DNS vs Thoracic Stabilization Exercises in Thoracic Kyphosis

NCT07255794 | Not Yet Recruiting

• 1 other identifier: MU-FHP-DNS-TS-2025-02
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to compare the effects of Dynamic Neuromuscular Stabilization (DNS) exercises and thoracic stabilization exercises on thoracic erector spinae muscle strength, thoracic kyphosis angle, pain and trunk stabilization in individuals with thoracic kyphosis. Thirty participants aged 18-40 years with thoracic kyphosis will be randomly allocated to a DNS exercise group or a thoracic stabilization exercise group. Surface EMG biofeedback will be used to assess thoracic erector spinae muscle activation, while pain, thoracic kyphosis angle and trunk endurance will be evaluated using validated clinical tests. The interventions will be applied for 6 weeks, and outcomes will be assessed before and after the intervention period.

Conditions

Kyphosis

Keywords

dynamic neuromuscular stabilization(DNS); electromyography; thoracic stabilization exercises

Outcome Measures

Primary Outcomes (1)

• Thoracic Kyphosis Index (Flexible Ruler Measurement)

  Thoracic kyphosis will be measured using a flexible ruler placed from C7 to T12 in standing posture. The curve will be transferred to paper and the kyphosis index will be calculated using the formula (H/U) × 100, where H is the height and U is the length of the curve. Higher scores indicate greater kyphosis. Analysis Metric: Change from baseline to Week 6 in kyphosis index.

  Baseline and Week 6

Secondary Outcomes (5)

• Thoracic Erector Spinae Muscle Activity (Surface EMG, µV)

  Baseline and Week 6

• Pain Intensity - Visual Analog Scale (VAS)

  Baseline and Week 6

• Plank Test (Core Endurance, seconds)

  Baseline and Week 6

• Lateral Plank Test (Oblique Endurance, seconds)

  Baseline and Week 6

• Sorensen Back Extensor Endurance Test (seconds)

  Baseline and Week 6

Study Arms (2)

Dynamic Neuromuscular Stabilization (DNS) Group (DNSG)

EXPERIMENTAL

Behavioral: Dynamic Neuromuscular Stabilization Exercises

Thoracic Stabilization Exercise Group (TSG)

EXPERIMENTAL

Behavioral: Thoracic Stabilization Exercise

Interventions

Dynamic Neuromuscular Stabilization Exercises BEHAVIORAL

Participants in the DNS group will perform Dynamic Neuromuscular Stabilization exercises based on developmental kinesiology. The program includes prone (4.5-month position), modified prone over a Swiss ball, quadruped (9-month position) and prone exercises on a Swiss ball with bilateral hand support. All exercises emphasize proper spinal alignment, diaphragmatic breathing and coordinated activation of the deep stabilizing muscles. Participants will complete two supervised sessions per week and perform home exercises twice daily (10 repetitions per exercise) for 6 weeks. An exercise diary will be used to monitor adherence.

Dynamic Neuromuscular Stabilization (DNS) Group (DNSG)

Thoracic Stabilization Exercise BEHAVIORAL

Participants in the thoracic stabilization group will perform a structured thoracic and scapular stabilization program including foam roller thoracic extension in supine, prone thoracic extension, child's pose with thoracic extension and scapular retraction exercises. The exercises are designed to improve thoracic mobility, strengthen the thoracic extensors and enhance postural alignment. Participants will complete two supervised sessions per week and perform home exercises twice daily (10 repetitions per exercise) for 6 weeks. Exercise adherence will be tracked with an exercise diary, and participants who miss the program for three consecutive days will be withdrawn from the study.

Thoracic Stabilization Exercise Group (TSG)

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age between 18 and 40 years.
• Presence of thoracic kyphosis based on clinical and flexible ruler assessment.
• Able to perform exercise-based interventions.
• Voluntarily agrees to participate and signs the informed consent form.
• No neurological, systemic, cardiac or orthopedic condition that would prevent safe participation in the exercise program.

You may not qualify if:

• Age outside the range of 18-40 years.
• Pregnancy.
• Malignancy.
• History of spinal surgery within the last year.
• Currently performing spinal or intensive core stabilization exercises.
• Visual, auditory or cognitive impairment that would interfere with cooperation during the intervention.
• Contraindications to exercise participation.
• Non-adherence to the exercise program (not performing exercises for three consecutive days).

Sponsors & Collaborators

• Esra BECENI: lead

Study Sites (1)

Mudanya University

Bursa, 16940, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Kyphosis

Condition Hierarchy (Ancestors)

Spinal Curvatures; Spinal Diseases; Bone Diseases; Musculoskeletal Diseases

Study Officials

• Esra Beceni, Lecturer

  Mudanya University Vocational School , Physiotherapy Program"

  STUDY DIRECTOR

• Server Erdoğmuş Gülcan, PhD students

  Mudanya University, Faculty of Health Sciences, Department of Physiotherapy

  PRINCIPAL INVESTIGATOR

• Ata Ekşi, Undergraduate student

  Mudanya University, Faculty of Health Sciences, Department of Physiotherapy

  STUDY CHAIR

Central Study Contacts

Esra Beceni, Lecturer

CONTACT

+905387358097; esra.beceni@mudanya.edu.tr

Server Erdoğmuş Gülcan, PhD Students

CONTACT

+905397829714; server.erdogmus@mudanya.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Randomization will be done by the sealed envelope method.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: lecturer

Model Details: a randomized, controlled, assessor-blind, prospective study

Study Record Dates

• First Submitted: November 20, 2025
• First Posted: December 1, 2025
• Study Start: December 1, 2025
• Primary Completion: January 30, 2026
• Study Completion: February 15, 2026
• Last Updated: December 1, 2025

Record last verified: 2025-11

Locations

TU (1)