Dynamic neuromuscular stabilization in the management of chronic spinal pain: A systematic review and meta-analysis.

Abstract

BackgroundChronic spinal pain is a leading cause of long-term disability worldwide. Dynamic Neuromuscular Stabilization (DNS), based on developmental kinesiology principles, has emerged as a rehabilitation approach aimed at improving movement patterns and neuromuscular control. However, its effectiveness in chronic spinal pain remains unclear.ObjectiveTo systematically evaluate the effectiveness of DNS, in reducing pain and improving functional disability in individuals with chronic spinal pain.MethodsThis systematic review and meta-analysis were conducted according to PRISMA guidelines. Electronic databases were searched up to August 2025. Twelve studies involving 531 participants met the inclusion criteria. Pain and disability outcomes were assessed using validated instruments. Standardized mean differences (SMDs) were calculated using a random-effects model. Risk of bias was assessed using ROB 2.0, methodological quality using the PEDro scale, and certainty of evidence using GRADEpro.ResultsDNS demonstrated a moderate effect on pain reduction compared with control interventions (SMD = -0.51; 95% CI: -1.03 to 0.00; p = 0.05), although substantial heterogeneity was observed. A statistically significant improvement in disability was also found (SMD = -0.49; 95% CI: -0.89 to -0.10; p = 0.02). Overall certainty of evidence was low because of methodological limitations and variability among studies.ConclusionDNS may improve functional outcomes in chronic spinal pain, while its effect on pain reduction appears limited. Further high-quality randomized controlled trials with standardized protocols are required to establish long-term effectiveness.