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

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: Not yet recruiting
• Conditions: Healthy Older Adults; Age-Related Balance Impairment
• Intervention / Treatment: Other: Dynamic Neuromuscular Stabilization Exercises; Other: Balance Exercises

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: Interventional
• Enrollment (Estimated): 18
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Elif Develi, PhD C; Phone Number: 0905555936293; Email: elifstn@yahoo.com

Study Locations

• Turkey (Türkiye)
  • Ataşehir
    • Istanbul, Ataşehir, Turkey (Türkiye), 34758
      • Yeditepe University
      • Contact: Elif Develi, PhD C; Phone Number: 0905555936293; Email: elifstn@yahoo.com

Participation Criteria

Eligibility Criteria

• 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

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
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

Outcome Measure	Measure Description	Time Frame
Short Physical Performance Battery (SPPB)	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)	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)	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

Outcome Measure	Measure Description	Time Frame
Hand Grip Strength Test	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)	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)	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

• Sponsor: Yeditepe University
• Investigators: Principal Investigator: Irmak Sıla Çetinel, Yeditepe University

Study record dates

Study Major Dates

• Study Start (Estimated): March 30, 2026
• Primary Completion (Estimated): April 30, 2026
• Study Completion (Estimated): May 15, 2026

Study Registration Dates

• First Submitted: January 12, 2026
• First Submitted That Met QC Criteria: March 22, 2026
• First Posted (Actual): March 27, 2026

Study Record Updates

• Last Update Posted (Actual): March 27, 2026
• Last Update Submitted That Met QC Criteria: March 22, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Balance; Quality of Life; Older Adults; Hand Grip Strength; Functional Capacity; Dynamic Neuromuscular Stabilization
• Other Study ID 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