This was a pre-test, post-test control group design with 30 subjects randomly selected and divided into two groups, an experimental group (Group A) and a control group (Group B) with 15 subjects in each. The study was carried out in Sardar Bhagwan Singh PG Institute of Biomedical Sciences, Dehradun, from November 2014 to April 2015. Randomisation was done using lottery method and ethical approval was taken from the Institutional Ethical Review Committee. The total duration of the study was one week and prior to the study, the subjects signed the informed consent form to approve their voluntary participation.

Inclusion criteria: All the subjects between 30-50 years of age and presenting with main complaint of neck pain were included in the study.

Exclusion criteria: Subjects with any inflammatory, infective or neoplastic pathology or with history of recent trauma, vertebrobasilar insufficiency or congenital anomalies were excluded from the study. Patients were prescribed medications in case of severe pain and they were asked to report to the hospital on that day itself and then those patients were excluded.

Sensorimotor functions were measured by measuring CJPE and cervical joint range of motion. Disability was measured by NDI. Experimental group received KT for 1 week whereas control group received Sham tape for 1 week. Readings and measurements were taken on the first day before the intervention and 1 weeks after the intervention for CJPE, range of motion and neck disability using an inclinometer instrument, universal goniometer and NDI questionnaire, respectively [14].

In supine position, a magnetic inclinometer affixed to the patient’s forehead such, that the centre of the inclinometer was in alignment with the tip of the nose [Table/Fig-1a] [15]. All the patients were instructed to close their eyes, nod a few times and then return their head to a comfortable resting position. They were allowed to choose any position for ease of their head. This became the neutral head position. Their head was then positioned at 30° of rotation and then returned to 0° with eyes closed [Table/Fig-1b]. The patient was then asked to reproduce the angle three times with the eyes closed within a 60 seconds period. Three angles were recorded for right and left side rotation separately. The absolute difference in the target angle was calculated and used for statistical analysis [16].

[Table/Fig-1]:

a) Neutral Head Position for CJPE; b) Observed Target Head Position for CJPE; c) Measurement of cervical range of motion; d) Application of kinesio Tapeover upper trapezius muscle.

The patient was positioned in the seated position looking directly forward. The axis of a long arm goniometer centered over the apex of the cranium [Table/Fig-1c]. The inactive arm of the goniometer was associated with the acromion process and the transportable arm bisecting the patient’s nose. The patient was asked to turn around toward each side as far as achievable. The amount of motion in degrees recorded along with the most appropriate descriptor [17,18].

The NDI is a widely used survey for evaluation of neck disability. The test-retest reliability (ICC) of the questionnaire is 0.94-0.99 [19]. NDI scores vary from zero (most desirable state of health) to 50 (least desirable state of health). Each of the 10 items is scored from 0-5. The maximum score is therefore 50. The subject was asked to tick or circle the one choice from the given sections, which most closely describe their problem [20].

The subject was asked to sit comfortably on a chair. The part to be treated was exposed, i.e., the upper Trapezius, and Serratus anterior. The KT applied to the patient in the form of “I-strap” over the upper Trapezius for inhibition [Table/Fig-1d]. The tape was applied in the direction from insertion to origin, and Serratus anterior of the same side was for facilitation, but the direction from origin to insertion [21].

The subject was asked to sit comfortably on a chair. The part to be treated was exposed for upper Trapezius, and Serratus anterior muscle. The KT was applied to the patient using sham maneuver, i.e., there was no direction of application of KT.

The data were analysed using SPSS Software Version 17.0. The paired t-test was used to compare the effects of training within the group A and B. The unpaired t-test was used for comparing the effect of proprioception, CROM and NDI in between the group A and B. Level of significance was set at 95%. A p-value less than 0.05 was considered statistically significant.

The mean age of the population in group A and B was 35.93±10.89 and 26.26±6.50 years, respectively. There were 15 participants in each group and all were males. Unpaired t-test was performed between group A and B. The results showed significant difference (p<0.05) at week one (post intervention) of proprioception and NDI variables whereas CROM was non significant [Table/Fig-2].

