Effect of exercise and manual therapy or kinesiotaping on sEMG and pain perception in chronic low back pain: a randomized trial.

Chronic low back pain guidelines suggest combining exercise with manual therapy, while cautioning against using kinesiotape on its own. This trial looked at whether adding manual therapy or kinesiotape to a 12-week exercise program made a difference to pain and to the electrical activity of core muscles, the rectus abdominis and multifidus, in people with mild disability from chronic low back pain. All three groups reported meaningful drops in pain over the 12 weeks, but the abstract found no discernible distinction between exercise alone and exercise combined with manual therapy or kinesiotape when it came to pain scores. Interestingly, muscle activity changes in the exercise group's abdominal muscles did not track with pain improvement, suggesting pain relief happened independently of measured muscle changes.

The main limitation is that this is a single trial, and the abstract does not report the number of participants in each arm, so how confident we can be in these comparisons is unclear.

If you live with chronic low back pain, you have probably heard that exercise, manual therapy, and even kinesiotape are all used to help. This study asked whether adding manual therapy or kinesiotape to a 12-week exercise program made pain relief better than exercise on its own, in people with mild back-related disability. Everyone in the trial, regardless of which combination they received, reported feeling less pain by the end.

But there was no clear sign that adding manual therapy or kinesiotape gave extra benefit over exercise alone for how much pain people felt. Interestingly, changes measured in muscle activity in the abdominal area did not line up with how much pain improved, meaning the pain relief did not seem to depend on those muscle changes. This was one trial, and it does not tell us that one approach is better than another for pain reduction.

It also does not tell us whether these results would hold up over a longer period or in people with more severe back pain.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This blinded, three-arm randomised controlled trial (NCT05544890) compared 12 weeks of core stability or motor control exercise combined with either manual therapy or kinesiotape in patients with chronic low back pain and mild disability per the Oswestry Disability Index, using intention-to-treat analysis. Pain was assessed via visual analog scale, and trunk muscle activation via surface electromyography of the rectus abdominis and multifidus. All groups showed significant reductions in perceived pain, but the abstract reports no discernible distinction between exercise alone and exercise plus manual therapy or kinesiotape on VAS outcomes, meaning the added modalities did not demonstrate a clear advantage over exercise in this comparison.

The exercise group showed positive changes in mean and peak EMG values of the right rectus abdominis, but improvements in VAS were observed independently of changes in muscle electrical activity, indicating dissociation between subjective pain relief and measured muscle activation. Exact sample sizes per arm and confidence intervals are not given in the abstract, limiting appraisal of precision and between-group effect magnitude. As a single trial without head-to-head statistical comparison data reported here, these findings should be interpreted as preliminary regarding the added value of manual therapy or kinesiotape over exercise alone.