Six Weeks Effects of Dynamic Neuromuscular Stabilization (DNS) Training in Obese Postpartum Women With Low Back Pain: A Randomized Controlled Trial

Abstract

Background: The worldwide prevalence of obesity and low back pain (LBP) has recently dramatically increased and is mainly indicated among postpartum women, leading to a range of adverse health consequences. Objective: This study aimed to investigate the effects of 6 weeks of Dynamic Neuromuscular Stabilization training (DNS) in obese postpartum women with LBP. Method: This was a pretest-posttest study design. The study was conducted with 40 obese postpartum women with LBP randomized to receive DNS ( n = 20) or General Exercise (GE, n = 20) 6 times a week for 6 weeks. The data were gathered before and after the 6-week intervention. Results: Forty participants completed the study (mean ± SD, age 29.30 ± 3.77 years; weight 88.10 ± 6.09 kg; height 165.40 ± 6.31 cm; and BMI, 32.19 ± 1.07 kg/m2). The overall group-by-time interaction was significant for Numeric Pain-Rating Scale, Modified Oswestry Disability Questionnaire, Fear-Avoidance Beliefs Questionnaire, Inspiration and Expiration Breath Hold Time, and Respiratory Rate outcomes. The global rating of change was significantly different between groups ( p < .05). The rate of improvement was higher in the DNS group compared to the GE group in all 6 tests. Conclusion: The present study confirms that DNS is applicable in obese postpartum women with LBP and effectively improved NPRS, MODQ, FABQ, BHT, and RR. It is clinically suggested that DNS is imperative based on ideal ontogenetic patterns to attain optimal results for obese postpartum women with LBP.

Pain Neuroscience Education and Motor Control Exercises versus Core Stability Exercises on Pain, Disability, and Balance in Women with Chronic Low Back Pain

“…Low back pain (LBP) is associated with disorders and disabilities in balance [ 3 , 4 ] and movement [ 5 ]. Several non-surgical treatments have been offered to help and decrease LBP, such as joint manipulation [ 2 ], acupuncture [ 6 ], traditional therapeutic exercises [ 7 , 8 ], and medication [ 9 , 10 ]. However, the small effects of these treatments indicated that effective treatment methodologies are needed to achieve a significant therapeutic effect.…”

A Systematic Review and Meta-analysis of Randomized Controlled Trials of Stabilizing Exercises for Lumbopelvic Region Impact in Postpartum Women With Low Back and Pelvic Pain

“…Seven other studies were omitted because of the following reasons: (a) without control group (Adnan et al, 2021; Unsgaard-Tøndel et al, 2016), (b) duplicate study (Bastiaenen et al, 2004; Stuge et al, 2004), (c) review article (Sakamoto & Gamada, 2019), (d) lack of access to data (Chaudry et al, 2013), and (e) study with different population (Raza et al, 2020). 11 studies (Bastiaenen et al, 2006; Ehsani et al, 2020; ElDeeb et al, 2019; Ghavipanje et al, 2021; Gutke et al, 2010; Khorasani et al, 2020; Mens et al, 2000; Sakamoto et al, 2018; Saleh et al, 2019; Stuge et al, 2004; Teymuri et al, 2018) met our inclusion criteria and were entered in the meta-analysis (PRISMA flow diagram; Figure 1). Studies were performed in Iran ( n = 4), Netherland ( n = 2), Egypt ( n = 2), Sweden ( n = 1), Japan ( n = 1), and Norway ( n = 1).…”

“…Pain-related fear and avoidance behavior increase disability and diminished movement in sufferers with chronic pain (ElDeeb et al, 2019). Therefore, it can be recommended that decreased pain by stabilizing exercises may reduce fear-avoidance patterns resulting in reducing disability (George et al, 2008; Ghavipanje et al, 2021). The activation of TrA and multifidus forms a deep muscle corset, improving stiffness to the spinal and pelvic segments while movements, hence decreasing pain and improving movement patterns (ElDeeb et al, 2019).…”

“…The stabilizing exercise programs with a focus on the integrated spinal stabilizing system (ISSS) (Frank et al, 2013; Ghavipanje et al, 2021; Hodges & Gandevia, 2000; Shirley et al, 2003), precise muscular timing, and coordination for movement efficiency and breathing techniques (Frank et al, 2013; Ghavipanje et al, 2021) were considered appropriate for reducing pain and improving disability. Moreover, decreased activity level can cause a disability undoubtedly associated with fear of movement in patients with LBP (Gutke et al, 2011).…”

“…Furthermore, the combination of stabilizing exercises with respiratory training (particularly inspiratory training), specific exercises for the gluteus muscles, neuromuscular electrical stimulation, thoracic spine mobilization, or myofascial release technique allows more significant improvement. Respiratory resistance determines muscular contractions of the abdominal muscles and diaphragm with increased intra-abdominal pressure, contributing to a decrease in lordotic curve and promoting postural adjustment (Frizziero et al, 2021; Ghavipanje et al, 2021).…”