Open Journal of Urology, 2013, 3, 261-268
http://dx.doi.org/10.4236/oju.2013.36049 Published Online October 2013 (http://www.scirp.org/journal/oju)
Psycho-Physiological Combined Therapy
on the Sexual Desire*
Roohallah Bay1#, Shaiful Bahari Ismail2, Fatemeh Bay3
1Sexual and Family Therapy Group, Departmen t of Family Medicine, School of Medical Sciences,
Universiti Sains Malaysia (USM), Kelantan, Malaysia
2Department of Family Medicine, Uni ve r si ti Sains Malaysia (USM), Kelantan, Malaysia
3Department of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
Email: #ir_psychology@yahoo.com
Received August 7, 2013; revised September 7, 2013; accepted September 15, 2013
Copyright © 2013 Roohallah Bay et al. This is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Objective: Hypoactive Sexual Desire is characterized as a lack or absence of sexual fantasies and desire for sexual ac-
tivity. The current study ex amines the effects of psycho- physiological th erapy (stretch therapy combined with breath ing
exercise) on the sexual desire among heterosexual men. Methods: We used “convenience sampling” for this research;
80 people were recruited. For collection of data, we used an identical quasi-experimental design called “nonequivalent
control group.” Ther apy sessions each lasting (20) 90 to 120 min were carried out on 3 alternate days of week. The vo-
lunteers have been selected from heterosexual men with stable relationship, those who married minimum of 6 months,
within 20 to 55 years old, who attended to HUSM Family Clinic. Pre-tests, post-tests, and follow-up tests were con-
ducted in a HUSM clinic (Malaysia). For assessment we used Hurlbert Index of Sexual Desire (HISD). Results: The
psycho-physiological group had better post-test scores compared to the control group. Also follow-up test scores were
marginally better compared to the control group, but this difference did not reach statistical significance. Also age and
education level of participants didn’t have any significant effect on this intervention. Conclusion: Psycho-physiolog ical
combined therapy including stretching and breathing exercise appears to result in better improvement in sexual desire
compared to control group but this improvement is not great. It increases sexual desire of heterosexual men, whenever
people follow the therapy.
Keywords: Combined Therapy; Sex; Desire
1. Introduction
Hypoactive sexual desire is considered as a sexual dys-
function and is listed under the Sexual and Gender Iden-
tity Disorders of the DSM-IV. It is characterized as a
lack or absence of sexual fantasies and desire for sexual
activity for some period of time [1].
During the last few de cades, marital tensio ns and stresses
have influenced various dimensions of life. Studies done
on married persons compatible with marital life show that
they live largely with healthy food, body and nutrition
and thus suffered less from psychological difficulties [2].
At the root of a couple’s argument over a day to day,
mundane matter is often the need for intimate contact.
This is not to say that sexual intercourse is a panacea for
all problems couples encountering in life. However, the
desire of the need for intimate contact inclusive of some
form of physical contact is fundamental to personal he alth
and in fact fundamental to human nature. Sex is an indi-
vidual psychological event, and the attitudes of the indi-
vidual. His/her earlier experience, anxiety, tiredness and
overwork can all have a major dama ging effect on sex [3].
It is evident that in direction to confront these difficu l-
ties, prevention and training and reform are very impor-
tant in order to increase knowledge & power of people in
correct & suitable reaction with life events. At present,
paying attention to current relationship in marital and
family life & its sexual relationship in order to overco me
this problem is among the most important steps.
There are clear evidences that from the first of 1980,
psychotherapy has grown very fast towards integration.
This movement puts the best approach together to make a
better & more complete treatment model [4].
*This study was supported by USM SHORT TERM GRANT from the
Universiti Sains Malaysia from the Health Campus, School of Medical
Sciences.
#Corresponding author.
C
opyright © 2013 SciRes. OJU
R. BAY ET AL.
262
Within this way, psycho-physiological sex-therapy is
one of the new alterative and complementary therapies in
order to keep saving marriage and increasing society
welfare.
Sex therapy is the result of relatively recent scientific
attention to human sexual function and dysfunction. In-
creased knowledge of physiology and psychology of hu-
man sexual behavior brought a new professional appre-
ciation for human sexual response. At a time in our soci-
ety, when sexuality is being more openly discussed, we
are beginning to realize how uninformed, many people,
really are about this important personal topic. Sex ther-
apy can be helpful for individuals and couples depending
on the issue being addressed. Some issues can be dealt
with on an individual basis, while others are best treated
in the context rel at i onship of a couple [5].
