Effects of Dynamic Stabilizatıon Exercises and HVLA Manipulatıon in Low Back Paın (DNSHVLA)

SEFA HAKTAN HATIK

Status: Completed

Conditions: Neuromuscular Subluxation of Joint; Low Back Pain

Treatments: Other: Dynamic Neuromuscular Stabilization; Other: Chiropractic Manipulation (HVLA - high velocity low amplitude)

Study type: Interventional

Funder types: Other

Identifiers

NCT06277700

CMT001

Details and patient eligibility

About

Our aim is to contribute to the literature by comparatively examining the effects of DNS exercises and chiropractic HVLA manipulation on pain, pain-related functional impairment (disability), physical competence level, dynamic fitness level of core muscles and postural deviations in patients with chronic nonspecific low back pain.

Full description

Sixty volunteers aged between 20 and 45 years will participate in this study. Before starting the study, anthropological measurements (height, weight, body mass index) were made. After these measurements, the participants will be randomly divided into four groups.

The groups will be formed as chiropractic manipulation (CM) group (n=15), dynamic neuromuscular stabilization (DNS) group (n=15), CM + DNS group (n=15) and control group (CG) (n=15).

The KM group will receive 8 sessions of High Velocity Low Amplitude (HVLA) chiropractic manipulation twice a week for 4 weeks and the DNS group will receive 8 sessions of (DNS) exercise twice a week for 4 weeks and each session will last 50 minutes. The KM+DNS group will receive a total of 8 sessions of DNS exercises and HVLA chiropractic manipulation twice a week for 4 weeks.

Participants will be assessed a total of 3 times during the study; just before the intervention starts, 2 weeks after the intervention starts, after the 4th session, 4 weeks after completing the intervention, after the 8th session.

Participants will be assessed with Visual Analog Scale (VAS), Roland Morris Disability Questionnaire (RMDQ), Dynamic Neuromuscular Stabilization - Heel Slip Test (DNS-HS), Oswety Disability Index (ODI) and posture assessment will be performed using PostureScreen Mobile application.

Enrollment: 60 patients

Sex: All

Ages: 20 to 45 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 7 points in Oswetry Disability Index (ODI)
• Participants should be between the ages of 20 and 45
• Normal radicular tests
• Being diagnosed with low back pain 6 months
• Not having perception problems and being able to cooperate well
• Signing the voluntary consent form

Exclusion criteria

• Pregnancy
• History of previous spinal canal surgery
• Presence of neurological deficits
• Presence of cancer
• Having an inflammatory or rheumatologic disease
• Spinal deformities (due to infection or trauma, compression fracture)

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 4 patient groups

Chiropractic Manipulation (CM) Group

Experimental group

Description:

In the side lying position, lumbar chiropractic manipulation will be performed over the transverse process of the vertebra thought to have vertebral subluxation. A total of 8 sessions of chiropractic manipulation will be performed 2 times a week.

Treatment:

Other: Chiropractic Manipulation (HVLA - high velocity low amplitude)

Dynamic Neuromuscular Stabilization (DNS) Group

Experimental group

Description:

Participants in the groups receiving DNS exercise therapy will be given individualized exercises under the supervision of a physiotherapist. Firstly, the participants will be taught the skill of posterior diaphragm activation in the supine position and the ability to direct the intra-abdominal pressure caudally, while preventing the cranial movement of the thorax, so that the chest and pelvis are in a neutral position and the thoracic diaphragm and pelvis are aligned in parallel. Our aim in this alignment is that with the correct diaphragm movement pattern, the deep stabilizers will be activated as a reflex response to intra-abdominal pressure change. Participants will be asked to focus on and maintain this alignment throughout the entire DNS exercise pattern. Exercises will be done 2 times a week for 50 minutes for 4 weeks.

Treatment:

Other: Dynamic Neuromuscular Stabilization

CM + DNS Group

Experimental group

Description:

This group receives a treatment as a combination of the treatments described above.

Treatment:

Other: Chiropractic Manipulation (HVLA - high velocity low amplitude)

Other: Dynamic Neuromuscular Stabilization

Control Group

No Intervention group

Description:

No treatment will be applied to the control group.