Dynamic Neuromuscular Stabilization Research Articles

Effectiveness of Dynamic Neuromuscular Stabilization and Flexibility Exercises for Non-Specific Low Back Pain in Bharatanatyam Dancer: A Case Study

Effectiveness of Dynamic Neuromuscular Stabilization and Flexibility Exercises for Non-Specific Low Back Pain in Bharatanatyam Dancer: A Case Study

The Role of Dynamic Neuromuscular Stabilization Exercises in Stress Urinary Incontinence Among Females Aged 18-40 Years

The Role of Dynamic Neuromuscular Stabilization Exercises in Stress Urinary Incontinence Among Females Aged 18-40 Years

Investigating the Effects of Dynamic Neuromuscular Stabilization Exercises on Chest Mobility, Upright Sitting Height, and Quality of Life in Obese Women

Investigating the Effects of Dynamic Neuromuscular Stabilization Exercises on Chest Mobility, Upright Sitting Height, and Quality of Life in Obese Women

Inter-rater reliability of the dynamic neuromuscular stabilization diaphragm tests among individuals with non-specific low back pain and neck pain

BackgroundThe Dynamic Neuromuscular Stabilization (DNS) diaphragm test and intra-abdominal pressure regulation test (IAPRT) are qualitative clinical tests that assess postural stability provided by the diaphragm. ObjectiveEvaluate the inter-rater reliability of the diaphragm test and IAPRT between an experienced and novice DNS clinician among individuals with non-specific low back pain (LBP) and neck pain. MethodsForty-five participants with non-specific LBP and/or neck pain were assessed by an experienced and novice DNS physiotherapist in the diaphragm test and IAPRT, and scored on a visual analog scale (VAS) according to five different criteria. ResultsModerate reliability was noted when assessing LBP and neck pain patients in the diaphragm test and IAPRT (p < 0.001). Moderate reliability also existed when assessing only LBP (p < 0.001) or neck pain (p = 0.002, p = 0.009) independently. Patients with lower pain (NPRS score of 5 or < ) demonstrated lower intra-class correlation coefficients, yet still moderate reliability in the diaphragm test (p = 0.004) and IAPRT (p = 0.001). Patients with higher pain (NPRS score of 6 or > ) demonstrated greater intra-class correlation coefficients, with the diaphragm test resulting in good reliability (p < 0.001). ConclusionsThe diaphragm test and IAPRT demonstrate moderate reliability between an experienced and novice DNS clinician when evaluating LBP and neck pain patients, with a greater degree of reliability noted in patients suffering from higher reported pain.

Effect of dynamic neuromuscular stabilization training using the inertial load of water on functional movement and postural sway in middle-aged women: a randomized controlled trial

BackgroundChronic stress and diseases occur more frequently in middle-aged compared to younger women and this is often the result of physical, psychological and socio-economic changes. These health consequences reduce lower body muscle mass and flexibility, leading to generalized impairments in functional movement and balance. Dynamic Neuromuscular Stabilization (DNS) training using the inertial load of water is known for its positive impact on functional strength improvement and muscle stabilization.ObjectiveThis study aimed to determine the effect of DNS training using inertial water loads on functional movement and postural sway in middle-aged women.MethodA sample of 24 middle-aged women participated in the study and were randomly divided into two groups: the experimental group, n = 12 (age: 58.33 ± 1.48 yrs, height: 162.16 ± 1.27 cm, weight: 61.77 ± 2.21 kg) and control group, n = 12 (age: 59.58 ± 1.13 yrs, height: 160.1 ± 1.13 cm, weight: 57.51 ± 1.12 kg). Center of Pressure (COP), moving distance, Root Mean Square (RMS), movement area and Functional Movement Screen (FMS) were conducted and analyzed pre- and post-examination. Participants engaged in the DNS training regimen, which utilized the inertial load of water, for 60 min each session, conducted twice weekly for 12 weeks.ResultsThere were significant differences in the COP distance (p < 0.001), RMS (p < 0.05), COP area and FMS test (p < 0.001) in the pre-post comparison of each group. And significant differences were found in COP distance (p < 0.05), RMS (p < 0.05), COP area (p < 0.05) and FMS test (p < 0.05) between groups. The DNS training improved the dynamic stability of single-leg standing, torso stability and functional movement in middle-aged women.ConclusionDNS training programs using the inertial load of water have been shown to be effective in movement improvement and posture retention ability, which is beneficial for functional movement, equilibrium strategy, and dynamic stability of middle-aged women. Furthermore, the DNS training method designed in this study can be useful for trainees who require posture correction in a safe and effective way regardless of their age and gender.