Now considering the above-mentioned, this research is
going to investigate the effectiveness of psycho-physio-
logi cal combined th erapy (Stretch Th erapy combined Brea-
thing Exercise) on the Sexual desire in Hete rosexual Men.
Currently, stretch therapy is increasing in the United
States, where 10 - 15 million people participate in
stretching classes [6]. In 1997, more than 40% of people
living in the United States had practiced at least one type
of complementary or alternative therapy; psycho-physio-
logical stretch therapy is one of the modalities included
in this term [7]. Finally, 65% of people receiving mental
health services eng age in one type o f modality of alterna-
tive or adjunctiv e therapy [8].
The findings have described possible benefits of s tre tch-
ing to protect mental health. Specifically the literature
suggests that some style of them such as yoga may be
related to an increase in coping skills, and self-esteem,
and a decrease stress, anxiety, and depression [9-12].
Research has shown that some kinds of breathing ex-
ercises such as Bhasrika help in treatment. They affect
mind, brain and nervous system and increase oxygen lev-
els and reduce carbon dioxide levels in the blood. In
these breathing styles, the abdominal muscles and dia-
phragm are used which put pressure on the internal or-
gans. Also, Regular practice of breathing exercises will
ensure proper oxygenation of all parts of the body and
cure many diseases. Proper oxygenation helps purify the
blood and removal of toxins and carbon dioxide from the
body [13].
Stretching and the improvement of flexibility have been
an important goal bo th in the recreational and th erapeutic
field in the belief that it is beneficial in promoting good
physical and mental function [14-17]. It is claimed that
stretching can reduce injury risk, relax hypertonic mus-
cles, lengthen shortened tissue [18,19], and help improve
faulty posture [15,20,21]. In spite of its constant use and
clinically observable results, the research remains some-
what con trovers ial in d etermin ing how eff ective stretch-
ing is, and indeed how stretching achieves its effects.
Utilizing various movement philosophies, for example
Proprioceptive Neuromuscular Facilitation (PNF) [22],
Feldenkrais1 [23], Pilates [24], and Tai Chi [25], can
help restore or improve flex ibility, decrease pain and im-
prove coordination, thereby improve overall function. The
following article and ensu ing articles by different autho rs
will attempt to review and explain some basic facts, phi-
losophies and observations regarding flexibility and how
and why it is of such clinical importance.
The purpose of this study was to address 1 main hy-
pothesis and 2 minor hypotheses. The main hypotheses
of this research are to evaluate if psycho-physiological
combined therapy (Stretch Therapy combined Breathing
Exercise) has an effect on the Sexual desire among Het-
erosexual Men and if a difference exists between the ef-
fects of psycho-physiological combined therapy (Stretch
Therapy combined Breathing Exercise) and those of con-
trol group on the Sexual desire. The minor hypotheses
are to test if differences exist between the effects of psy-
cho-physio logical co mbined th erapy (Stre tch Therapy c o m-
bined Breathing Exercise) and control group on the Sex-
ual desire among Heterosexual Men when (1) age, and (2)
education level, are considered either individually or as a
whole.
2. Material and Methods
In this research, the independent variable is ps ych o - p h ys i o-
logical combined therapy (Stretch Therapy combined
Breathing Exercise), and the dependent variable is the
sexual desire of heterosexu al men. The therapy schedu le,
gender (only Male), Co morbidities (Stable, No n-Cardiac
and without Prostatic Disease), social, economic and
cultural factors, the location and the environment of ther-
apy, and the therapist are control variables. Moderator
variables are education level and age (we would study
the subjects in 2 part of age: 20 - 35 and 36 - 55 ).
3. Intervention Therapy Methods
Psycho-Physiological Combine d Therapy:
For this research, we used Static Stretching and Brea th-
ing Exercise techniques to make an integration therapy.
Static stretching involves a muscle that is slowly and
passively stretched to full range, continued tension is
then maintained for an extended period of time e.g. 2 ±
15 min, to further increase its length. For maximum gains,
it is important that the person stretching waits until the
muscles relax in the assumed pos ition.
Each one of treatment session will start with 10 minute
warming up and rhythmic breathing (10 Sec inhales, 25
Sec blocking the breath, 15 Sec exhales, and 10 Sec
blocking the breath) techniques. Then, we will continue
with Stretch Therapy. Each muscle would be stretched
Copyright © 2013 SciRes. OJU
R. BAY ET AL. 263
separately. And all of the surfaces muscles would be
stretched. Patient should exhale, when muscle would be
stretched, and patients should inhale, when it would be
released. And ultimately, we would finish each session
with rhythmic breathing techniques and 5 minute warm-
ing down. In this research program, we consider twenty
(20) 90 - 120 minutes session.
