EFFECTS OF McKENZIE AND LUMBAR STABILISATION PROTOCOLS ON SEXUAL DYSFUNCTION IN PATIENTS WITH CHRONIC MECHANICAL LOW BACK PAIN

Abstract

Chronic Mechanical Low Back Pain (CMLBP) has been associated with sexual dysfunction (SD). This problem is often not included in the management of individuals with CMLBP. McKenzie and Lumbar stabilisation are well established protocols for managing LBP. However, effects on SD have not been well elucidated. This study was designed to investigate the comparative effects of McKenzie and Lumbar stabilisation protocols on SD in patients with CMLBP. The quasi-experimental study involved 61 (males=23, females=38) individuals with CMLBP and associated SD consecutively recruited from the orthopaedic and general outpatient clinics. University of Ilorin Teaching Hospital. Participants were randomly assigned to either McKenzie Protocol Group (MPG; males=11; females=20) or Lumbar Stabilisation Protocol Group (LSPG; males=12; females=18). The MPG received McKenzie exercises (extension in prone lying, standing and side gliding exercises). The LSPG received lumbar stabilisation exercises (isometric co-contraction in prone lying, crook lying, kneeling, sitting positions, closed and open chain kinetic exercises). Both groups received treatment twice weekly for eight consecutive weeks. Sexual function questionnaire was used to assess sexual variables in females; (Sexual Desire female [SDf], Lubrication, Orgasm, Sexual Satisfaction [SSf] and SD Total female [SDTf]) and males; (Sexual Desire ma1e [SDm], Erectile Dysfunction [ED], Ejaculation [Ej], Sexual Satisfaction [SSm] and SD Total male [SDTm]. Participants were assessed at baseline, 4th and 8th week of the study. Reduction from baseline scores signifies improvement in sexual dysfunction. Data were analysed using descriptive statistics and Student t - test at ex. 0.05. The ages of MPG (49.3±12.8 years) and LSPG (52.3± 10.5 years) were comparable. At baseline, sexual variables were comparable in MPG and LSPG. In Females SDf (4.30±0.7 vs 4.5±0.8); SSf (7.9±1.6 vs 8.12±1.3); Lubrication (9.3±2.2 vs 9.7±2.7); Orgasm (11.6±2.4 vs 11.8±2.1); SDTf (33.1±5.6 vs 34.1± 5.6); and for Males: SDm (3.6±1.3 vs 4.08±0.8); SSm (7.3±1.7 VS 7.46±1.3); ED (7.2±1.2 VS 7.5±2.2); Ej (7.7±2.2 VS 6.7±2.4); SDTm (25.7±3.9 VS 26.8±6.0) for MPG and LSPG respectively. At week four sexual variables were comparable in MPG and LSPG respectively: for Females SDf (3.7±0.8 vs 3.3±1.0); SSf (7.3±1.9 vs 8.4±7.0); Lubrication (8.0±2.2 vs 7.00±2.1); Orgasm (1.4±1.7 vs 10.1±1.8); SDTf (29.4±5.3 vs 28.8±9.0); for Males: SDm (2.9±1.1 vs 3.2± 1.0); SSm (6.0± 1.6 vs 5.6± 1.1); ED (6.1 ±1.0 vs 5.8±1.7; Ej (7.3±2.2 vs 6.0± 1.3) for MPG and LSPG. At week 8, LSPG had significant greater reduction in sexual dysfunction than MPG in SDf and SSf in females: SDf (3.4±0.8 vs 2.3± 1.2); SSf (6.2± 1.5 vs 5.1 ±1.2) respectively. However, MPG and LSPG had comparable effects on Lubrication; Orgasm and SDTf at week eight: Lubrication (6.7± 1.5 vs 6.3±2.0); Orgasm (9.6± 1.5 vs 9.0± 1.8) and SDTf (25.9±4.3 vs 22.8±5.8) for females. In Males, LSPG had a significant greater reduction in all the sexual variables than MPG at week 8, SDm (2.90± 1.0 vs 2.2±0.7); SSm (5.9±1.1 vs 4.3±0.8); ED (6. 1±1.2 vs 4.6± 1.1); Ej (7.3±1.9 vs 5.0±1.1); and SDTm (22.2±3.5 vs 15.9±3.5) respectively. This study observed that Lumbar stabilisation protocol resulted in greater improvement than McKenzie protocol in sexual dysfunction, sexual desire, sexual satisfaction and erectile dysfunction in patients with chronic mechanical low back pain.