Effects of IASTM and Kinesiology Taping on Mechanical Neck Pain in University Students

\*\*Background and Rationale\*\*

Chronic mechanical neck pain is a common musculoskeletal condition among university students, particularly those enrolled in health sciences programs. Prolonged studying, sustained cervical flexion, static postures, extensive use of digital devices, and academic stress may contribute to neck pain and associated functional limitations. Effective, accessible, and non-pharmacological treatment approaches are therefore important for managing neck pain in this population.

Instrument-assisted soft tissue mobilization (IASTM), including the Graston Technique, is a manual therapy approach that uses specially designed instruments to apply controlled mechanical stimulation to soft tissues. Previous studies suggest that IASTM may improve pain intensity, soft tissue mobility, cervical range of motion, and functional outcomes in individuals with mechanical neck pain.

Kinesiology taping is another non-invasive physiotherapy intervention commonly used to support musculoskeletal function and pain management. It may provide sensory feedback, improve movement awareness, and contribute to pain reduction and functional improvement.

Although both interventions have been investigated separately, evidence directly comparing their effects in university students with chronic mechanical neck pain remains limited.

\*\*Study Objective\*\*

The primary objective of this study is to compare the effects of the Graston Technique and kinesiology taping on pain intensity, cervical range of motion, and neck-related disability in university students with chronic mechanical neck pain.

\*\*Study Design\*\*

This study is designed as a three-arm, parallel-group, randomized controlled trial involving 60 university students aged 18-25 years.

Eligible participants will have localized mechanical neck pain lasting at least three months and a baseline pain intensity of at least 3/10 on the Visual Analog Scale.

Participants will be randomly allocated to three groups in a 1:1:1 ratio using block randomization. The randomization sequence will be generated by an independent researcher who is not directly involved in delivering the interventions. Group assignments will be concealed in sequentially numbered, opaque, sealed envelopes until allocation.

\*\*Interventions\*\*

Group A: Graston Technique / IASTM

Participants will receive instrument-assisted soft tissue mobilization twice weekly for 12 weeks. The treatment will target the cervical soft tissues, upper trapezius, and levator scapulae muscles bilaterally. Treatment will be performed using controlled sweeping techniques with tolerable pressure. Participants will also receive standardized postural education and static stretching exercises.

Group B: Kinesiology Taping

Participants will receive kinesiology taping once weekly for 12 weeks. The tape will be applied to the cervical region and associated muscles, including the upper trapezius and/or levator scapulae, according to the treatment protocol. The tape will remain in place for approximately 3-4 days following each application. Participants will also receive standardized postural education and static stretching exercises.

Group C: Control

Participants in the control group will receive standardized postural education and static stretching exercises without Graston Technique or kinesiology taping.

The exercise program provided to all three groups will include cervical retraction, chin-tuck exercises, scapular retraction, and static stretching of the cervical musculature.

\*\*Outcome Assessments\*\*

Clinical outcomes will include pain intensity measured using the Visual Analog Scale (VAS), cervical range of motion measured using a universal goniometer, and neck-related disability assessed using the Neck Disability Index (NDI).

All outcomes will be assessed at three time points:

• Baseline (T0): Before the initiation of the interventions.
• Week 6 (T1): Mid-intervention assessment.
• Week 12 (T2): Post-intervention assessment.

The repeated assessments will allow examination of changes over time and comparisons of treatment effects among the three groups.

\*\*Expected Contribution\*\*

This study will provide comparative evidence regarding the effectiveness of two commonly used non-pharmacological physiotherapy interventions for chronic mechanical neck pain in university students. The findings may contribute to clinical decision-making and the development of accessible physiotherapy management strategies for this population.

Participants in this group will receive instrument-assisted soft tissue mobilization (IASTM) twice weekly for 12 weeks (24 sessions). The intervention will be applied bilaterally to the cervical soft tissues, upper trapezius, and levator scapulae muscles using specially designed instruments and controlled sweeping techniques at a tolerable pressure. Participants will also receive standardized postural education and static stretching exercises, including cervical retraction, chin-tuck exercises, scapular retraction, and stretching of the cervical musculature. Clinical outcomes will be assessed at baseline, week 6, and week 12.