4. Materials and Research Methodology
Our samplegroups of 80 heterosexual men were selected
from volunteers who were registered at who visited
HUSM clinic of Kotabharu (Kelantan, Malaysia). We
used “Convenience Sampling” about this point. The vol-
unteers have selected from heterosexual men with stable
relationship, those who married minimum of 6 months,
within 20 to 55 years old, who attended to HUSM Family
Clinic. For data collection, we used quasi-experimental
designs called “non-equivalent control group.” Pre-tests
were done on both groups before intervention began,
post-tests were done after intervention had been com-
pleted, and follow-up tests were done 1 month after the
last session.
For the setting, we used a hall at Men’s Health clinic
at HUSM. For the experimental group, we conducted ten
(20) 90 to 120 minute meetings on 3 alternate days of
week, while for the control group, we left the m to follow
own ordinary life. We conducted this program for 20
sessions and had 3intervention session every week.
To measure the effects of intervention, we used pre-
tests, post-tests and follow-up tests. Also Cardiac Pa-
tients, Uncontrolled Types 1 and 2 Diabetic Patients,
HbA1c < 8.5%, Patient with Prostatic Disease, Major
Uncontrolled Psychiatric Disorders, Chronic arthritis,
His to r y o f a l cohol or drug abuse and Clinically significant
baseline laboratory abnormality have been as Subject
Exclusion Criteria; And Signed informed Consent, Het-
erosexual Married Men minimum of 6 months and aged
> 20 and <50 years as Subject Inclusion Criteria.
5. Statistical Methods
Data entry and statistical analyses were done using SPSS
version 19. In descriptive statistics, we used the mean
and standard deviation (SD), as well as tables and charts.
In inferential statistics, in order to compare the data, we
used Repeated Measure ANOVA.
For assumption checks, we examine the residuals for
normality and equality of variances. On examination of
histogram of residuals, all of them are normally distrib-
uted. Extend of spread of error variances by each level
looked similar, so assumption of equal variances met.
Further, the Levene’s test was not significant, so assu mp-
tion of equ al variances assumed.
6. Procedure
We announced this research at hospital and clinics of
Universiti Sains Malaysia (Kelantan). Then, the volun-
teers for this research were asked to complete forms to
get information about the volunteers’ ages, genders, dru gs
used, education levels, other illnesses that they suffered,
etc. This information was necessary both to form similar
groups to prevent obstructive variable effects and to man -
age the control and the moderator variables, as well as
the obstructive factors.
Initially, we had 150 volunteer heterosexual men. The n,
by paying attention to the control and moderator vari-
ables and trying to decrease obstructive variables, we
invited them for interviews and checkups. We, the time
of the interviews, researcher obtained information on the
patients’ backgrounds, durations of disease, kinds of med i-
cines used, and nutrition with lists of daily meals, and etc.
Then, according to the research design (unequal control
groups), we made an experimental group and one control
group. Ultimately, from the 100 patients, we placed 80
people in both groups randomly.
The duration for all therap y sessions was around 90 to
120 minutes, and we conducted 20 therapy sessions for
each of the volunteers in the experimental group. It is i m-
portant to note that before starting the therapy sessions,
all of the volunteers (both the placebo and the experi-
mental groups) went to the HUSM clinic to medical
checkup. Then before starting the therapy sessions, we
made pre-test on all of the volunteers (both the control
and the experimental groups).
For the experimental group’s patients, we conducted
psychophysiological combined therapy (stretching ther-
apy combined with breathing exercise) during each ses-
sion on 3 alternate days per week. At the end of ther apy,
for both the experimental and control group’s we made
post-test. Then, we left the experimental group to get back
ordinary life too. Around one month after finishing the
therapy sessions, on a specified day, we made follow-up
test on all patients of both groups, to get how long the
effect of therapy would remain.
7. Assessment
In order to assessment of sexual desire, we used Hurlbert
Index of Sexual Desire (HISD) [26 ] .
8. Results
Data shown P value Mauchly’s Test is less than 0.05
(0.000) and Epsilon Greenhouse-Geisser is more than
0.75 (0.830); so we have to read Greenhouse-Geisser
from within subject effect table.
As you see in Table 1, the time P value is 0.122. it
means some changes have happened with passing time
Copyright © 2013 SciRes. OJU
R. BAY ET AL.
264
Table 1. Tests of within subjects effec ts.
Source df F Sig.
