Comparison of Core Stabilization Exercises versus Dynamic Neuromuscular Stabilization Exercises in Non-specific Chronic Low Back Pain: Study Protocol for a Randomized Clinical Trial.

BACKGROUND

Non-specific chronic low back pain (NSCLBP) is a common musculoskeletal condition characterized by impaired neuromuscular control, reduced postural stability, and functional deficits. Core stabilization exercises (CSE) are widely used but may have limitations in coordinated, multi-muscle activation. Dynamic neuromuscular stabilization (DNS), based on developmental kinesiology, seeks to restore neuromuscular control by engaging integrated diaphragm and core muscle activation. Despite their clinical use, direct comparative evidence between CSE and DNS in NSCLBP remains scarce.

OBJECTIVE

To compare the effects of DNS and CSE on pain, lumbar muscle electromyography (EMG) activity, balance, posture, kinesiophobia, and quality of life in patients with NSCLBP

Methods

This study will include two parallel groups. A total of 34 participants aged between 20 and 50 years diagnosed with NSCLBP will be recruited on the basis of inclusion and exclusion criteria. The participants will be divided into two groups: (1) DNS with interferential therapy (IFT) and hot pack (n = 17) and (2) core stabilization exercises with IFT and hot pack (n = 17). The intervention will be given 3 times per week for 6 weeks. Outcome measures will include pain intensity, EMG activity of erector spinae and multifidus muscles, balance, posture analysis, kinesiophobia, and health-related quality of life. Assessments will be conducted at baseline and post-intervention.

RESULTS

Normality will be assessed using the Shapiro-Wilk test. Baseline differences will be analyzed by independent samples t-tests, and intervention effects by mixed-design ANOVA.

DISCUSSION: Both DNS and CSE are expected to improve pain, neuromuscular activity, balance, posture, kinesiophobia, and quality of life. Comparing objective outcomes across groups will identify which intervention offers greater clinical benefit.

CONCLUSION

This trial will provide evidence to guide clinicians in selecting the most effective exercise intervention for NSCLBP rehabilitation. © 2026 Wiley Periodicals LLC.