The Effects of Dynamic Neuromuscular Stabilization Approach
Condition: Low Back Pain; Rehabilitation; Treatment
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      When the positive effects of the recently popular "Dynamic Neuromuscular Stabilization (DNS)"
      approach are examined, it suggests that it may be a possible treatment option in geriatric
      individuals with chronic nonspecific low back pain (CSNLP). Based on the principles of
      developmental kinesiology, the DNS approach takes advantage of infants' motor development
      curves in the treatment of motor disorders. The main focus is on regulating intra-abdominal
      pressure and the integrated spinal stabilizing system (ISSS) through specific functional
      exercises based on the positions exhibited by a healthy infant. According to the DNS, every
      developmental position is an exercise position, but every exercise must follow basic
      principles. These principles are restoration of correct respiratory pattern and
      intra-abdominal pressure, respectively; ensuring correct support during dynamic activities of
      the extremities and ensuring biomechanical alignment during movement. Considering the
      principles of exercise, there appears to be a potential mechanism of action for anomalies in
      geriatric individuals with CNSLBP. Therefore, in our study, we aimed to examine the effect of
      DNS approach on functional movement patterns, balance, quality of life and exercise capacity
      in geriatric individuals with CNSLBP. It is the first randomized controlled study in the
      literature, and our hypothesis is that the DNS approach may be an effective therapeutic
      approach on these parameters.
    

Detailed description: 
      It has been reported that during isometric upper and lower extremity flexion exercises in
      individuals with chronic nonspecific low back pain (CSNLP), the mobility of the diaphragm
      decreases, especially in the anterior-middle portions. The regulation of intra-abdominal
      pressure is impaired due to insufficient mobility of the diaphragm and causes compressive
      forces on the vertebrae due to the compensatory activity of the superficial spinal extensors.
      Muscle imbalance between the upper and lower quadrants also results in an abnormal position
      of the chest or rib cage, negatively affecting lung function and exercise capacity. When the
      positive effects of the recently popular "Dynamic Neuromuscular Stabilization (DNS)" approach
      are examined, it suggests that it may be a possible treatment option in geriatric individuals
      with CSNLP. Based on the principles of developmental kinesiology, the DNS approach takes
      advantage of infants' motor development curves in the treatment of motor disorders. The main
      focus is on regulating intra-abdominal pressure and the integrated spinal stabilizing system
      through specific functional exercises based on the positions exhibited by a healthy infant.
      According to the DNS, every developmental position is an exercise position, but every
      exercise must follow basic principles. These principles are restoration of correct
      respiratory pattern and intra-abdominal pressure, respectively; ensuring correct support
      during dynamic activities of the extremities and ensuring biomechanical alignment during
      movement. Considering the principles of exercise, there appears to be a potential mechanism
      of action for anomalies in geriatric individuals with CNSLBP. Therefore, in our study, we
      aimed to examine the effect of DNS approach on functional movement patterns, balance, quality
      of life and exercise capacity in geriatric individuals with CNSLBP. It is the first
      randomized controlled study in the literature, and our hypothesis is that the DNS approach
      may be an effective therapeutic approach on these parameters.
    

Intervention name(s): Dynamic neuromuscular stabilization approach; Conventional treatment
Intervention type(s): Other; Other
Intervention description(s): The experimental group will follow a DNS exercise protocol based on previous procedure for a whole period of 6 weeks (three 50-min sessions per week) in addition the conventional treatment.; Patients from both groups will receive a conventional 6-week treatment programme (18 treatment sessions, three a week, for 30-40min duration).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: low back pain; rehabilitation; stabilization; exercises; balance