The Effects of Dynamic Neuromuscular Stabilization Exercises in Addition to Conventional Treatment on Functional Capacity, Core Stabilization Muscle Strength, and Balance in Female Patients With Chronic Low Back Pain

Low back pain, which is currently considered a public health problem, is commonly encountered. A significant proportion of low back pain cases is of mechanical origin. "Lumbar discopathy" is a general term used to describe conditions such as Lumbar Discopathy, Lumbar Disc Herniation, Lumbosacral Radiculopathy, and internal disc injury. There are various treatment approaches available for the management of lumbar discopathy in individuals presenting with low back pain. The therapeutic effectiveness of conventional exercise in alleviating low back pain has been well-documented in the literature, and research continues on the impact of different types of exercise on low back pain. One such approach is Dynamic Neuromuscular Stabilization (DNS), which aims to restore the integrated spinal stabilization system through specific functional exercises based on the developmental kinesiological positions of a healthy infant. The DNS perspective holds that each developmental position represents an exercise position. With repetition, these exercises promote the formation of an automatic pattern of central control that becomes a fundamental component of daily movements and skills. The aim of this study is to investigate the effects of conventional physiotherapy protocols and DNS exercises applied in addition to these protocols on functional capacity, the force-generating ability of core stabilization muscles, static and dynamic balance, low back pain and lumbar functionality, and quality of life in female patients diagnosed with Lumbar Disc Herniation and experiencing chronic pain. In this study, the control group received a conventional physiotherapy program for 8 weeks, 4 days per week. The intervention group received the same conventional program plus Dynamic Neuromuscular Stabilization exercises. Outcome measures included the 6-Minute Walk Test (6MWT), core muscle strength assessment, Flamingo Balance Test, Star Excursion Balance Test (SEBT), Numeric Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), and the International Physical Activity Questionnaire (IPAQ), all of which were administered before and after the treatment. As a result, statistically significant differences were observed in both the control and intervention groups when comparing pre- and post-treatment values in the NPRS, 6MWT, ODI, IPAQ, SEBT, Flamingo Balance Test, and core strength as measured by a pressure biofeedback unit. Furthermore, statistically significant differences in NPRS, ODI, and pressure biofeedback results were found in favor of the intervention group when comparing between groups. Keywords: Low back pain, DNS, Developmental Kinesiology