Time Greenhouse-Geisser 1.660 2.2220.122
Time*Group Greenhouse-Geisser 1.660 8.0770.001
Time*Group*Age Greenhouse-Geisser 1.660 1.9990.148
Time*Group*Education Greenhouse-Geisser 1.660 0.2190.763
but statistically it is not sign ificant. The time and group P
value is significant (0.001). It means some change hap-
pened in groups with passing time.
Also as you see in Table 2, the group P value is 0.434.
There is no difference between the groups regardless of
time.
In order to g et the quantity of changing, we should g et
the details from Estimate Marginal Mean data.
As you see in Table 3, experimental group Estimate
Marginal Mean data shows pretest sexual desire has been
54.637 and in posttest it increased to 63.216 and ulti-
mately in follow-up test it change to 63.444.
Simultaneously control group Estimate Marginal Mean
data shows pretest sexual desire has been 65.467 and in
posttest it decreased to 62.933 and ultimately in fol-
low-up test it change to 62.583.
If you compare posttest and follow-up test mean score
of experimental group (63.216 and 63.444) with pretest
lower to upper b ound range (48.305 - 60.969) you would
find the experimental group changing in posttest is sig-
nificant. But you couldn’t find same situation in control
group. It means experimental group got improvement
within combined psycho-physiological therapy.
As you see in Table 1, the time, group and age P value
is 0.148. It means the age has had some effects on groups
with passing Time but statistically the effect differentia-
tion is not significant.
Also as you see in Tabl e 2, the group and ag e P-value
(between groups) is not significant (0.478). It mean we
can say regardless to time, statistically age has had no
effect on groups.
In order to g et the quantity of changing, we should g et
the details from Estimate Marginal Mean data. As you
see in Table 4, experimental group Estimate Marginal
Mean data shows age group 1 (20 - 35) pretest sexual
desire has been 52.417 and in posttest it increased to
66.194 and ultimately in follow-up test it change to
67.889.
And Estimate Marginal Mean data shows age group 2
(36 - 55) pretest sexual desires have been 56.857 and in
posttest it increased to 60.238 and ultimately in follow-
up test it change to 59.000.
Simultaneously control group Estimate Marginal Mean
data shows age group 1 (20 - 35) pretest sexual desire has
been 64.000 and in posttest it decreased to 61.900 and
ultimately in follow-u p test it change to 61.500.
Table 2. Tests of between subjects effects.
Source df F Sig.
Group 1 0.619 0.434
Group*Age 1 0.509 0.478
Group*Education 1 0.213 0.646
Table 3. Group*time.
95% Confidence Interval
Group Time Mean Std. Error Lower Bound Upper Bound
154.6373.173 48.305 60.969
263.2162.784 57.661 68.772
Experimental
363.4443.206 57.047 69.842
165.4673.450 58.583 72.350
262.9333.027 56.893 68.973 Control
362.5833.486 55.628 69.539
And Estimate Marginal Mean data shows age group 2
(36 - 55) pretest sexual desire has been 66.933 and in
posttest, it decreased to 63.967 and ultimately in follow-
up test it change to 63.667.
As you see in Table 1, the time, group and education P
value is 0.763. It mean the education level have had
some effects on groups with passing Time but statically
the effect differentiation is not significant.
Also as you see in Table 2, the group and Education P
value (between groups) is not significant (0.646). It means
we can say regardless to time, statically education has
had no effect on groups.
In order to g et the quantity of changing, we should g et
the details from Estimate Marginal Mean data. As you
see in Table 5, experimental group Estimate Marginal
Mean data shows educatio n group 1 (primary-secondary)
pretest sexual desire has been 55.940 and in posttest it
increased to 65.488 and ultimately in follow-up test it
changed to 64.667.
And Estimate Marginal Mean data shows education
group 2 (tertiary) pretest sexual desires has been 53.333
and in posttest it increased to 60.944 and ultimately in
follow-up test it change to 62.222 .
Simultaneously control group Estimate Marginal Mean
data shows education group 1 (primary-secondary) pre-
test sexual desire has been 69.100 and in posttest it de-
creased to 65.867 and ultimately in follow-up test it
change to 66.500.
And Estimate Marginal Mean data shows education
group 2 (tertiary) pretest sexual desire has been 61.833
and in posttest, it decreased to 60.000 and ultimately in
follow-up test it change to 58.667 .
9. Discussion
Approximately 35% of all family medicine departments
Copyright © 2013 SciRes. OJU
R. BAY ET AL.
Copyright © 2013 SciRes. OJU
265
Table 4. Group*age*time.