The effect of dynamic neuromuscular stabilization on trapezius muscle activation during shoulder exercises in individuals with rounded shoulder posture: a pilot study

Aims: The aim of this pilot study is to investigate the impact of dynamic neuromuscular stabilization (DNS) technique on the activation of the upper, middle, and lower parts of the trapezius muscle during commonly used shoulder exercises in individuals with rounded shoulder posture. Methods: The study was conducted with 15 individuals exhibiting rounded shoulder posture. The determination of rounded shoulder posture was based on measuring the distance in centimeters between the posterior corner of the lateral acromion prominence and the bed in a supine position. If this distance was 2.5 cm or more, it was considered as rounded shoulder posture. Participants were taught three different shoulder exercises and the DNS respiratory technique, a component of Dynamic Neuromuscular Stabilization. The exercises were randomly performed with and without DNS, and the activation of the upper (UT), middle (MT), and lower (LT) parts of the trapezius muscle was measured separately using an 8-channel surface electromyography (EMG) system (Noraxon Ultium, Scottsdale, USA). Results: The activation of all parts of the trapezius muscle was found to be higher when exercises were performed with DNS compared to without DNS (p&lt;0.05). Additionally, the UT/MT and UT/LT activation ratios were compared during the exercises with and without DNS. It was observed that only during the 1st exercise, the UT/LT activation ratio was higher when exercises were performed with DNS (p&lt;0.05), while in all other cases, it was similar (p&gt;0.05). Conclusion: The primary findings of the study suggest that the activation of all parts of the trapezius muscle is higher when exercises are performed with DNS. This implies that DNS may contribute to more effective exercise performance in terms of the activation of the relevant muscle group, indicating potential positive effects of DNS in rehabilitation programs. However, the participant profile in our study is limited to individuals with rounded shoulder posture. Further research in different populations is needed to generalize the obtained results.

Effectiveness of dynamic neuromuscular stabilization, neurodevelopmental techniques and proprioceptive neuromuscular facilitation on trunk and gait parameters in patients with subacute stroke: A three-arm parallel randomised clinical trial

Background Today, stroke is the principal cause of demise in both developed and developing countries. There are different techniques used to treat patients with sub-acute stroke. Trunk muscles play a key role, i.e. in keeping the spine and trunk in place. This stabilization requires moving the head and extremities freely and selectively. The aim of this study is to compare the effectiveness of dynamic neuromuscular stabilization (DNS), neurodevelopmental techniques (NDT) and proprioceptive neuromuscular facilitation (PNF) on trunk and gait parameters in the subacute phase of stroke. This study is intended to ascertain the efficacy of all three approaches individually and to compare the effectiveness of DNS, NDT and PNF on trunk and gait parameters. Furthermore, the findings of this study could be used to assist post-stroke survivors in their early recovery and improve their level of independence. Methods In this interventional study, participants will be divided into three groups, and in each group, 20 patients will be assigned randomly to each group using the sequentially numbered opaque sealed envelope method. Group A patients will be given DNS, Group B will be given NDT, and Group C will be given PNF. The patients will be given treatment for five days for four consecutive weeks. Outcome measures that will be used are trunk impairment scale (TIS), dynamic gait index (DGI) and gait parameters. Data will be collected before and after the 4-week treatment period. Conclusions After the study, a conclusion will be drawn regarding which treatment technique is most suitable among all the three strategies for treating stroke patients if the hypothesis of the study is found valid. Clinical Trials Registry – India (CTRI) reference no. CTRI/2022/06/043037; date of registration 22/05/2022.

