Comments on “Demonstration of kinesio taping effect by ultrasonography in neck pain”

Dear Editor,

Ceylan et al.¹ showed that the Visual Analog Scale (VAS) and Neck Disability Index (NDI) scores in the kinesio taping group were statistically significantly improved when compared to the exercise group (p<0.05). According to the authors, “the combination of kinesio taping and exercise therapy was effective in reducing nonspecific neck pain and neck disability”. Unfortunately, the authors’ conclusion is different from the results presented. By the way, they themselves recognized that “in this study, there was no group that did not receive treatment to show the true effect of the kinesio taping” (p. 1456). That is, it was not possible to know if kinesio taping helped to reduce pain and disability.

Besides, the study did not present the minimal clinically important change (MCIC) of the disability and the pain for patients with neck pain. We know that comparisons of outcomes (e.g., pain and disability) must consider the MCIC of the differences because the p-value only shows statistical significance, whose interpretation translates just a hypothesis test governed by a probability of previously defined error (α)². Most persons interpret p<0.05 to mean that the probability that chance is responsible for the finding is less than 5% and that the probability that the finding is a true finding is more than 95%. Both these interpretations are incorrect; unfortunately, they are widely prevalent because they are an easy way to explain and understand a slightly tricky concept³.

The MCIC for the NDI (scale range, 0–50) is 10.5 points, and for the pain on the Numerical Pain Rating Scale (scale range, 0–10) it is 4.3 points⁴. Regarding disability, the kinesio taping did not show MCIC. Regarding pain, the authors used an instrument (VAS) that does not have an established MCIC for patients with neck pain. In addition, they did not present raw mean difference ($\Delta ={\overline{\text{X}}}^1-{\overline{\text{X}}}^2$) or assess the effect size (Cohen's d=[M1–M2]/S_pooled) of the comparisons between the groups.

As such, the new conclusion is that kinesio taping added to an exercise program for patients with neck pain is not superior to the same exercise program without the addition of kinesio taping (i.e., kinesio taping seems to be ineffective).

• Funding: This study was partially supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES – report number 001). However, the funding source had no involvement in the study design, collection, analysis, interpretation of data, writing of the report, and in the decision to submit the article for publication.

REFERENCES

• ¹
  Ceylan CM, Korkmaz MD, Corum M, Kesiktas FN. Demonstration of kinesio taping effect by ultrasonography in neck pain. Rev Assoc Med Bras (1992). 2022;68(10):1452-7. https://doi.org/10.1590/1806-9282.20220668
  » https://doi.org/10.1590/1806-9282.20220668
• ²
  Pontes-Silva A. Statistical significance does not show clinical relevance: we need to go beyond the p-value. J Clin Exp Hepatol. 2022;12(5):1402. https://doi.org/10.1016/j.jceh.2022.04.017
  » https://doi.org/10.1016/j.jceh.2022.04.017
• ³
  Andrade C. The p value and statistical significance: misunderstandings, explanations, challenges, and alternatives. Indian J Psychol Med. 2019;41(3):210-5. https://doi.org/10.4103/IJPSYM.IJPSYM_193_19
  » https://doi.org/10.4103/IJPSYM.IJPSYM_193_19
• ⁴
  Pool JJ, Ostelo RW, Hoving JL, Bouter LM, Vet HC. Minimal clinically important change of the neck disability index and the numerical rating scale for patients with neck pain. spine (Phila Pa 1976). 2007;32(26):3047-51. https://doi.org/10.1097/BRS.0b013e31815cf75b
  » https://doi.org/10.1097/BRS.0b013e31815cf75b

Publication Dates

• Publication in this collection
  15 May 2023
• Date of issue
  2023

History

• Received
  28 Oct 2022
• Accepted
  22 Jan 2023