95% Confidence Interval
Group Age Time Mean Std. ErrorLower Bound Upper Bound
1 52.417 2.905 46.619 58.214
2 66.194 2.549 61.108 71.281
20-35
3 67.889 2.936 62.031 73.747
1 56.857 5.642 45.599 68.115
2 60.238 4.950 50.360 70.116
Experimental
36-55
3 59.000 5.701 47.624 70.376
1 64.000 6.038 51.951 76.049
2 61.900 5.298 51.328 72.472
20-35
3 61.500 6.101 49.325 73.675
1 66.933 3.338 60.273 73.594
2 63.967 2.929 58.123 69.811
Control
36-55
3 63.667 3.373 56.937 70.397
Table 5. Group*education*time.
95% Confidence Interval
Group Education Time Mean Std. ErrorLower Bound Upper Bound
1 55.940 2.552 50.849 61.032
2 65.488 2.239 61.021 69.956
primary_secondary
3 64.667 2.578 59.522 69.812
1 53.333 5.810 41.739 64.928
2 60.944 5.098 50.772 71.117
Experimental
tertiary
3 62.222 5.871 50.507 73.938
1 69.100 2.663 63.787 74.413
2 65.867 2.336 61.205 70.528
primary_secondary
3 66.500 2.690 61.131 71.869
1 61.833 6.365 49.132 74.534
2 60.000 5.585 48.856 71.144
Control
tertiary
3 58.667 6.431 45.833 71.500
offer some kind of instruction in alternative therapies.
According to Bricklin, approximately 40% of the US
population is found to be using alternative therapies [27].
As popular interest in alternative medicine has in creased,
so has advanced practical nurse involvement, research
attention and the likelihood of insurance reimbursement.
Research interest in alternative therapies at the National
Institute of Health is growing. The Organization of Al-
ternative Medicine (OAM) has recently f unded a study of
alternative therapies at several academic centers, includ-
ing, among others, Harvard, Stanford and Columbia medi-
cal schools. Meanwhile, managed care organizations and
insurance companies, including Mutual of Omaha, Blue
Cross/Blue Shield of Washington and Alaska, and U.S.
Health Care, are offering special health plan s that include
alternative therapies [27].
We hypothesized that combined psycho-physiological
therapy (Stretch therapy combined breathing exercise)
have effect in self-reported sexual desire compared to
control group. Consistent with our hypotheses, psycho-
physiological group achieved greater improvements in
sexual desire compared to participants in control group.
We observed a trend towards greater improvements in
sexual desire for psycho-physiological therapy group com-
pared to participants in control group, but this difference
did not reach statistical significance. Overall, these find-
ings provide support for the beneficial effects of com-
bined psycho-physiological therapy (Stretch therapy com-
bined breathing exercise) on sexual desire for 20 - 55
years old heterosexual men. Also the data had shown that
age and education doesn’t have any significant effect in
the psycho-physiological intervention.
Several studies suggest that higher levels of physical
activity are associated with improved sexual function
[28-30]. In a 2006 meta-analysis, Ch eng et al. o bse rved a
dose-response relationship between levels of physical
activity and ED, with higher levels of activity predicting
lower risk of ED and vice versa [31]. In a cross-sectional
R. BAY ET AL.
266
study of 1506 men in Hong Kong, Ch eng and Ng (2007)
determined that greater self-reported physical activity
(expressed as energy expenditure per month) was associ-
ated with lower levels of self-reported ED, particularly
among men who were overweight. Esposito et al. (2004)
randomly assigned 110 obese men with ED either to a
two-year diet and physical activity gr oup intervention, or
to an education control group. After two years, the inter-
vention group reported better erectile function compared
to the control group. Furthermore, increased physical ac-
tivity was associated with improvements in ED, inde-
pendent of weight loss. Relationships between physical
activity and sexual dysfunction have not been studied as
thoroughly in women. One study by Wilbur et al. exam-
ined the effects of a 24-week moderate intensity walking
program on menopausal symptoms, including uro-genital
symptoms of vaginal dryness, irritation, decreased sexual
desire, and pain during intercourse. This study did not
show significant improvements in uro-genital symptoms
in the walking group as compared to the control group.
However, adherence was low in the walking group [32].
Shapiro & Cline [33] also ev aluated the eff ect of st r e t c h -
ing and breathing exercise on mood. Participants were
eight women and three men, ages 23 to 59. There was no
control group. Results indicated significant changes for 9
out of the 15 moods including a decrease in anxiety, fr us-
tration, stress, and fatigu e and an increase in feeling con-
tent, happy, optimistic, and relaxed.