Procedure: Instrument-Assisted Soft Tissue Mobilization (IASTM) · Behavioral: Postural Education and Stretching Exercises

Participants in this group will receive kinesiology taping once weekly for 12 weeks (12 applications). The tape will be applied to the cervical region, upper trapezius, and/or levator scapulae muscles using appropriate tension to provide muscular and postural support. Each application will remain in place for 3 days. Participants will also receive standardized postural education and static stretching exercises, including cervical retraction, chin-tuck exercises, scapular retraction, and stretching of the cervical musculature. Clinical outcomes will be assessed at baseline, week 6, and week 12.

Procedure: Kinesiology Taping · Behavioral: Postural Education and Stretching Exercises

Participants in the control group will receive standardized postural education and static stretching exercises for 12 weeks without instrument-assisted soft tissue mobilization (IASTM) or kinesiology taping. The exercise program will include cervical retraction, chin-tuck exercises, scapular retraction, and stretching of the cervical musculature. Exercises will be performed according to individual tolerance without increasing pain. Clinical outcomes will be assessed at baseline, week 6, and week 12.

Behavioral: Postural Education and Stretching Exercises

Instrument-assisted soft tissue mobilization (IASTM) will be applied twice weekly for 12 weeks, totaling 24 sessions. The intervention will target the cervical soft tissues, upper trapezius, and levator scapulae muscles bilaterally. Participants will be positioned comfortably in a seated position with appropriate head and upper extremity support. Following skin preparation and application of a suitable lubricant, controlled sweeping techniques will be performed along the direction of muscle fibers using specially designed instruments at a tolerable pressure. Treatment intensity will be adjusted according to participant tolerance, and the procedure will be discontinued if adverse reactions occur.

Kinesiology taping will be applied once weekly for 12 weeks, totaling 12 applications. The intervention will target the cervical region, upper trapezius, and/or levator scapulae muscles. The tape will be applied using appropriate tension to provide muscular and postural support. Each application will remain in place for approximately 3-4 days. Before application, the skin will be examined for wounds, irritation, dermatological conditions, or adhesive allergies. Participants will be instructed to remove the tape and inform the researcher if itching, redness, burning, or discomfort occurs.

All participants will receive a standardized postural education and exercise program throughout the 12-week intervention period. Postural education will focus on maintaining appropriate cervical alignment and reducing prolonged static postures during academic activities and digital device use. The exercise program will include cervical retraction, chin-tuck exercises, scapular retraction, and static stretching of the cervical musculature. Exercises will be adjusted according to individual tolerance and performed without increasing pain. The same educational and exercise components will be provided to all three study groups.

Time frame: Baseline, Week 6, and Week 12

Neck pain intensity will be assessed using the Visual Analog Scale (VAS), a 10-cm scale ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity. Changes in VAS scores from baseline to weeks 6 and 12 will be evaluated to compare the effects of instrument-assisted soft tissue mobilization (IASTM), kinesiology taping, and control interventions. The primary comparison will be the change from baseline to week 12.

Time frame: Baseline, Week 6, and Week 12

Neck-related disability will be assessed using the Neck Disability Index (NDI), a 10-item questionnaire evaluating the impact of neck pain on daily activities. Each item is scored from 0 to 5, resulting in a total score ranging from 0 to 50. Higher scores indicate greater disability. Changes in NDI scores from baseline to weeks 6 and 12 will be evaluated to compare functional improvements among the three intervention groups.

Time frame: Baseline, Week 6, and Week 12

Active cervical range of motion will be measured in degrees using a universal goniometer. Cervical flexion, extension, right and left lateral flexion, and right and left rotation will be assessed. Changes in cervical mobility from baseline to weeks 6 and 12 will be evaluated to compare improvements among the three intervention groups. Greater range of motion generally indicates improved cervical mobility.

Time Frame:

Effects of IASTM and Kinesiology Taping on Pain, Cervical Range of Motion, and Disability in University Students With Mechanical Neck Pain: A Randomized Controlled Trial