Role of Dynamic Neuromuscular Stabilization Exercises in Physical Rehabilitation: A Systematic Review

The objective of this study was to systematically review and evaluate the relevant literature on dynamic neuromuscular stabilization (DNS) exercises. A literature search was conducted from inception to February, 2023 within PubMed, Medline, Google Scholar, Science Direct and EBSCO to identify studies related to the role of DNS in the rehabilitation of musculoskeletal and neurological conditions. The databases were searched using the following key words: Dynamic neuromuscular stabilization, pain, physical function, stroke, hemiplegia. After the initial search full text studies related to the use of DNS exercises in the rehabilitation of musculoskeletal or neurological conditions were selected for further review irrespective of study design. A quantitative analysis of the selected studies was done by using the Joanna Briggs Institute Critical Appraisal tool. The systematic review identified a total of 16 studies (seven low risk, six medium risk and three high risk of bias) that met the inclusion criteria. These studies examined the effects of DNS exercises on a range of conditions, including low back pain, cerebral palsy, stroke, migraines, and posterior cortical atrophy. The findings consistently demonstrated significant improvements in core muscle activation, joint stability, functional movements, and pain reduction following DNS intervention. Additionally, improvements in specific condition-related outcomes were reported in several studies, indicating the potential effectiveness of DNS in addressing deficits related to musculoskeletal and neurological conditions. The findings of this systematic review suggest that DNS exercises have a beneficial impact on physical rehabilitation outcomes in individuals with musculoskeletal and neurological conditions. The activation of core muscles and the integrated spinal stabilization system (ISSS), facilitated through DNS, promote spinal stability, reduce pain, and enhance functional movements. This study is registered as PROSPERO No. CRD42021278224.

Comparative Effects of Dynamic Neuromuscular Stabilization Exercises on Lumbar Proprioception, Movement Control and Functional Activity Limitation in Movement Control Impairment Subgroup of Non-Specific Chronic Low Back Pain: RCT Interim Analysis

Comparative Effects of Dynamic Neuromuscular Stabilization Exercises on Lumbar Proprioception, Movement Control and Functional Activity Limitation in Movement Control Impairment Subgroup of Non-Specific Chronic Low Back Pain: RCT Interim Analysis

Comparing the Efficacy of Dynamic Neuromuscular Stabilization Exercises and Kegel Exercises on Stress Urinary Incontinence in Women: A Pilot Study.

Background and objective Stress urinary incontinence (SUI) is a prevalent condition affecting women of various age groups, significantly impacting their quality of life. To address this multifaceted issue, a comprehensive approach that goes beyond traditional pelvic floor exercises is needed. Dynamic neuromuscular stabilization (DNS) exercises, targeting the integrated spinal stabilization system, offera promising alternative. Thus, this study aimed to compare the effectiveness of DNS exercises and Kegel exercises in managing SUI among women. Methods This single-blinded, pilot study involved 24 women aged 18-40 years with mild to moderate SUI. Participants were divided into DNS and Kegel exercise groups. Outcome measures included perineometer readings, electromyography (EMG) data, and the Urogenital Distress Inventory-6 (UDI-6). Statistical analysis compared baseline and 12-week data within and between groups, and rank-biserial correlation coefficient (r) as a measure of effect size in our study wascalculated. Results At 12 weeks, the DNS group showed significant improvement in pelvic floor muscle strength compared to Kegel exercises (p = 0.005). Both groups had significantly enhanced pelvic floor muscle strength (p < 0.05). A significant change occurred for EMG average, EMG peak, and EMG maximum voluntary contraction (MVC) at 12 weeks (average p = 0.005; peak p = 0.001; MVC p = 0.009), with significant improvements in both groups (p < 0.05). For UDI-6, a significant difference emerged between the two groups at 12 weeks (p < 0.05), with significant improvements in both groups individually from baseline to 12 weeks (p < 0.05). The effect size "r" for all variables indicated a medium to large effect size, underscoring the substantial and significant impact of DNS exercises in managing SUI among women compared to Kegel exercises. Conclusion This study suggests that DNS exercises, emphasizing the coordinated activation of the diaphragm, abdominals, multifidus, and pelvic floor, may provide a more effective approach for managing SUI in women compared to traditional Kegel exercises.

