Effects of Dynamic Neuromuscular Stabilization Exercises in Non-Specific Chronic Low Back Pain Patients

Recruiting

Brief Summary: This study will examine and compare the therapeutic outcomes of Dynamic Neuromuscular Stabilization (DNS) with Strengthening and Flexibility Exercises (SFE) in patients with Non-Specific Chronic Low Back Pain (NSCLBP) with Movement Control Impairment (MCI).

The intended study is an assessor-blinded, experimental, randomized controlled trial with two parallel arms and two measurement points: baseline assessment and at the end of the six-week intervention or after the conclusion of 30 sessions of intervention. A total of 66 subjects having non-specific chronic low back pain will be chosen based on inclusion criteria and randomly assigned to one of the two groups (33 subjects in each group). Outcome variables will include lumbar segmental stability (sagittal plane inter-vertebral rotations and translations), lumbo-pelvic dynamic stability, trunk endurance, proprioception, pain, disability, kinesiophobia and quality of life. Both groups will receive progressive group-specific exercises. Group A will receive DNS Exercises and Group B will receive generally prescribed strengthening and flexibility exercises (SFE) for 30-45 minutes per session. Altogether, participants will have maximum 5 sessions of supervised training in a week for a total of 6 weeks (30 sessions).

Recruitment & Eligibility

Inclusion Criteria

Numeric Pain Rating Scale (NPRS) of 2 or more 2.
Positive prone instability test 3.
Two or more positive test findings on Luomajoki MCI tests battery as â€¨well as MCI specific complaints of pain elicitation in static postures 4.
Score of 20% or more on Oswestry Disability Index version 2.1a (ODI v 2.1a).

Exclusion Criteria

Back discomfort caused by a specific pathology, such as a disc herniation, tumour, infection, or fracture, osteoporosis, structural deformity, inflammatory illness, radicular syndrome, or cauda equina syndrome 2.
Lower Back pain that is constant or severe, as determined by clinical criteria, due to nerve root irritation â€¨ 3.
Any Spinal surgery or Major surgery within the past years â€¨ 4.
Current Pregnancy or post partum period less than 6 months and a multiparous woman who â€¨has given birth more than twiceâ€¨ 5.
BMI â‰¥ 30 Or Presence of co-morbidity (e.g. history of angina, shortness of breath, â€¨uncontrolled hypertension), which may limit exercise performance.
Straight Leg â€¨Raise (SLR) less than 50Â° Or positive sacroiliac-joint pain provocation tests â€¨ 7.
Patients with a score of â‰¥ 72 on the Ã–rebro Musculoskeletal Screening Questionnaire -12 (OMSQ-12) will be excluded to avoid confounding by psychosocial factors.

Primary Outcome Measures

Name	Time	Method
1. Lumbar Segmental Motion	Two measurement points -At the baseline and at the end of the six-week intervention or 30 sessions
2. Lumbo-Pelvic Dynamic Stability â€¨	Two measurement points -At the baseline and at the end of the six-week intervention or 30 sessions
3. Trunk Endurance	Two measurement points -At the baseline and at the end of the six-week intervention or 30 sessions
4. Proprioception â€¨	Two measurement points -At the baseline and at the end of the six-week intervention or 30 sessions

Secondary Outcome Measures

Name	Time	Method
Kinesiophobia â€¨(Fear of Movement)	Two measurement points -At the baseline and at the end of the six-week intervention or 30 sessions
Quality of life â€¨	Two measurement points -At the baseline and at the end of the six-week intervention or 30 sessions
Pain â€¨
Functional Disability â€¨	Two measurement points -At the baseline and at the end of the six-week intervention or 30 sessions

Locations (1): Pt. Deendayal Upadhyaya National Institute for Persons with Physical Disabilities (Divyangjan)
🇮🇳
Delhi, DELHI, India
Pt. Deendayal Upadhyaya National Institute for Persons with Physical Disabilities (Divyangjan)
🇮🇳Delhi, DELHI, India
Manju Kaushik
Principal investigator
9891182228
manju.vats@rediffmail.com