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

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.