Effect of the Dynamic Neuromuscular Stabilization Technique on Functional Capacity in Overweight and Obese Individuals: A Randomized Controlled Trial.

Background Individuals with overweight and obesity (OW/OB) have poorperformance in weight-bearing exercises, resulting in lowfunctional capacity. The dynamic neuromuscular stabilization (DNS) technique was created to engage the core-postural chain in conjunction with the core muscles, generating enough intra-abdominal pressure to dynamically support the spine through muscular activity. DNS is a strategy that emphasizes the activation of the spine's intrinsic stabilizers, as well as proper breathing patterns, before any intended functional movement. The aim and objective of this study was to determine the effectiveness of the DNS technique on functional capacity in OW/OB individuals and to compare the effectiveness of the DNS and conventional approach. Methods The study recruited 100 individuals, who were separated into an experimental group (DNS technique) and a control group (conventional exercises), each with 50 participants. Outcomemeasures, including a six-minute walk test (SMW test) and body mass index (BMI), were taken pre-treatment and post-treatment. Results and discussion Based on the inclusion criteria of this study, the age group included was 20 to 25 years old. Pre- and post-treatment statistically significant changes were observed in the experimental and control groups in the BMI and SMW test. However, the BMI (kg/m2) was not statistically significant in the experimental group (t-value=-0.15, p=0.87) and control group (t-value=-0.22, p=0.82). Moreover,in the SMW test (meter), no statistical significance was found in the experimental group (t-value=-0.15, p=0.87) and control group (t-value=- 0.22, p=0.82). Conclusions Both groups are effective in increasing the functional capacity of obese and overweight individuals. The study indicates a strong need for further research into its long-term effectiveness in the OW/OBpopulation.

The Effect of Dynamic Neuromuscular Stabilization Exercises on Balance and Fear of Falling in Female Elderly

Introduction: The present study was an attempt to investigate the effect of a course of dynamic neuromuscular stabilization (DNS) exercises on balance and fear of falling in female elderly with a history of falling.&#x0D; &#x0D; Methods: In this quasi-experimental study, 30 female elderly people with a history of falling based on entry and exit criteria were purposefully selected as a sample of study. Then, they were randomly assigned into two control and exercise groups. The variables related to static balance and dynamic balances were assessed by sharpened Romberg Test and Standing Up and Walking Test, respectively. Also, Falls Efficacy Scale International was used to measure the fear of falling. The exercise group performed DNS exercises for 8 weeks, 3 sessions, and 50 minutes per session. Data were analyzed by using paired t-test and analysis of covariance in SPSS24 software at the significant level of p &lt; 0.05.&#x0D; &#x0D; Results: A significant difference between pretest and posttest in static balance with open eyes (p = 0.0001, t = -7.19), static balance with closed eyes (p = 0.0001, t = -8.02), dynamic balance (p = 0.0001, t = 6.49) and fear of falling (p = 0.0001, t = 7.29) in DNS exercise group. Also, there were significant differences between DNS and control groups in static balance with open eyes (p = 0.0001, F = -14.67), static balance with closed eyes (p = 0.0001, F = 14.002), dynamic balance (p = 0.0001, F = 20.12) and fear of falling (p = 0.006, F = 09.07).&#x0D; &#x0D; Conclusion: It is recommended that therapists use dynamic neuromuscular stabilization exercises in female elderly to improve balance and reduce the fear of falling.

