A comparison of the effectiveness of dynamic neuromuscular stabilization exercises and chiropractic HVLA lumbar manipulation in individuals with chronic nonspecific low back pain

The aim of this study is to comparatively examine the effects of chiropractic HVLA lumbar manipulation and Dynamic Neuromuscular Stabilization (DNS) Exercises on pain, physical competence, amount of functional impairment due to pain, dynamic adaptability of core muscles and postural deviations in individuals with chronic non-specific low back pain. Fifty people aged 20-45 years participated in the study. They were randomly divided into 4 groups as Control group, Chiropractic HLVA manipulation group (KM), DNS exercises group (DNS) and Chiropractic HVLA manipulation + DNS exercises group (KM+DNS). Except for the control group, all participants received sessions twice a week for 4 weeks. Before the program, at the end of the 2nd week and at the end of the study, pain was assessed by Visual Analog Scale, physical disability by Roland Moris Disability Questionnaire, functional impairment due to pain by Oswerty Scale, dynamic adaptability of core muscles by DNS-HS test and posture by PostureScreen Mobile. Significance was evaluated at P<0.05 level. There were no significant differences between the groups in terms of age, gender and body mass index (p>0.05). In intragroup comparisons, there is a significant difference in all parameters except postural deviation values of the KM group (p<0.05). There is a significant difference in all parameters except frontal postural deviation values of DNS and KM+DNS groups (p<0.05). In the comparison between groups, the KM+DNS group was superior to the other groups in the 2nd measurement of pain (p<0.05), and in all other parameters, the DNS and KM+DNS groups were similar to each other and superior to the Control group (p<0.05). In the clinical management of pain in individuals with chronic non-specific low back pain, the combination of chiropractic HVLA manipulation and DNS exercises in the clinical management of pain will provide an earlier improvement response on pain. We believe that DNS exercises and chiropractic HVLA manipulation should be preferred together in the treatment program of individuals with chronic non-specific low back pain.