DNS: Face-to-face and Telerehabilitation

NCT07775560 | Recruiting

• 1 other identifier: AIB-FTR-RA-01
• Study Type: interventional
• Target: 34
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare the effects of Dynamic Neuromuscular Stabilization (DNS) exercises delivered face-to-face (YDNS) and via tele-rehabilitation (TDNS) on respiratory function, balance, posture, core endurance, and deep stabilization system performance in healthy adults. A total of 34 participants will be randomly assigned to YDNS or TDNS groups and complete an identical 6-week DNS exercise program (3 sessions per week). Assessments will be conducted at baseline and post-intervention, including pulmonary function, Y-Balance Test, posture analysis, McGill's core stability tests, deep stabilization assessment, and patient satisfaction. All evaluations will be performed face-to-face by certified physiotherapists.

Conditions

Healthy

Keywords

core stabilization; balance; posture; respiratory parameters

Outcome Measures

Primary Outcomes (7)

• Spirometric Pulmonary Function FEV1

  Pulmonary function will be assessed in the sitting position using a portable spirometer (Cosmed Pony FX, Italy) in accordance with the American Thoracic Society (ATS) guidelines. Before the test, participants will be instructed to wear loose and comfortable clothing and to avoid heavy meals immediately before the assessment. Participants will also be advised to temporarily discontinue specific inhaled medications if instructed by their physician. For the test, participants will sit in an upright position and will be fitted with a nose clip. They will place their lips tightly around a disposable mouthpiece connected to the spirometer. After taking a maximal deep inspiration, participants will be instructed to exhale into the mouthpiece as forcefully and rapidly as possible until complete expiration.

  Through study completion, an average of 1 year

• Spirometric Pulmonary Function FVC

  Pulmonary function will be assessed in the sitting position using a portable spirometer (Cosmed Pony FX, Italy) in accordance with the American Thoracic Society (ATS) guidelines. Before the test, participants will be instructed to wear loose and comfortable clothing and to avoid heavy meals immediately before the assessment. Participants will also be advised to temporarily discontinue specific inhaled medications if instructed by their physician. For the test, participants will sit in an upright position and will be fitted with a nose clip. They will place their lips tightly around a disposable mouthpiece connected to the spirometer. After taking a maximal deep inspiration, participants will be instructed to exhale into the mouthpiece as forcefully and rapidly as possible until complete expiration.

  Through study completion, an average of 1 year

• Spirometric Pulmonary Function FEV1/FVC ratio

  Pulmonary function will be assessed in the sitting position using a portable spirometer (Cosmed Pony FX, Italy) in accordance with the American Thoracic Society (ATS) guidelines. Before the test, participants will be instructed to wear loose and comfortable clothing and to avoid heavy meals immediately before the assessment. Participants will also be advised to temporarily discontinue specific inhaled medications if instructed by their physician. For the test, participants will sit in an upright position and will be fitted with a nose clip. They will place their lips tightly around a disposable mouthpiece connected to the spirometer. After taking a maximal deep inspiration, participants will be instructed to exhale into the mouthpiece as forcefully and rapidly as possible until complete expiration.

  Through study completion, an average of 1 year

• Y-Balance Test

  Dynamic balance will be assessed using the Y-Balance Test. Four measuring tapes will be positioned on the floor to form intersecting lines, creating a star-shaped grid with 45° angles. Only three directions will be tested: anterior (A), posteromedial (PM), and posterolateral (PL). Participants will place their dominant foot at the center of the grid while reaching as far as possible with the opposite foot in the specified directions. The plantar surface of the first metatarsophalangeal joint of the stance foot will be required to remain at the grid center to ensure consistency. Testing will begin in the anterior direction and proceed clockwise. During posterolateral reaching tasks, participants will be instructed to reach behind the stance leg. Each participant will perform three practice trials followed by three test trials in each direction. The average of the three test trials will be recorded as the test score. To account for limb length differences, normalized reach distance will

  Through study completion, an average of 1 year

• Biering-Sorenson Test

  Trunk extensor endurance will be assessed using the Biering-Sørensen Test. Participants will be positioned prone on a treatment table with their anterior superior iliac spines aligned with the table edge, allowing the upper body to extend beyond the edge. Stabilization straps will be applied across the pelvis, thighs, and lower legs to secure participants to the table. With arms crossed over the chest, participants will be instructed to lift their trunk until it is parallel to the floor. A digital inclinometer will be placed between the scapulae to monitor trunk angle. Participants will be asked to maintain this horizontal position for as long as possible. The holding time will be recorded with a stopwatch. The test will be terminated when the trunk angle deviates more than 10° from the starting position or when the participant voluntarily stops.

