Effects of Diaphragmatic Kinesio Taping Combined With Pulmonary Rehabilitation on Diaphragm Muscle Thickness in Intensive Care Patients

Participants allocated to this group will receive a structured pulmonary rehabilitation program combined with diaphragmatic Kinesio taping. Pulmonary rehabilitation will be administered for three consecutive days, and Kinesio tape will be applied to the anterior and posterior aspects of the trunk along the diaphragmatic region and will remain in place for three days.

Participants will receive a structured pulmonary rehabilitation program three times daily for three consecutive days. Each session will last approximately 30-45 minutes and will include in-bed positioning, active-assisted range-of-motion exercises, pursed-lip breathing, chest breathing, diaphragmatic breathing, thoracic expansion exercises, maximal inspiratory breath-holding, breathing control, incentive spirometry, and controlled coughing and huffing techniques. Exercises will be performed for 10 repetitions. Heart rate, respiratory rate, blood pressure, and oxygen saturation will be monitored throughout the sessions. The intervention will be discontinued if clinical instability or predefined safety concerns occur.

Diaphragmatic Kinesio taping will be performed using elastic therapeutic tape (Dr. Flexi) and a ligament correction technique. The tape will be applied to the anterior and posterior aspects of the trunk along the costal margins. Anteriorly, the central portion of the tape will be anchored approximately 2.5 cm below the xiphoid process, while posteriorly, the central portion will be anchored at the T12 vertebral level. The tape will be applied with tension along the costal arches, while the ends will remain tension-free. Participants will be instructed to perform deep inspiration during application. The tape will remain in place for three consecutive days. Skin sensitivity will be assessed before application.

Participants allocated to the control group will receive routine patient education as part of standard hospital care. Education will include information about their medical condition, smoking cessation when applicable, preventive health measures, adequate nutrition, avoidance of physical inactivity, vaccination, and the importance of respiratory exercises. Participants' understanding of the educational content will be evaluated through verbal questions.

Participants allocated to this group will receive the same structured pulmonary rehabilitation program as the experimental group for three consecutive days. No diaphragmatic Kinesio taping will be applied.

Participants will receive a structured pulmonary rehabilitation program three times daily for three consecutive days. Each session will last approximately 30-45 minutes and will include in-bed positioning, active-assisted range-of-motion exercises, pursed-lip breathing, chest breathing, diaphragmatic breathing, thoracic expansion exercises, maximal inspiratory breath-holding, breathing control, incentive spirometry, and controlled coughing and huffing techniques. Exercises will be performed for 10 repetitions. Heart rate, respiratory rate, blood pressure, and oxygen saturation will be monitored throughout the sessions. The intervention will be discontinued if clinical instability or predefined safety concerns occur.

Participants allocated to the control group will receive routine patient education as part of standard hospital care. Education will include information about their medical condition, smoking cessation when applicable, preventive health measures, adequate nutrition, avoidance of physical inactivity, vaccination, and the importance of respiratory exercises. Participants' understanding of the educational content will be evaluated through verbal questions.

Participants allocated to the control group will receive routine patient education as part of standard hospital care. Education will include information about their medical condition, smoking cessation when applicable, preventive health measures, adequate nutrition, avoidance of physical inactivity, vaccination, and the importance of respiratory exercises. Participants' understanding of the educational content will be evaluated through verbal questions.

Participants allocated to the control group will receive routine patient education as part of standard hospital care. Education will include information about their medical condition, smoking cessation when applicable, preventive health measures, adequate nutrition, avoidance of physical inactivity, vaccination, and the importance of respiratory exercises. Participants' understanding of the educational content will be evaluated through verbal questions.

End-inspiratory diaphragm muscle thickness will be measured in millimeters using ultrasonography with a high-frequency linear transducer (4-12 MHz). Measurements will be performed with participants in the supine position. Three consecutive measurements will be obtained at each assessment, and the mean value will be calculated. The change in diaphragm muscle thickness from baseline to Day 3 will be evaluated.

End-expiratory diaphragm muscle thickness will be measured in millimeters using ultrasonography. Three consecutive measurements will be obtained at each assessment, and the mean value will be calculated. Changes in end-expiratory diaphragm muscle thickness between baseline and Day 3 will be evaluated.

Diaphragm thickening fraction will be calculated using the following formula: [(end-inspiratory diaphragm thickness - end-expiratory diaphragm thickness) / end-expiratory diaphragm thickness] × 100. The results will be expressed as percentages. Changes from baseline to Day 3 will be compared between groups.

Diaphragm excursion will be assessed using M-mode ultrasonography with a low-frequency curvilinear transducer (2-5 MHz) positioned below the right costal margin. Diaphragmatic movement during respiration will be recorded, and changes between baseline and Day 3 will be evaluated.

Cough-related quality of life will be evaluated using the Leicester Cough Questionnaire (LCQ), which consists of 19 items covering physical, psychological, and social domains. Total scores range from 3 to 21, with higher scores indicating better cough-related quality of life. Changes in total scores from baseline to Day 3 will be evaluated.

Anxiety symptoms will be assessed using the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A). The subscale consists of seven items, with total scores ranging from 0 to 21. Higher scores indicate greater anxiety symptom severity. Changes from baseline to Day 3 will be evaluated.

Depression symptoms will be assessed using the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). The subscale consists of seven items, with total scores ranging from 0 to 21. Higher scores indicate greater depression symptom severity. Changes from baseline to Day 3 will be evaluated.