Effects of Dynamic Neuromuscular Stabilization on Lumbar Curvature, Pelvic Alignment, and Pain in Individuals with Hyperlordosis and Chronic Non-specific Low Back Pain: A Quasi-Experimental Study

Abstract

Background: Non-specific chronic low back pain (NSCLBP) is highly prevalent and often linked with lumbar hyperlordosis and anterior pelvic tilt (APT). Conventional treatments provide limited long-term benefit, and dynamic neuromuscular stabilization (DNS) has emerged as a potential alternative. Objectives: The present study aimed to evaluate the effects of DNS exercises on lumbar curvature, pelvic alignment, and pain intensity in women with hyperlordosis and NSCLBP. Methods: Thirty women aged 30 - 50 years with NSCLBP and lumbar hyperlordosis were allocated to an experimental group (n = 15) receiving a six-week DNS program (three sessions/week) or a control group (n = 15) performing daily activities only. Lumbar lordosis angle was measured with a flexible ruler, APT with a digital inclinometer, and pain with a Visual Analog Scale (VAS). Outcomes were assessed pre- and post-intervention. Data were analyzed using paired t-tests and ANCOVA (α = 0.05). Results: Participants in the DNS group showed significant improvements compared to controls. The lumbar lordosis angle decreased by an average of 3.67° (from 59.00 ± 2.72 to 55.33 ± 2.82; P = 0.002; Cohen’s d = 1.33), APT decreased by 3.04° (from 13.54 ± 1.97 to 10.50 ± 2.75; P = 0.003; d = 1.27), and pain intensity reduced by 2.73 points on the VAS (from 6.93 ± 2.21 to 4.20 ± 2.93; P = 0.032; d = 1.05). The ANCOVA confirmed significant between-group differences for all outcomes: lordosis (P = 0.004, η2 = 0.272), pelvic tilt (P = 0.012, η2 = 0.210), and pain (P = 0.038, η2 = 0.150). Conclusions: The DNS exercises were associated with reductions in lumbar hyperlordosis, APT, and pain intensity in women with NSCLBP. While findings suggest DNS may be a promising non-invasive approach for postural correction and pain relief, conclusions should be interpreted cautiously due to the small sample size, single-gender sample, and quasi-experimental design. Further randomized controlled trials with larger and more diverse populations are warranted.