  Through study completion, an average of 1 year

• Trunk Flexor Test

  Trunk flexor will be assessed using the Trunk Flexor Test. Participants will be positioned with the trunk at 60° of flexion, while the hips and knees are maintained at 90° of flexion. The arms will be crossed over the chest. Participants will be instructed to maintain this position for as long as possible. The test will be terminated when the participant can no longer hold the position. The duration (in seconds) will be recorded with a stopwatch.

  Through study completion, an average of 1 year

• Side Plank Test

  Side plank will be assessed using the Side Plank Test on a mat, performed on the dominant side. Participants will extend their legs so that the knees and feet are aligned. While lifting the hips off the mat, body weight will be supported only by the lower elbow and feet. The test will be terminated when the side plank position deteriorates or the hips drop. Test duration will be recorded in seconds.

  Through study completion, an average of 1 year

Secondary Outcomes (3)

• Posture

  Through study completion, an average of 1 year

• Deep Stabilization System (DSS) Function Assessment

  Through study completion, an average of 1 year

• Treatment Satisfection

  Through study completion, an average of 1 year

Study Arms (2)

T-DNS

EXPERIMENTAL

Other: DNS Exercises via Telerehabilitation

F-DNS

EXPERIMENTAL

Other: Face-to-face DNS Exercises

Interventions

DNS Exercises via Telerehabilitation OTHER

Participants in the T-DNS group will complete the same 6-week DNS exercise program (3 sessions per week, 18 sessions total, 50 minutes each) following the identical progression: warm-up, DNS core exercises, and cool-down. The content and progression of exercises are identical to the YDNS group (weeks 1-2: basic activation; weeks 3-4: intermediate stabilization; weeks 5-6: advanced stabilization with dynamic movements). Sessions will be conducted remotely through an online platform, with certified DNS physiotherapists providing live supervision, guidance, and corrective feedback in real time.

T-DNS

Face-to-face DNS Exercises OTHER

Participants in the F-DNS group will complete a 6-week Dynamic Neuromuscular Stabilization (DNS) program, consisting of three supervised sessions per week (18 sessions, each 50 minutes). Each session includes a 5-minute warm-up (light walking, joint mobilization, dynamic stretching), 40 minutes of DNS-based core and stabilization exercises, and a 5-minute cool-down (light walking, static stretching). The exercise protocol progresses across three phases: basic activation (weeks 1-2), intermediate stabilization (weeks 3-4), and advanced stabilization combined with dynamic movements (weeks 5-6). Sessions will be delivered face-to-face by certified DNS physiotherapists who provide real-time supervision and feedback.

F-DNS

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Aged between 18 and 35 years.
• Not engaged in regular physical activity within the past 6 months.
• No history of musculoskeletal disorders or chronic diseases.
• Able to participate consistently in the exercise program.
• For the Tele-DNS (TDNS) group: access to reliable internet and appropriate technical equipment for the duration of the intervention.

You may not qualify if:

• Diagnosis or history of neurological, cardiovascular, respiratory, or metabolic diseases.
• History of spinal or extremity surgery.
• Pregnancy.
• Presence of postural deformities or any orthopedic conditions that may affect balance.

Sponsors & Collaborators

• Istinye University: lead

Study Sites (1)

Aleyna Çelik Fizyoterapi ve Danışmanlık Merkezi

Istanbul, Uskudar, Turkey (Türkiye)

RECRUITING

Study Officials

• Reyhan Aydın, PT

  Istinye University

  STUDY CHAIR

• Çiçek Günday, Asst.Prof.

  Istinye University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Reyhan Aydın, PT

CONTACT

+905380732413; reyhanaydin@istinye.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Asst. Prof.

Study Record Dates

• First Submitted: November 26, 2025
• First Posted: August 20, 2026
• Study Start: March 30, 2026
• Primary Completion (Estimated): December 30, 2026
• Study Completion (Estimated): December 30, 2026
• Last Updated: August 20, 2026

Record last verified: 2026-08

Locations

TU (1)