Dual-Task Neuromuscular Warm-Up Exercises in Chronic Low Back Pain

August 8, 2026 updated by: Yunus Emre Tutuneken, Istinye University

Immediate Effects of Dual-Task Neuromuscular Warm-Up Exercises on Balance and Proprioception in Individuals With Chronic Nonspecific Low Back Pain: A Randomized Controlled Study

This study aims to investigate the immediate effects of dual-task neuromuscular warm-up exercises on balance and proprioception in individuals with chronic nonspecific low back pain. Participants will be randomly assigned to either a dual-task neuromuscular warm-up exercise group or a neuromuscular warm-up exercise group. Both groups will also receive the same conventional physiotherapy program. Balance, proprioception, lumbar muscle properties, pressure pain threshold, and flexibility will be assessed before and after the intervention to determine whether adding cognitive tasks to neuromuscular warm-up exercises provides additional immediate benefits.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

40

Phase

  • Not Applicable

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

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosed with nonspecific low back pain persisting for at least 3 months.
  • Pain intensity of ≥3 on the Visual Analog Scale (VAS).
  • Sufficient cognitive ability to understand and follow verbal and written instructions in Turkish.
  • Independent mobility sufficient to perform the tests and exercises.
  • Willingness to participate and provision of written informed consent.

Exclusion Criteria:

  • Acute disc herniation, spinal stenosis, spondylolysis, or spondylolisthesis.
  • Previous spinal surgery or a history of severe trauma affecting the spine.
  • Rheumatic diseases, malignancy, infection, or neurological diseases that may cause low back pain.
  • Sensory or motor loss in the lower extremities or deep tendon reflex loss indicating radiculopathy.
  • Known vestibular or visual system disorders.
  • Body mass index (BMI) ≥30 kg/m².
  • Pregnancy.
  • Physiotherapy/rehabilitation treatment or steroid injection targeting the lumbar region within the previous 3 months.
  • Use of analgesics, muscle relaxants, or sedatives within the previous 24 hours that may affect balance or pain threshold.
  • Other orthopedic or systemic health conditions that may interfere with exercise or balance testing.

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Dual-Task Neuromuscular Warm-Up Exercise Group
Other: Dual-Task Neuromuscular Warm-Up Exercise Group
Participants will perform neuromuscular warm-up exercises combined with cognitive tasks, including single-leg balance with backward counting, squats with word generation, tandem walking with counting, balance pad standing with a memory task, and step-up exercises with a reaction task. Participants will also receive the same conventional physiotherapy program, including hot pack, TENS, therapeutic exercises, and breathing exercises.
Active Comparator: Neuromuscular Warm-Up Exercise Group
Other: Neuromuscular Warm-Up Exercise
Participants will perform the same neuromuscular warm-up exercises without cognitive tasks, including single-leg balance, squats, tandem walking, balance pad standing, and step-up exercises. Participants will also receive the same conventional physiotherapy program, including hot pack, TENS, therapeutic exercises, and breathing exercises.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Balance
Time Frame: Immediately before and after the intervention (same day)
Balance assessed using the ProKin Balance Measurement System.
Immediately before and after the intervention (same day)
Proprioception
Time Frame: Immediately before and after the intervention (same day)
Lower-extremity joint position sense assessed using the ProKin Balance Measurement System.
Immediately before and after the intervention (same day)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Lumbar Erector Spinae Muscle Tone
Time Frame: Immediately before and after the intervention (same day)
Muscle tone assessed using MyotonPRO.
Immediately before and after the intervention (same day)
Lumbar Erector Spinae Muscle Stiffness
Time Frame: Immediately before and after the intervention (same day)
Muscle stiffness assessed using MyotonPRO.
Immediately before and after the intervention (same day)
Lumbar Erector Spinae Muscle Elasticity
Time Frame: Immediately before and after the intervention (same day)
Muscle elasticity assessed using MyotonPRO.
Immediately before and after the intervention (same day)
Pressure Pain Threshold
Time Frame: Immediately before and after the intervention (same day)
Pressure pain threshold assessed using an algometer.
Immediately before and after the intervention (same day)
Hamstring and Lumbar Muscle Flexibility
Time Frame: Immediately before and after the intervention (same day)
Flexibility assessed using the Sit and Reach Test.
Immediately before and after the intervention (same day)
Global Perceived Change
Time Frame: Immediately after the intervention.
Perceived change following the intervention assessed using the Global Rating of Change Scale.
Immediately after the intervention.

Collaborators and Investigators

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

Sponsor

Istinye 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)

August 25, 2026

Primary Completion (Estimated)

March 5, 2027

Study Completion (Estimated)

March 10, 2027

Study Registration Dates

First Submitted

August 8, 2026

First Submitted That Met QC Criteria

August 8, 2026

First Posted (Actual)

August 12, 2026

Study Record Updates

Last Update Posted (Actual)

August 12, 2026

Last Update Submitted That Met QC Criteria

August 8, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 102

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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