Effects of Eight-week Dynamic Neuromuscular Stabilization Exercises on the Static and Dynamic Balance of Educable Mentally Retarded Female Students

Background and Aims Balance is an important factor in people with intellectual disability to have an independent life. These people are weak static and dynamic balance due to lack of development in their central nervous system, defects in the sensory-motor pathways, and having a sedentary life. This study aims to determine the effect of eight weeks of dynamic neuromuscular stabilization (DNS) exercises on static and dynamic balance of educable mentally retarded female students Methods In this study, participants were 26 educable mentally retarded female students aged 15-20 years (Mean age: 17.19±1.50 years, IQ: 61.15±6.07, weight: 58.9±12.73 kg, height: 157.92±6.07 cm) who were selected using purposive and convenience sampling methods and randomly divided into two groups of training (n=13) and control (n=13). Before and after training, their static balance and dynamic balance on the right and left feet were evaluated using a foot scan device. Subjects in the training group performed DNS exercises at 24 sessions, each session for 40 minutes. No intervention was provided to the control group; they performed their routine activities. Repeated measures analysis of variance was used to analyze the data. The significance level was set at 0.05. Results After eight weeks of DNS exercises, the results showed a significant improvement in static balance (F=72.54, P=0.001), dynamic balance on the right foot (F=90.90, P=0.002) and dynamic balance on the left foot (F=61.58, P=0.001) in the training group compared to the pretest scores and compared to the control group. Conclusion DNS exercises can be used as an effective method to improve static and dynamic balance of educable mentally retarded female students.

Impact of Different Physiotherapy Programs on Balance and Gait in Patients with Cerebral Infarction

Background. An ischemic stroke has long-term adverse effects on the physical, emotional, and social well-being of the stroke survivor, so it is very important to help the patient regain independence and lost functions as quickly and efficiently as possible. Dynamic Neuromuscular Stability exercises can restore movement patterns in these patients by simulating central nervous system.&#x0D; The aim. To compare the effects of conventional physiotherapy and dynamic neuromuscular stabilization integrated into conventional physiotherapy on balance and gait in patients with cerebral infarction.&#x0D; Methods. The study included 30 subjects who survived an ischemic stroke. Subjects were randomly divided into two groups of 15 people in each for different interventions: Conventional physiotherapy and Conventional physiotherapy combined with integrated dynamic neuromuscular stabilization. Subjects were examined at a baseline and after the interventions. Patients’ balance was assessed using the Biodex platform, which was chosen to evaluate fall risk, trunk stability, stability limits and sensory organization. Gait parameters (step length and step width) of the affected and unaffected leg were assessed using the Zebris FDM-T treadmill.&#x0D; Results. Both conventional physiotherapy and physiotherapy with integrated dynamic neuromuscular stabilization improved gait parameters of the patients, as well as improving the results of the tests of fall risk, postural stability, stability limits, and the results of the sensory integration test when testing with eyes open on a stable surface (p&lt;0.05). However, the results of the sensory integration tests while standing on a stable surface with eyes closed (p&lt;0.001), with eyes open on an unstable surface (p&lt;0.001) and with eyes closed on an unstable surface (p=0.021) improved only post physiotherapy with integrated dynamic neuromuscular stabilization.&#x0D; Conclusions. Both conventional physiotherapy and physiotherapy with integrated dynamic neuromuscular stabilization significantly improved gait and balance parameters in stroke patients.&#x0D; Keywords: Dynamic neuromuscular stabilization, stroke, balance, trunk stability, gait.