Arpita suggested that stretch and breathing exercise
such as yoga may lead to physiological balance, a de-
crease in psychological distress, and an increase in self-
esteem. Vahia, Vinekar, and Donngaji (1966) studied 30
hospital patients with a range of diagnoses including de-
pression, peptic ulcer, schizophrenia, and anxiety reac-
tion disorder. Treatment consisted of stretching postures,
philosophy, breathing techniques, and meditation for an
average of four to six weeks. Patients attended classes six
days a week for one-half hour to an hour. Results indi-
cated that patients suffering from anxiety and depressive
disorders showed a decrease in symptoms [34].
Our study supports a link between alternative healing
therapies and increase in mean sexual desire. This creates
a need for structured programs teaching lifestyle change,
non-pharmacologic interventions and alternative thera-
pies in conjunctio n with conventional treatment. Alterna-
tive therapies can be extremely useful adjuncts to con-
ventional care, and they sometimes provide the most ap-
propriate treatment for treat conditions, such as sexual
desire, erection disorder and sexual satisfaction.
The psychological role has always been one of pa-
tients’ advocates. If lifestyle changes and alternative heal -
ing, such as stretch therapy combined breathing exercise,
are taught to patients, the risk of sexual problems and its
other side effects on family life will decrease. Pharma-
cologic treatment is an area of expertise that requires
special attention in family problems population. However,
there can be adverse side effects with medication. By
implementing holistic healing classes, the therapist can
give patients the found atio n to redu ce stress in their liv es,
thereby reducing the need for conventional medical treat-
ment. Therapist can also experience both the benefits and
the limitations of these approaches and find ways to use
them with their patients. By embarking on these extended
courses of study, the clinical results may justify the in-
vestment of time and energy [35].
The findings of our study have implications for ad-
vanced psycho-physiological practice, education and
health care of low sexual desire patients and for others
who suffer from sexual problems. The implementation of
psycho-physiological therapy (stretch therapy combined
breathing exercise) classes taught by a psycho-physio-
logist in the outpatient clinic should be considered at the
patient’s first clinic visit. A shift in emphasis from treat-
ing to teaching highlights the psychological function as a
guide and teacher and makes patient care a more fulfill-
ing partnership. All psychologists should have know-
ledge of holistic healing and implementation of psycho-
physiological therapy (stretch therapy combined breath-
ing exercise) as classes in schools of psychology will
introduce the concept of alternative healing therapies
[36].
Our study has raised questions and has impacted other
areas. Alternative and combined therapies suggest a wi der
vision of what medicine can and should be through ap-
preciation of the interconnectedness of mind and body,
emphasis on enhancing the body’s own capacity for heal-
ing and the use of the entire world’s healing traditions.
Alternative therapies can be used as an adj unct to treat all
disease states of the mind and body. It is entirely possible
that in less than a generation, the approach and tech-
niques currently called “alternative” will be an integral
part of the practice of all family and sex therapist, psy-
cho-physiology and neuro-psychology practitioners .
Our study established combined psycho-physiological
therapy (stretch therapy combined breathing exercise) as
important to the family and sexual problem patient popu-
lations as it provides the patient with the power to de-
crease stress and to enhance the body’s own capacity for
healing. Integration of stretch therapy and breathing ex-
ercise in treatment plans allows a collaborative and de-
mocratic relationship between the advanced psycho-
physiological practition er, other health providers, and the
patient, who then reaps the psychological and physio-
logical rewards of feeling more in control of their own
lives.
10. Limitations
These results are unique to this trial, and will need to be
Copyright © 2013 SciRes. OJU
R. BAY ET AL. 267
replicated in future research. In this research, the sample
size may not be representative, as samples would only be
from Kota Bharu (Kelantan-Malaysia) and within limited
time frame, so future researchers are encouraged to ex-
tend these results to other popu lations, and to continu e to
pursue research on sexual dysfunction and marital satis-
faction.
In this research, we had to get the sample from volun-
taries who would like to attend for this intervention, and
then we placed these people in groups randomly. But
after analyzing we got the group base lines, which ha-
ven’t been completely the same. It seems experimental
group voluntaries, who had more motivation to attend in
experimental group, already have had some more diffi-
cult situations or they were feeling to have more prob-
lems in comparing voluntaries of control group. That’s
why we can find clear differences among scores and tests
of groups but because of mentioned cause, these differ-
ences statistically are not significant, although it is clear
that the intervention has had good effect on experimental
group, if you check th e resu lts and mean scores of groups.
