Effects of Dynamic Neuromuscular Stabilization on Lower Limb Muscle Activity, Pain, and Disability in Individuals with Chronic Low Back Pain: A Randomized Controlled Trial

Abstract

Background and Objectives: Chronic low back pain (CLBP) is associated with altered neuromuscular control. Dynamic Neuromuscular Stabilization (DNS) targets core–limb coordination; however, its specific impact on lower-limb electromyographic (EMG) activity during gait remains unclear. Materials and Methods: Fifty-five young adults with non-specific CLBP (pain ≥ 3 months with no identifiable specific pathology) completed the trial (overall mean age 23.7 ± 1.3 years). Participants were randomized to an 8-week DNS program or a control. Pre-/Post-intervention surface EMG during gait and clinical outcomes (VAS, ODI) were assessed. Results: Compared with control, DNS showed lower adjusted Post-test VAS (3.08 ± 0.25 vs. 6.13 ± 0.24; ηp2 = 0.596) and ODI (15.73 ± 1.55% vs. 34.36 ± 1.52%; ηp2 = 0.579). Directionally, DNS was associated with phase-specific EMG modulation: tibialis anterior during mid-stance was lower (ηp2 = 0.137), rectus femoris during push-off was lower (ηp2 = 0.119), biceps femoris during push-off was lower (ηp2 = 0.168), and vastus medialis at heel-strike was higher (ηp2 = 0.077) relative to control. Other muscle–phase pairs showed no adjusted between-group differences. Conclusions: An 8-week DNS program was associated with clinically meaningful reductions in pain and disability and with phase-specific changes in lower-limb EMG during gait. These findings support DNS as a promising rehabilitation option for young adults with CLBP; confirmation in larger trials with active comparators is warranted.