Relationship Between Functional Movements of the Mandible and Core Stability in Young Healthy Adults

Background. Temporomandibular joints (TMJs) have a common neuromuscular connection with neck and scapula, so dysfunction of one or both joints can lead to changes in the spine posture and vice versa. Due to the compensatory mechanism, occurring following TMJ functional disorders, the balance between facial and neck muscle activity is disrupted. A change in any biomechanical unit inevitably results in a change of the posture control system, but there is a lack of research evaluating the relationship between functional movements of the TMJ and trunk stability.&#x0D; The aim. To determine the relationship between core stability and functional movements of the mandible.&#x0D; Methods. The study included 20 participants aged between 20 and 40 years. Participants were tested individually. Tests and measurements selected for the study: trunk stability assessment by functional Dynamic Neuromuscular Stabilization (DNS) tests; assessment of static trunk muscle endurance by McGill endurance tests; assessment of TMJ range of motion using a ruler.&#x0D; Results. Participants performed best on the DNS Supine test with legs raised up, and performed worst on the squat, bear position tests and trunk extension static endurance test. 90% of the participants had impaired range of motion of mandible protrusion, 60% had mandibular depression limitations. The static endurance of trunk flexion was 136.85±96.97 s, extension – 141.45±94.52 s, left side– 98.00±76.08 s, right side– 99.95±96, 99 s.&#x0D; Conclusion. There are strong, moderate and weak linear inverse functional relationships between trunk stability and TMJ mobility. The weaker the core stability, the more restricted the mobility of the mandible.&#x0D; Keywords: temporomandibular joint, TMJ dysfunction, dynamic neuromuscular stabilization, core stability.

An impairment-based physical therapy program for runners with femoroacetabular impingement (FAI).

Purpose. Running is a common sport and recreational activity in the United States. Due to its dysfunctional implication in runners, femoroacetabular impingement (FAI) is increasingly recognized as a problematic source of anterior hip pain. The purpose of this case series was to describe an impairment-based physical therapy intervention in non-professional runners with FAI.&#x0D; Materials and methods. Two males, non-professional runners with a mean age of 28.5± 2.1 years, both with a diagnosis of femoroacetabular impingement (FAI), were treated with manual therapy, dynamic neuromuscular stabilization (DNS), and functional training. At initial evaluation, subjects were examined and completed self-reported outcome measures including the visual analog scale (VAS), and the patient-specific functional scale (PSFS). At discharge, they completed the same outcome measures along with the global rating of change (GROC) questionnaire.&#x0D; Results. Both subjects showed clinically meaningful improvement in pain and function above the minimal clinically important difference (MCID). Upon discharge, subject 1 had a 86% reduction in VAS score, a 75% improvement in PSFS score, and a GROC score of 6; subject 2 had a 88% reduction in VAS, a 64% improvement in PSFS, and a GROC score of 5.&#x0D; Conclusion. The overall improvement observed in this study was clinically meaningful to subjects who participated, however, because a cause and effect cannot be inferred from case series studies, follow-up randomized clinical/controlled trials are recommended to further investigate the studied intervention on runners with FAI.

The effects of dynamic neuromuscular stabilization approach on clinical outcomes in older patients with chronic nonspecific low back pain: a randomized, controlled clinical trial

Objective We aimed to examine the effects of Dynamic Neuromuscular Stabilization (DNS) approach in older patients with chronic non-specific low back pain (CNSLBP). Methods A total of 72 participants with CNSLBP were assigned to either the experimental group (n = 36) or control group (n = 36) in this randomized study. A conventional physiotherapy program was administered to the participants in the control group for 3 days per week for a total of 6 weeks. In addition to the conventional program, DNS exercise protocol was performed for 3 days per week for 6 weeks for the participants in the experimental group. While quality of movements and exercise capacity were our primary outcomes, functional balance and quality of life constituted our secondary outcomes. The participants were assessed both at baseline and post-treatment. Results The improvement in a deep squat, in-line lunge, hurdle step, shoulder flexibility, rotary trunk stability, total Functional Movement Screening score, and Timed-up and Go Test score was greater in the experimental group (p<.05). The improvement was similar in both groups in terms of the rest of outcome measures. Discussion This study demonstrated the effectiveness of the DNS approach on some functional movement patterns and functional balance performance in older patients with CNSLBP.