So it is suggested that following future and similar re-
searches should pay attention to motivation of voluntar-
ies and try to use other methods of sampling.
Also, additional research is needed for mechan isms by
which psycho-physiological exercise and treatment im-
prove family and sexual functioning, with an emphasis
on other populations and women.
11. Acknowledgements
This study was supported by USM SHORT TERM
GRANT from the University Sains Malaysia from the
Health Campus, School of Medical Sciences.
REFERENCES
[1] J. Waite-Linda, “Why Marriage Matters,” Strengthening
Marriage Round Table, Washington DC, 1997.
[2] American Psychiatric Association, “Diagnostic and Sta-
tistical Manual of Mental Disorders—IV—Text Revi-
sion,” 4th Edition, American Psychiatric Association,
Washington DC, 2004.
[3] M. Crowe and J. Ridley, “Therapy with Couples: A Be-
havioral—Systems Approach to Couple Relationship and
Sexual Problems,” Pub Black Well Science Ltd., Malden,
2006.
[4] M. R. Gold-Fried and L. G. Cstonguay, “The Future of
Psychotherapy Integration,” Psychotherapy, Vol. 29, No.
1, 1992, pp. 4-10.
http://dx.doi.org/10.1037/0033-3204.29.1.4
[5] D. M. Schnarch, “Sexual-Marital Therapy with Mature
Couples,” Family Therapy News, New York, Vol. 26, No.
3, 1995.
[6] R. Corliss, “The Power of Yoga,” Electronic Version,
Time Magazine, April 23, 2001.
[7] L. Eisenberg, “Complementary and Alternative Medicine:
What Is Its Role?” In: A. P. Fishman and M. Hager, Eds.,
Education of Health Professionals in Complementary/
Alternative Medicine, Macy Foundation, New York, 2001,
pp. 32-41.
[8] L. Bassman and G. Ullendahl, “Complementary/Alterna-
tive Medicine: Ethical, Professional, and Practical Chal-
lenges for Psychologists,” Professional Psychology Re-
search and Practice, Vol. 34, No. 3, 2003, pp. 264-270.
http://dx.doi.org/10.1037/0735-7028.34.3.264
[9] Arpita, “Physiological and Psychological Effects of Hatha
Yoga: A Review of the Literature,” The Journal of the
International Association of Yoga Therapists, Vol. 1,
2000, pp. 1-28.
[10] D Campbell and K. Moore, “Yoga as a Preventative and
Treatment for Depression, Anxiety, and Stress,” Interna-
tional Journal of Yoga Therapy, Vol. 14, No. 1, 2004, pp.
53-58.
[11] D. Shapiro and K. Cline, “Mood Changes Associated
with Iyengar Yoga Practices: A Pilot Study,” Interna-
tional Journal of Yoga Therapy, Vol. 14, 2004, pp. 35-44.
[12] A. Woolery, H. Myers, B. Sternlieb, L. Zeltzer, “A Yoga
Intervention for Young Adults with Elevated Symptoms
of Depression,” Alternative Therapies, Vol. 10, No. 2,
2004, pp. 60-63.
[13] D. Vora, “Health in Your Hands,” Vol. 1, Navneet Publi-
cations Limited, Mumbay, 1898.
[14] J. C. Travell, D. G. Simons, “Myofascial Pain and Dys-
function: The Trigger Point Manual,” Vol. 1-2, William
and Wilkins, Baltimore, 1994.
[15] V. Janda and G. Jull, “Muscles and Motor Control In Low
Back Pain: Assessment,” In: L. T. Twomey and J. R. Tay-
lor, Eds., Physical Therapy of the Low Back, Churchill
Livingstone, New York, 1987.
[16] V. Janda, “Muscles and Cervicogenic Pain Syndromes,”
In: R. Grant, Ed., Physical Therapy of the Cervical and
Thoracic Spine, Churchill Livingstone, New York, 1988.
[17] B. H. Bunkan, “Muskel Spanningar,” Under Sokning
Ochbe Handling Liber, Stockholm, 1980.
[18] P. Markos, “Ipsilateral and Contralateral Effects of Pro-
prioceptive Neuromuscular Facilitation Techniques on
Hip Motion and Electromyographic Activity,” Physical
Therapy, Vol. 59, No. 11, 1979, pp. 1366-1373.
[19] B. R. Etnyre and L. D. Abraham, “Gains in Range of
Ankle Dorsiflexion Using Three Popular Stretching Tech-
niques,” American Physical Medicine, Vol. 65, No. 4,
1986, pp. 189-196.
