Effects of Dynamic Neuromuscular Stabilization Exercises Versus Balance Exercises in Older Adults

March 22, 2026 updated by: Elif Develi, Yeditepe University

Effects of Dynamic Neuromuscular Stabilization Exercises Versus Balance Exercises on Functional Outcomes, Balance, and Quality of Life in Older Adults

The aim of this study is to compare the effects of Dynamic Neuromuscular Stabilization (DNS) based exercises and balance exercises on functional capacity, balance, muscle strength, and quality of life in older adults.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Aging leads to a decline in postural control, muscle strength, balance, and functional capacity, increasing the risk of falls and negatively impacting quality of life. Therefore, investigating the effectiveness of exercise approaches targeting neuromuscular control and stability in older adults is of great importance.

Dynamic Neuromuscular Stabilization (DNS) is a developmental kinesiology-based approach that aims to reactivate the deep stabilizer system, promote diaphragmatic breathing, and restore optimal movement patterns. Traditional balance exercises are commonly used in older adults to improve balance performance. However, evidence regarding the effects of DNS exercises on functional capacity, balance, and quality of life in older adults is limited.

The aim of this randomized controlled clinical trial is to compare the effects of Dynamic Neuromuscular Stabilization exercises and traditional balance exercises on functional capacity, balance, and quality of life in older adults. Individuals aged 65 and over will be included in the study and randomized into two groups: a DNS exercise group and a balance exercise group.

Functional capacity and physical performance assessments will be conducted using the Hand Grip Strength Test, Short Physical Performance Battery (SPPB), and Timed Up and Walk Test. Trunk stability and deep stabilizer system activation will be assessed using the Stabilizer Pressure Biofeedback (SPB) device. Physical activity level will be measured using the Physical Activity Assessment Scale for the Elderly, and quality of life will be measured using the SF-12 Quality of Life Scale. All assessments will be conducted before the intervention and after the exercise program.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
18

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Turkey (Türkiye)
    • Ataşehir
      • Istanbul, Ataşehir, Turkey (Türkiye), 34758
        • Yeditepe University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Older adults aged 65 and over, of both sexes
  • Ability to walk independently and perform basic daily living activities without assistance
  • Willingness to participate and written consent

Exclusion Criteria:

  • Severe neurological disorders or advanced cognitive impairment
  • Serious cardiopulmonary or systemic diseases that would prevent participation in exercise
  • History of orthopedic surgery or acute trauma within the last 6 months
  • Psychiatric disorders or communication difficulties that would prevent participation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Dynamic Neuromuscular Stabilization (DNS) Exercise Group
Participants assigned to this group will receive Dynamic Neuromuscular Stabilization (DNS) exercises focusing on trunk stabilization, diaphragmatic breathing, and activation of the deep stabilizing system.
Other: Dynamic Neuromuscular Stabilization Exercises
Participants in this group will receive Dynamic Neuromuscular Stabilization (DNS) exercises based on developmental kinesiology principles. The intervention focuses on activation and coordination of the deep stabilizing system, diaphragmatic breathing, regulation of intra-abdominal pressure, and restoration of optimal postural and movement patterns. Exercises will be performed in progressively challenging positions appropriate for older adults and will be supervised by a physiotherapist throughout the intervention period.
Active Comparator: Balance Exercise Group
Participants assigned to this group will receive conventional balance exercises aimed at improving postural control and functional balance.
Other: Balance Exercises
Conventional static and dynamic balance exercises commonly used in geriatric rehabilitation, including weight-shifting and functional balance tasks, supervised by a physiotherapist.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Short Physical Performance Battery (SPPB)
Time Frame: 6 weeks

The Short Physical Performance Battery (SPPB) will be used to assess functional capacity, including balance, gait speed, and lower extremity strength in older adults. Higher scores indicate better physical performance. In elderly individuals, a total SPPB score of 8 points or less is considered a clinically significant threshold for poor physical performance and frailty.

Assessments will be conducted as an initial assessment before the six-week exercise program and as a final assessment after the program is completed.
6 weeks
Timed Up and Go Test (TUG)
Time Frame: 6 weeks

The Timed Up and Go Test will be used to evaluate dynamic balance and functional mobility. Shorter completion times indicate better balance and mobility performance. In the elderly population, a TUG test duration of 13.5 seconds or more is used as a cut-off value indicating an increased risk of falls.

Assessments will be conducted as an initial assessment before the six-week exercise program and as a final assessment after the program is completed.
6 weeks
Stabilizer Pressure Biofeedback (SPB)
Time Frame: 6 weeks

Stabilizer Pressure Biofeedback will be used to assess activation and control of the deep stabilizing system during specific stabilization tasks. In elderly individuals, maintaining a pressure change of 0-2 mmHg compared to an initial pressure of 40 mmHg during the abdominal drawing-in maneuver, as assessed by Stabilizer Pressure Biofeedback, is considered the optimal value for proper activation of the deep abdominal muscles.

Assessments will be conducted as an initial assessment before the six-week exercise program and as a final assessment after the program is completed.
6 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Hand Grip Strength Test
Time Frame: 6 weeks

Hand grip strength will be assessed using a hand dynamometer to evaluate upper extremity muscle strength as an indicator of overall muscle function. In elderly individuals, a hand grip strength below 16 kg in women and 27 kg in men is considered an indicator of low muscle strength and possible sarcopenia.

Assessments will be conducted as an initial assessment before the six-week exercise program and as a final assessment after the program is completed.
6 weeks
Physical Activity Scale for the Elderly (PASE)
Time Frame: 6 weeks

The Physical Activity Scale for the Elderly (PASE) will be used to assess habitual physical activity levels in older adults. A PASE score of 67 or below is considered indicative of low physical activity levels and physical inactivity in elderly individuals.

Assessments will be conducted as an initial assessment before the six-week exercise program and as a final assessment after the program is completed.
6 weeks
Short Form-12 Health Survey (SF-12)
Time Frame: 6 weeks

Health-related quality of life will be evaluated using the Short Form-12 (SF-12) questionnaire, including physical and mental component summary scores. In older individuals, SF-12 component scores below 50 indicate that health-related quality of life is below societal norms.

Assessments will be conducted as an initial assessment before the six-week exercise program and as a final assessment after the program is completed.
6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Yeditepe University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Irmak Sıla Çetinel, Yeditepe University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 30, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 30, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 15, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 12, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 22, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 27, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 27, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 22, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IrmakCetinel

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

It's not decided yet.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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