Influence of patient-reported outcomes on the effect of exercise therapy, manual therapy, and kinesiotaping in chronic low back pain: secondary statistical analysis

To evaluate the relationship between pain catastrophizing, treatment modality, pain intensity, and functional disability in patients with chronic lower back pain, while also accounting for the effects of kinesiophobia and self-efficacy using generalized linear mixed models. Secondary analysis of a randomized controlled trial. Outpatient clinical setting. Forty-eight adults with chronic low back pain participated in the study. Participants were randomized into three intervention groups receiving therapeutic exercise (ET) either alone, combined with manual therapy (ET_{manualtherapy}), or with kinesiotape (ET_kinesiotape). Each group underwent two sessions per week for 12 weeks. Disability, pain intensity, kinesiophobia, pain catastrophizing, and self-efficacy were assessed at baseline, 3, 6, and 12 weeks. Generalized linear mixed models revealed a significant reduction in pain over time in all intervention groups (p < 0.001). A significant interaction was identified between the treatment group and catastrophizing levels (p = 0.023), with the Kinesiotape group being the only one showing increased pain scores associated with higher PCS levels. Regarding disability, significant effects were found for catastrophizing (p = 0.015), kinesiophobia (p < 0.001), and self-efficacy (p = 0.008), as well as a significant interaction between the group and self-efficacy (p = 0.003). In the groups without kinesiotaping, lower self-efficacy was associated with increased disability; however, this pattern was not observed in the kinesiotape group. The study found that pain and disability improved over time in all the intervention groups. However, psychological factors influenced outcomes differently depending on the treatment, with catastrophizing increasing pain only in the kinesiotape group. Thus, kinesiotaping may offer a protective effect by modulating psychological influences in chronic lower back pain.Trial registration NCT05544890.