[20] C. H. Wang, P. McClure, N. E. Pratt and R. Nobilini,
“Stretching and Strengthening Exercises: Their Effect on
Three Dimensional Scapular Kinematics,” Archives of
Physical Medicine and Rehabilitation, Vol. 80, No. 8,
1999, pp. 923-929.
[21] E. F. Wright, A. D. Domenech and J. R. Fischer, “Use-
fulness of Posture Training for Patients with Temporo-
mandibular Disorders,” Journal of the American Dental
Association, Vol. 131, No. 2, 2000, pp. 202-210.
[22] M. A. More, “An Electromyographic Investigation of
Copyright © 2013 SciRes. OJU
R. BAY ET AL.
Copyright © 2013 SciRes. OJU
268
Muscle Stretching Techniques,” Unpublished Master’s
Thesis, University of Washington, Seattle, 1979.
[23] R. Ofir, “The Feldenkrais Method, the Importance and
Potency of Small and Slow Movements,” Physical Ther-
apy Forum, Vol. 42, No. 5, 1990, pp. 3-5.
[24] K. Swaim, “An Alternative Therapy: Pilate’s Method,”
PT Magazine, October 1993, pp. 55-58.
[25] S. L. Wolf, C. Coogler and T. Xu, “Exploring the Basis
for Tai Chi Chuan as a Therapeutic Exercise Approach,”
Archives in Physical Medicine and Rehabilitation, Vol.
78, No. 8, 1997, pp. 886-892.
http://dx.doi.org/10.1016/S0003-9993(97)90206-9
[26] C. Apt and D. F. Hurlbert, “The Sexuality of Women in
Physically Abusive Marriages: A Comparative Study,”
Journal of Family Violence, Vol. 8, No. 1, 1992, pp. 57-
69. http://dx.doi.org/10.1007/BF00986993
[27] M. Bricklin, “Positive Living and Health,” Rodale Press,
Pennsylvania, 1990.
[28] C. G. Bacon, M. A. Mittleman, I. Kawachi, E. Giovan-
nucci, D. B. Glasse r an d E. B. Rimm, “Sexua l Func t io n in
Men Older Than 50 Years of Age: Results from the
Health Professionals’ Follow-Up Study,” Annals of In-
ternal Medicine, Vol. 139, No. 3, 2003, pp. 161-168.
http://dx.doi.org/10.7326/0003-4819-139-3-200308050-0
0005
[29] K. Esposito and D. Giugliano, “Obesity, the Metabolic
Syndrome, and Sexual Dysfunction,” International Jour-
nal of Impotence Research, Vol. 17, 2005, pp. 391-398.
http://dx.doi.org/10.1038/sj.ijir.3901333
[30] K. Esposito, E. Giugliano, C. Di Palo, G. Giugliano, R.
Marfella, E. D’Andrea, et al., “Effect of Lifestyle Chan-
ges on Erectile Dysfunction in Obese Men: A Randomi-
zed Controlled Trial,” JAMA, Vol. 291, No. 24, 2004, pp.
2978-2984. http://dx.doi.org/10.1001/jama.291.24.2978
[31] J. Y. Cheng, E. M. Ng, J. S. Ko and R. Y. Chen, “Physi-
cal Activity and Erectile Dysfunction: Meta-Analysis of
Population-Based Studies,” International Journal of Im-
potence Research, Vol. 19, 2006, pp. 245-252.
http://dx.doi.org/10.1038/sj.ijir.3901521
[32] J. Wilbur, A. M. Miller, J. McDevitt, E. Wang and J.
Miller, “Menopausal Status, Moderate-Intensity Walking,
and Sympto ms in Midlife Women,” Research and Theory
for Nursing Practice, Vol. 19, No. 2, 2005, pp. 163-180.
[33] D. Shapiro and K. Cline, “Mood Changes Associated
with Iyengar Yoga Practices: A Pilot Study,” Interna-
tional Journal of Yoga Therapy, Vol. 14, 2004, pp. 35-44.
[34] Arpita, “Physiological and Psychological Effects of Hatha
Yoga: A Review of the Literature,” The Journal of the
International Association of Yoga Therapists, Vol. 1,
2000, pp. 1-28.
[35] R. Bay, “Alternative and Psycho-Physiological Comple-
mentary Therapies,” Suchak Creations Publication, Pune,
2009.
[36] R. Bay, “Explanatory Dictionary of Type 2 Diabetes with
Psycho-Physiological Treatments,” Suchak Creations
Publication, Pune, 2009.