depression and fear avoidance, can exacerbate the pain and
increase the risk of mental disorders6]. Individual beliefs and behaviors related to pain also play
a significant role in the development and persistence of low-back pain7].

Dry needling :

The dry needling technique, pioneered by Gunn, is a widely utilized method for treating chronic
pain10]. This approach, when administered to trigger points, has the potential to reduce both the
quantity and sensitivity of trigger points linked to pain. As noted by Dommerholt11], dry
needling produces a range of effects such as an immediate decrease in local, referred, and
widespread pain, enhancement in joint flexibility and muscle activation, and rapid normalization
of active myofascial trigger points. A Cochrane review has indicated that dry needling could
serve as a valuable complement to other treatments for chronic low-back pain12]. Consequently,
targeting trigger points with dry needling in individuals suffering from chronic low-back pain
may lead to a significant reduction in sensitivity to low back pain13].

Kinesiotaping :

Kinesio Tape (KT) is a newly introduced therapeutic tool that has gained significant
popularity in prevention and rehabilitation protocols. Kinesio Taping (KT) is one of the various
treatment approaches suggested for TPs, providing a non-invasive, painless, and efficient method
with minimal side effects. Its extensive utilization as an effective therapeutic tool in a range of
prevention and rehabilitation protocols has made it highly valuable14].

Kinesio Taping, a popular intervention in recent years, involves the use of elastic
bandages. Despite its widespread use in clinical practice, there is insufficient evidence to support
its effectiveness. However, it is important to note that these conclusions are drawn from a limited
number of studies with low statistical power. As a result, there are still uncertainties regarding
the efficacy of Kinesio Taping as an adjunct treatment to established interventions like
conventional physiotherapy. To address these concerns, a comprehensive and high-quality
randomized controlled trial is needed to evaluate its true potential.

Clinical practice guidelines indicate that there are numerous interventions accessible for
managing individuals with chronic low back pain. However, the majority of these interventions
only have a limited impact on alleviating pain and reducing disability15].

Managing CLBP can be quite challenging, despite the numerous treatment options available.
Physiotherapy is a recommended treatment for CLBP, along with complementary medicines like
dry needling, kinesiotaping, and yoga[16]. Traditional physiotherapy treatments often include hot
packs, TENS, ultrasound therapy, and a home exercise program[17]. Some studies have
suggested combining physiotherapy with dry needling and kinesiotaping, but there is a lack of
research comparing the effects of these two methods when combined with physiotherapy. This
randomized clinical trial aims to address this gap by comparing the effects of dry needling and
kinesiotaping in combination with physiotherapy for patients with CLBP.
HYPOTHESIS

ALTERNATIVEHYPOTHESIS (H0):
There will be signicant difference between effect of kinesiotaping and dry needling when
combine with physiotherapy treatment in managing patients with chronic low back pain

NULL HYPOTHESIS (H1):

There will be no signicant difference between effect of kinesiotaping and dry needling when
combine with physiotherapy treatment in managing patients with chronic low back pain

o REVIEW OF LITERATURE

Prodhania MS, Ahsan GU, and Ali M. conducted a research study focusing on the
effectiveness of physiotherapy combined with dry needling in patients suffering from chronic
low back pain. The study, a two-armed single-center randomized controlled clinical trial,
involved participants who were randomly assigned to receive either a combination therapy of
standard physiotherapy and dry needling or solely standard physiotherapy. Eligible individuals,
aged 18 years and older, had been experiencing low back pain for a minimum of three months.
The results of the study indicated that the combined therapy was a more effective management
strategy for chronic low back pain compared to standard physiotherapy alone. This finding offers
plausible evidence supporting the use of combined therapy as an effective treatment option for
managing chronic low back pain[16].

Tüzün EH, Gıldır S, Angın E, Tecer BH, Dana KÖ, and Malkoç M conducted a study to
compare the effectiveness of dry needling and a classical physiotherapy program in patients
suffering from chronic low back pain caused by lumbar disc hernia. The study, which was a
single-blind, randomized control trial, involved the random allocation of 34 participants. The
findings of the study indicated that dry needling can be an effective treatment for reducing pain,
the number of trigger points, pain sensitivity, and fear of movement in patients with chronic low
back pain caused by lumbar disc hernia (PMID: 28931976).[17]

In a study published in the Annals of Physical and Rehabilitation Medicine (Volume 57,
Supplement 1, May 2014), B. Yavuz Keles, E. Yilmaz Yalcinkaya, B. Gunduz, A. Bardak, and
B. Erhan conducted a randomized controlled double study to investigate the effects of
kinesiotaping in patients with chronic lumbar disc herniation. The study focused on individuals
between the ages of 25 and 45 years old. The kinesiotaping intervention was administered three
times, once per week. The results of the study indicate that kinesio taping is effective in
improving functional outcomes, reducing pain, and decreasing the need for analgesic medication
in patients with chronic low back pain and disc herniation.[18]

