Gender Differences in Balance, Lumbar Multifidus Muscle, Pain, and Kinesiophobia in Patients with Lumbar Spinal Stenosis

Abstract

Aim: The aim of this study was to examine balance, lumbar multifidus muscle thickness and cross-sectional area (CSA), pain, disability and kinesiophobia levels, and to compare these parameters in terms of gender in patients with lumbar spinal stenosis (LSS). Material and Methods: This cross-sectional study included 59 patients, 33 (55.9%) female and 26 (44.1%) male, diagnosed with LSS by magnetic resonance imaging (MRI). Low back and leg pains, dynamic and static balances, disability and kinesiophobia levels of patients with LSS were evaluated. Lumbar multifidus muscle thickness and total CSA were obtained from MRI images. Obtained data were compared according to gender. Results: Females had significantly more low back pain than males (p=0.043), in patients with LSS. Additionally, females with LSS had worse dynamic and static balances (p=0.005, and p=0.001, respectively) and higher levels of disability (p=0.001), and kinesiophobia (p=0.001). Females with LSS had less lumbar multifidus muscle thickness and CSA than males on both the right and left sides. Also, right multifidus muscle thickness correlated with both dynamic (r=-0.289; p=0.027) and static (r=0.349; p=0.007) balances. Significant correlations were detected between low back and leg pain with dynamic and static balances, disability, and kinesiophobia in patients with LSS. Conclusion: Females with LSS have higher levels of pain, disability, and kinesiophobia than males. Also, LSS affects females' balance functions more and causes further degeneration of the multifidus muscle. Therefore, gender differences should be examined during the clinical follow-up process in LSS.

Keywords

• Lumbar spinal stenosis
• gender differences
• multifidius
• balance
• pain
• kinesiophobia

Lomber Spinal Stenozlu Hastalarda Denge, Lomber Multifidus Kası, Ağrı ve Kinezyofobide Cinsiyet Farklılıkları

Abstract

Amaç: Bu çalışmanın amacı lomber spinal stenozu (LSS) olan hastalarda denge, lomber multifidus kas kalınlığı ve kesit alanı (cross-sectional area, CSA), ağrı, sakatlık ve kinezyofobi düzeylerini incelemek ve bu parametreleri cinsiyet açısından karşılaştırmaktır. Gereç ve Yöntemler: Bu kesitsel çalışmaya manyetik rezonans görüntüleme (MRG) ile LSS tanısı konulan 33 (%55,9) kadın ve 26 (%44,1) erkek olmak üzere 59 hasta dahil edildi. LSS'li hastaların bel ve bacak ağrıları, dinamik ve statik dengeleri, özürlülük ve kinezyofobi düzeyleri değerlendirildi. MRG görüntülerinden lomber multifidus kas kalınlığı ve toplam CSA elde edildi. Elde edilen veriler cinsiyete göre karşılaştırıldı. Bulgular: LSS'li hastalarda, kadınlar erkeklere göre anlamlı olarak daha fazla bel ağrısına sahipti (p=0,043). Ayrıca, LSS'li kadınlarda daha kötü dinamik ve statik denge (sırasıyla p=0,005 ve p=0,001), daha yüksek düzeyde özürlülük (p=0,001) ve kinezyofobi (p=0,001) vardı. LSS'li kadınlarda hem sağ hem de sol tarafta lomber multifidus kas kalınlığı ve CSA erkeklere göre daha azdı. Ayrıca sağ multifidus kas kalınlığı hem dinamik (r=-0,289; p=0,027) hem de statik (r=0,349; p=0.007) denge ile koreleydi. LSS'li hastalarda bel ve bacak ağrısı ile dinamik ve statik dengeler, özürlülük ve kinezyofobi arasında anlamlı korelasyonlar saptandı. Sonuç: LSS'li kadınlarda erkeklere göre daha yüksek düzeyde ağrı, özürlülük ve kinezyofobi vardır. Ayrıca LSS, kadınların denge fonksiyonlarını daha fazla etkiler ve multifidus kasının daha fazla dejenerasyonuna neden olur. Bu nedenle LSS'de klinik takip sürecinde cinsiyet farklılıkları incelenmelidir.

Keywords

• lomber spinal stenoz
• cinsiyet farklılıkları
• multifidus
• denge
• ağrı
• kinezyofobi

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