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We hypothesized that DNS would result in greater muscular activity and associated core stability than NDT.įive healthy adults (mean age 26.1 ± 1.1 years, male: 5) and five hemiparetic stroke patients (mean age 50.8 ± 6.8 years, female: 2 male: 3) were recruited. Hence, the present study was undertaken to examine the therapeutic effects of NDT and DNS interventions on muscular activity in core muscles and the associated core stability and muscle thickness, assessed with electromyography (EMG), a pressure biofeedback unit (PBU), and ultrasound imaging, respectively. However, there is a dearth of objective therapeutic evidence supporting the efficacy of NDT or DNS for core stabilization. DNS utilizes the subconscious stimulation of special zones (chest zones) to reflexively mediate the diaphragm and other core stabilization muscles, which is extremely effective for individuals with reduced somatosensory or movement awareness . DNS was developed based on neurodevelopmental kinesiology and reflex-mediated core stabilization concepts .
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As a way to overcome this limitation, dynamic neuromuscular stabilization (DNS)-based core stabilization exercise has recently been employed to stimulate subconsciously and reflexively, rather than consciously or cognitively, train deep core muscles such as the diaphragm and the transversus abdominis/internal oblique (TrA/IO). Furthermore, as NDT-based core stabilization exercise emphasizes ‘conscious’ and active core stabilization to upright the spine, it might not be conducive for stroke patients if they are unable to follow the instructions due to cognitive impairment or reduced somatosensory or movement awareness . However, it is unclear whether NDT-based core exercise has such therapeutic effects in stroke patients. NDT-based exercise was found to be effective for increasing proximal stability, which is essential for postural control . In children with cerebral palsy (CP), core muscle strengthening of weak abdominal muscles has been shown to improve core muscle co-activation, joint stability, associated dynamic weight shifting, and postural and equilibrium upright reactions . NDT encourages ‘conscious’ and active postural core stabilization to upright the spine and involves activating abdominal muscles while maintaining the neutral posterior “pelvic tilting exercise” to selectively activate the deep core muscles . Neurodevelopmental treatment (NDT) is commonly used to improve postural core stability, but the outcomes of this treatment remain unclear. Postural core instability is associated with poor dynamic balance and a high risk of serious falls .