Ogunniran, Akodu, and Odebiyi, conducted a randomized control trial to investigate the
impact of kinesiology taping and core stability exercise on various clinical variables in
individuals suffering from non-specific chronic low back pain. The study focused on pain
intensity, lumbar range of motion, functional disability, sleep disturbance, and kinesiophobia in
patients with NSCLBP. Thirty-five participants were divided into three groups, and the findings
indicated a decrease in pain intensity, enhanced functional ability, improved psychological well-
being, and increased lumbar range of motion as a result of the interventions.[19]

Joanna Rajfur, Katarzyna Rajfur, Łukasz Kosowski, Karolina Walewicz, Robert Dymarek,
Kuba Ptaszkowski, and Jakub Taradaj conducted a study on the effect of dry needling in patients
with chronic low back pain. This study was a randomized control single-blinded study and
included a total of 40 patients who were divided into two groups: experimental and control. The
experimental group received dry needling sessions twice a week for four weeks, following the
five regulatory system (FRS) concept. On the other hand, the control group received sham
therapy using placebo needles. The subjective pain levels were measured using the visual
analogue scale (VAS), while the functional efficiency was assessed using the Oswestry Disability
Index (ODI). The findings of this study suggest that the dry needling program, based on the FRS
concept, along with an added exercise program, effectively reduces pain and improves functional
 efficiency.[20]

o OBJECTIVES OF STUDY

 To evaluate difference between effectiveness between dry needling versus kinesio taping
on patients with low back pain with physiotherapy treatment
 To evaluate evaluate pain reduction level using VAS scale using dry needling and
kinesio-taping in patients with low back pain

7. MATERIALS AND METHODS:

1. Consent form.

2. Data collection sheet.

3. Pen or pencil.

4. Visual analogue scale

5. Dry needles

6. Kinesio-tape

STUDY DESIGN:
Randomized – control study

7.1 SOURCE OF DATA:

 Patients with low back pain who are doing desk job in bank or offices
SAMPLE SIZE:
40

7.2 METHOD OF COLLECTION OF DATA

SAMPLING TECHNIQUE: Convinient Sampling Method.

INCLUSION CRITERIA:
1. Age: 18 – 55 years
2. Gender: Males and females.
3. subjects – who are at desk job in banks , offices schools and experiencing low back pain with
or without leg pain and understand the intervention

EXCLUSION CRITERIA:
1. Participants at present unemployed or recently retired
2. Participants who have fear to needles and refusing to give consent
3. Female participants with recent history of pregnancy in last 6 months

TECHNIQUE OF APPLICATION:

Methodology:

Prior to starting the procedure informed consent will be obtained from participants of the study
and detailed explanation about study and procedure will given to the participants.
The study will involve individuals who are part of the workforce and will be assessed based
on specific criteria for inclusion and exclusion. Those eligible for the study are patients seeking
treatment for low back pain and who are currently employed. Prior to any intervention,
participants will undergo a diagnostic interview administered by a qualified physiotherapist. If
deemed necessary, radiological and pathological tests will be carried out to assess the patient's
condition. Patients will be required to provide written informed consent before proceeding with
any treatment. Ensuring that patients are covered by insurance guarantees that they receive
optimal care for their condition.

STUDY DURATION:

 Approximately 1year.

OUTCOME MEASURES:
1. difference of pain reduction using two different techniques for treatment of low back pain

STATISTICAL ANALYSIS:

 The study will utilize using arithmetic mean and standard deviation to describe
continuous variables and frequency
 Sample t test will used for two group comparison
 Data will be analysed either IBM SPSS software or Microsoft excel

RESEARCH QUESTION:
Is there a notable distinction in the efficacy of two treatment alternatives, namely dry
needling and Kinesio taping with physiotherapy, for patients suffering from low back pain?
 7.3 Does the study require any investigations or interventions to be conducted
on Patients or other humans or animals? If so, please describe briefly.
yes

7.4 Has ethical clearance been obtained from your institutions in case of

Yes

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18. B. Yavuz Keles, E. Yilmaz Yalcinkaya, B. Gunduz, A. Bardak, B. Erhan Effect of

kinesiotaping in patients with chronic lumbar disc herniation: Randomized-
controlled, double-blind study
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20.Rajfur J, Rajfur K, Kosowski Ł, Walewicz K, Dymarek R, Ptaszkowski K, Taradaj J. The

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