Effects of Eight Weeks of Dynamic Neuromuscular Stabilization Exercises on the Balance of Older Men

Background and Aims Ageing is associated with physical changes where balance impairment is one of important consequences. In this study, we aim to investigate the effect of an 8-week dynamic neuromuscular stabilization (DNS) program on the balance of older men. Methods Thirty-six older men (age: 66.5±1.02 years, height: 171.8±1.17 cm, and weight: 75.4±2.16 kg) were purposefully selected based on the inclusion criteria. They were then paired based on the functional reach test score and randomly assigned to exercise (n=18) and control (n=18) groups. The pre-test and post-test assessments included the functional reach test and the Y balance test. The exercise group performed the DNS exercises for eight weeks (three sessions of one hour per week), while the control group performed their routine daily activities. The collected data were analyzed by repeated measures ANOVA in SPSS software. Results There was a significant interaction effect of time and group on the scores of both functional reach test and Y balance test (F(1,23)=12.17, P=0.002, η2&gt;0.35). From the pre-test to the post-test phase, there was a significant improvement in the exercise group, while no significant improvement was reported in the control group. Conclusion The DNS program can affect the balance of older men. It is recommended to use these exercises to improve their balance.

Effectiveness of dynamic neuromuscular stabilisation for improving trunk control in hemiplegic stroke: A scoping mini review

Stroke is one of the leading causes of mortality and morbidity in the adult population, resulting in significant cognitive and sensorimotor impairments affecting one-half of the body in most patients. The limitations that are attributed to trunk impairment affect the postural and respiratory functions due to either spasticity or weakness of trunk muscles, including the diaphragm. Physiotherapy is effective in interdisciplinary stroke management, with approaches utilising the principles of plasticity. This review focused on briefing the pathomechanical aspects of trunk impairment in hemiplegic stroke. The proposed mechanisms of Dynamic Neuromuscular Stabilization (DNS) as a treatment for hemiplegic stroke were analysed, and the existing research evidence for the efficacy of DNS in improving trunk control among stroke participants was critically reviewed. The findings substantiate the need for high-quality trials, emphasising study design, subset size, reflective outcomes, and regulated follow-ups.

Effects of Dynamic Neuromuscular Stabilization and Aquatic Exercises on the Pain, Disability, Lumbopelvic Control, and Spinal Posture of Patients With Non-specific Low Back Pain

Objectives: Using an exercise intervention to improve lumbopelvic control (LPC) can enhance the pain severity and disability of participants with non-specific low back pain (NSLBP). The present study aimed to compare dynamic neuromuscular stabilization (DNS) exercises and common aquatic exercises (AEs) in terms of improving the pain, disability, LPC, and spinal posture of patients with non-specific low back pain (NSLBP). Methods: This single-blind controlled clinical trial was conducted on 45 subjects who were randomly divided into three groups, such as DNS (n=15), AEs (n=15), and control (n=15). LPC, spinal posture, pain severity, and disability were assessed in pretest and six weeks after the intervention by pressure biofeedback, a spinal mouse device, the visual analog scale (VAS), and the Oswestry disability questionnaire, respectively. No intervention was implemented for the control group. Results: No significant differences were observed between the study groups regarding the impact of the interventions on improving pain and disability (P&gt;0.05). In addition, no significant difference was observed between the AEs and DNS groups regarding the improvement of LPC disorders (P&gt;0.05). The spinal inclination angle (P=0.03) and inclination of range of motion (P=0.05) were significantly improved only by the AEs. Discussion: According to the results, the DNS exercises and AEs had no significant differences in terms of impact on the improvement of pain, disability, and LPC. Therefore, proper alternatives can be used to enhance such dysfunctions in case of a lack of access to pools and hydrotherapy pools.