Paired t-test was used within group A to compare the pre and post values for proprioception, CROM, NDI and the results were found to be significant [Table/Fig-3].

Paired t-test was used within Group B to compare the pre and post values for proprioception, CROM, NDI and the results were found to be significant for CROM but were non significant for proprioception and NDI [Table/Fig-4].

In present study, no patients had reported severe pain and nobody was required to take medications.

The study clearly demonstrated a significant improvement in CJPE, CROM and NDI within group A [Table/Fig-3] (p<0.05), whereas significant improvement was shown in CROM for group B [Table/Fig-4]. While comparing both the groups significant improvement in proprioception and NDI were shown but not in CROM [Table/Fig-2].

Previous studies have suggested that KT enhances proprioceptive afferent feedback thus enhances the proprioception and supports the present study [3,22,23]. It is believed that KT effects on pain scores are related to produce benefits such as muscle facilitation or inhibition, joint realignment, as well as increasing proprioception by stimulating skin mechanoceptors which may contribute to proprioception improvement [6]. Some other studies demonstrated that an application of KT showed a reduction in neck pain and disability and changes in active CROM over a 7-Day period [20]. The present study showed a significant improvement in CROM within the group A and group B. KT has improved CROM by reducing the tone of the muscles, which may have increased due to sustained contraction of the muscles for long hours. KT application provides positional stimulus through the skin, which improves kinesthetic awareness of neck position, holding the neck in normal posture without putting tension on muscles and tissues thus increase ROM [24].

Another component of the present study was disability, which showed significant differences within the group. Present study has demonstrated that an application of KT showed a reduction in disability over a 7-day period. KT applied to the muscles could have caused the stimulation of mechanoreceptors causing an inhibition of transmission of pain impulses via the pain gate theory, thereby improving the NDI scores [21].

In continuation of the study, when comparison was done between groups, the analyses revealed a significant difference in the CJPE, and neck disability post intervention (p>0.05). Since the Sham tape was applied over the skin it would have exerted a pull over of the muscle through the skin. This would have resulted in a decrease in excitability because of inhibitory signal sent from the Golgi Tendon Organ (GTOs) of the same muscle [25]. This tension causes activation of Ib afferent fibers within the GTOs. Afferent fibres send signals to the spinal cord where the stimulus causes the activation of inhibitory interneurons within the spinal cord. These interneurons place an inhibitory stimulus upon the alpha motoneuron, decreasing the nerves excitability and decreasing the muscle efferent motor drive [25,26]. Therefore, the hypertonic muscle would have been inhibited leading an improvement in the faulty muscle mechanics producing an equally significant improvement in the results with the sham tape.

On the other hand, Kaya E et al., compared the effects of Kinesiotaping against traditional physical therapy modalities in patients with shoulder impingement syndrome for two weeks [27]. They found significant decrease in pain intensity and disability scores of arm, shoulder and hand scale in the kinesiotaping group in comparison with the other group. Another study by Hernández S et al., observed relief in pain after application of KT along with cervical thrust manipulation [20].

In this study, minor adverse events that resolved within 24 hours were observed in patients. After that the study investigated the short-term effects (7 days) of KT application. Hence, cannot predict the long-term effects of the procedure. In addition, therapists usually use a multimodal approach for the management of patients with neck pain and do not solely use KT as an isolated intervention. We suggest that future studies investigate whether the inclusion of either procedure may enhance the outcomes when added to interventions already proven effective, such as active exercises and stretching exercises.

The study concludes that there was a significant effect of KT on the improvement of CJPE and neck disability in patients with neck pain. The study can be conducted on various other muscles which are likely to get weak and tight. The study can be carried out for female population also. Further studies may explore for more specific neck pain conditions, longer follow-up periods should be implemented in future research.