Cardiovascular responses to McKenzie lumbar spine exercises in hypertensive individuals

Low back pain (LBP) is one of the most common health problems in the society. Repetitive lumbar spine exercises which are recommended by McKenzie such as flexion and extension exercises in lying (FIL and EIL) and flexion and extension exercises in standing (FIS and EIS), have been used in the assessment and management of low back pain since 20 years. Studies are done in normal individuals to see the cardiovascular changes after repetitive McKenzie exercises. So, there is a need to study the effect of these exercises on cardiovascular system in hypertensives, who are at risk to develop cardiovascular complications. Therefore, this study was undertaken to examine cardiovascular effects of McKenzie exercises in hypertensive individuals.

1. To measure the pattern of HR, SBP and RPP during flexion McKenzie lumbar spine exercises in hypertensive individuals.

2. To measure the pattern of HR, SBP and RPP during extension McKenzie lumbar spine exercises in hypertensive individuals.

3. To compare the changes in HR, SBP and RPP between flexion and extension McKenzie lumbar spine exercises in hypertensive individuals.

A convenience sample of 60 hypertensive individuals between the age group 30 to 60 years was recruited from the

M. S. Ramaiah teaching hospital, Bangalore. The subjects were administered flexion in lying (FIL), extension in lying (EIL), flexion in standing (FIS) and extension in standing (EIS) with a wash out period of 30 minutes between each exercise. Cross over trial was followed. Subjects performed 10 repetitions of assigned exercises. Blood pressure, Heart rate and rate pressure product were recorded before and after each set of repetition.

Paired t test was used to compare the amount of change in heart rate, systolic blood pressure and rate pressure product between resting and FIL, EIL, FIS and EIS exercises. For comparison of FIL with EIL and FIS with EIS, Paired t-test was used.Data analysis have shown that there is a significant change in blood pressure, heart rate and rate pressure product after 10 repetition of FIL, EIL, FIS and EIS exercises when compared with resting. Comparing FIL with EIL exercise and FIS with EIS showed a significant change in BP, HR and RPP. The effect size of flexion exercise showed more change in SBP, HR and RPP than Extension exercises.

In hypertensive individuals, McKenzie flexion exercises put a greater stress on the cardiovascular system than the extension exercises. Therefore, in such individuals, flexion exercises should be given under close monitoring.