Effects of Dynamic Neuromuscular Stabilization on Pain, Posture, and Respiratory Strength in Chronic Low Back Pain

Not Applicable

Not yet recruiting

• Conditions: Chronic Low-back Pain

• Registration Number: NCT06807710
• Lead Sponsor: Uskudar University

Brief Summary

This study aims to evaluate the effects of dynamic neuromuscular stabilization exercises on individuals experiencing chronic non-specific low back pain for at least six months. Pain intensity will be assessed using the Visual Analog Scale (VAS) marked on a 10 centimeter line. The impact of low back pain on daily activities will be evaluated through the Oswestry Disability Index, while its influence on quality of life will be determined using the Short Form-36 (SF-36). Postural changes related to low back pain will be assessed using the New York Posture Scale. The effects on respiratory muscles will be examined through lung volume measurements using a spirometer, and respiratory patterns will be identified using chest circumference measurements with a measuring tape.

Detailed Description

This study investigates the effects of dynamic neuromuscular stabilization (DNS) exercises on pain, posture, and respiratory muscle strength in individuals with chronic non-specific low back pain. Participants with low back pain persisting for at least six months will be included in the study. The primary objective is to assess the impact of DNS exercises on pain intensity, functional disability, quality of life, posture, and respiratory function.

Pain intensity will be measured using the Visual Analog Scale (VAS) on a 10-centimeter line. Functional disability related to low back pain will be evaluated using the Oswestry Disability Index, a reliable and valid tool for assessing the impact of back pain on daily activities. Quality of life will be measured using the Short Form-36 (SF-36), a comprehensive instrument assessing physical and mental health dimensions.

To evaluate postural changes, the New York Posture Scale will be employed, providing a systematic approach to assess spinal alignment and postural deviations. The study will also examine the effects of DNS exercises on respiratory muscle performance and lung function. Lung volumes will be measured using a spirometer, while respiratory patterns will be analyzed by chest circumference measurements at different thoracic levels using a measuring tape.

The intervention will involve a structured exercise program based on DNS principles, focusing on improving motor control, spinal stability, and neuromuscular coordination. Participants will be assessed at baseline and post-intervention, with follow-up evaluations conducted to observe the long-term effects of the intervention. The study aims to contribute to the understanding of DNS as an effective approach for managing chronic non-specific low back pain.

Study Timeline

• Study First Submitted: 2025-01-29
• Study First Submitted QC: 2025-01-29
• Status Verified: 2025-02
• Study First Posted: 2025-02-04
• Last Update Submitted: 2025-02-24
• Last Update Posted: 2025-02-25
• Study Start: 2025-03-03
• Primary Completion: 2025-05-03
• Study Completion: 2025-07-03

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• Aged between 18 and 50 years
• Experiencing continuous or intermittent low back pain for more than 3 months, localized between the L1 region and gluteal muscles

Exclusion Criteria

• Specific medical diagnoses such as spinal fractures or spinal stenosis
• Presence of rheumatological disorders
• Tumors
• History of lumbar surgery in the last 3 years
• Neurological problems
• Osteoporosis
• History of epilepsy, vertigo, headaches, or nausea
• Chronic lung diseases
• Prior physiotherapy treatment for low back pain
• Acute low back pain episodes
• Mental disorders
• Pregnancy

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Respiratory Muscle Strength	8 weeks	Respiratory muscle strength was measured using an electronic mouth pressure measuring device (Cosmed Ponyy Fx, Rome, Italy). Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured.
Visual Analog Scale (VAS)	8 weeks	The Visual Analog Scale (VAS) will be used to measure pain intensity by having participants mark their perceived level of pain on a 10-centimeter line ranging from 'no pain' to 'worst pain imaginable. The Visual Analog Scale (VAS) for pain ranges from a minimum of 0 to a maximum of 10, with higher scores indicating greater pain intensity.
New York Posture Analysis	8 weeks	The New York Posture Analysis is a validated and systematic tool used to evaluate postural alignment and deviations. This method involves visual inspection and scoring of key postural elements, including head, shoulders, spine, pelvis, and lower extremities, in both anterior-posterior and lateral views. Each segment is assessed for alignment and assigned a score based on observed deviations. The total score reflects the overall postural status, with higher scores indicating better postural alignment. This measure will be used to assess changes in posture pre- and post-intervention. The New York Posture Rating Scale scores range from a minimum of 0 to a maximum of 36, with higher scores indicating better posture.

Secondary Outcome Measures

Name	Time	Method
Oswestry Disability Index (ODI)	8 weeks	he Oswestry Disability Index is a self-reported questionnaire designed to assess how low back pain affects an individual's ability to perform daily activities. The index consists of 10 sections, each addressing a specific domain: pain intensity, personal care, lifting, walking, sitting, standing, sleeping, sexual life, traveling, and social life. Each section includes six response options scored from 0 (no disability) to 5 (maximum disability). The total score ranges from 0 to 50 points, with higher scores indicating greater levels of disability.
Short Form-36 (SF-36) Health Survey	8 weeks	The Short Form-36 (SF-36) Health Survey is a widely used self-reported questionnaire designed to assess health-related quality of life across eight domains: physical functioning, role limitations due to physical health, role limitations due to emotional health, energy/fatigue, emotional well-being, social functioning, pain, and general health perceptions. Each domain is scored on a scale from 0 to 100, with higher scores indicating better health and quality of life.
Chest Circumference Measurement	8 weeks	Chest circumference measurement is a simple and reliable method used to assess respiratory patterns and chest expansion. Measurements will be taken at three levels: axillary (upper thoracic), xiphoid (middle thoracic), and subcostal (lower thoracic) regions using a measuring tape. The difference between maximum inspiration and maximum expiration at each level will be recorded to determine the chest expansion.

Trial Locations

Locations (1)

Uskudar University Physiotherapy and Rehabilitation Application and Research Center; 🇹🇷 Istanbul, Turkey