Chronic Low Back Pain (Non-specific, Uncomplicated)NCT07318454
Comparison of Abdominal Expansion and Abdominal Drawing-In Training With Manual and Verbal Cueing in Chronic Non-Specific Low Back Pain
A study testing Abdominal Drawing-In Manoeuvre Training and Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training in people with Chronic Low Back Pain (Non-specific, Uncomplicated), run by National Yang Ming Chiao Tung University.
Trial summary
This study aims to investigate the interactive effects of two core stability training strategies-abdominal drawing-in manoeuvre (ADIM) and Dynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE)-and two instructional approaches (verbal cueing and manual facilitation) on training outcomes in individuals… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Chronic Low Back Pain (Non-specific, Uncomplicated)
- What is being tested?
- Abdominal Drawing-In Manoeuvre Training and Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 96 participants
- Where
- No sites listed yet
- Study dates
- Jan 2027to Oct 2028
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults aged 18 years or older.
- Clinically diagnosed with chronic non-specific low back pain, with symptoms persisting for more than 12 weeks.
- Able to understand the study procedures and comply with the full intervention and assessment protocol.
Who cannot join
- History of surgery involving the lower back or lower extremities.
- Presence of neurological symptoms, such as numbness or tingling sensations.
- Signs or symptoms of nerve root compression.
- History of any surgical procedure within the past 3 months.
- Diagnosis of cancer.
- Presence of major medical or psychiatric disorders.
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- Presence of systemic inflammatory disease.
- Pregnancy.
- Structural scoliosis of the spine.
- Inability to ambulate or stand independently, or other conditions deemed unsuitable for participation.
- Participation in any movement control-based exercise training within the past year.
- Accumulated experience of more than 4 weeks of abdominal drawing-in manoeuvre (ADIM) training or Dynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE) training within the past year.
About this study
Official title: A Randomized Controlled Trial Comparing Abdominal Expansion and Abdominal Drawing-In Training With Manual and Verbal Cueing in Individuals With Chronic Non-Specific Low Back Pain
This study aims to investigate the interactive effects of two core stability training strategies-abdominal drawing-in manoeuvre (ADIM) and Dynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE)-and two instructional approaches (verbal cueing and manual facilitation) on training outcomes in individuals with chronic non-specific low back pain.
A 2×2 factorial randomized controlled trial design will be employed. Ninety-six participants with chronic non-specific low back pain will be randomly allocated, using block randomization, to one of four intervention groups in equal proportions. All groups will receive a 4-week intervention program, with training conducted twice per week.
Outcome measures will be assessed at four time points: before the intervention (baseline), immediately after the first training session, at the completion of the 4-week intervention, and at a 3-month follow-up, to evaluate short-term and mid-term effects as well as the sustainability of training outcomes.
- Being tested
- Abdominal Drawing-In Manoeuvre Training, Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Abdominal Drawing-In Manoeuvre TrainingBehavioural
Abdominal drawing-in manoeuvre (ADIM) training is a core stability exercise strategy emphasizing selective activation and coordination of the deep abdominal musculature to enhance local trunk stability. Participants receive individualized, one-on-one training delivered by licensed physical therapists, conducted twice weekly for 4 weeks. Training is performed across functional positions and task-specific movements, with instruction provided using either verbal cueing or manual facilitation according to group allocation.
Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion TrainingBehavioural
Dynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE) training focuses on coordinated breathing and abdominal expansion to facilitate intra-abdominal pressure regulation and integrated postural control. Participants receive individualized, one-on-one training delivered by licensed physical therapists, conducted twice weekly for 4 weeks. Training is performed across functional positions and task-specific movements, with instruction provided using either verbal cueing or manual facilitation according to group allocation.
| Study group | Role | What they receive |
|---|---|---|
| ADIM With Verbal Cueing | Experimental | Participants receive abdominal drawing-in manoeuvre training with verbal cueing, delivered twice weekly for 4 weeks. Receives: Behavioral: Abdominal Drawing-In Manoeuvre Training |
| ADIM With Manual Cueing | Experimental | Participants receive abdominal drawing-in manoeuvre training with manual facilitation, delivered twice weekly for 4 weeks. Receives: Behavioral: Abdominal Drawing-In Manoeuvre Training |
| DNS-AE With Verbal Cueing | Experimental | Participants receive Dynamic Neuromusculoskeletal Stabilization abdominal expansion training with verbal cueing, delivered twice weekly for 4 weeks. Receives: Behavioral: Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training |
| DNS-AE With Manual Cueing | Experimental | Participants receive Dynamic Neuromusculoskeletal Stabilization abdominal expansion training with manual facilitation, delivered twice weekly for 4 weeks. Receives: Behavioral: Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain intensity
Pain intensity assessed using the Visual Analogue Scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable, with higher scores indicating greater pain intensity.
Measured: At baseline, after the first week of intervention, at the end of the 4-week intervention and at 3-month follow-up
Movement control performance
Movement control performance assessed using the Nine-Item Movement Control Test Battery, which evaluates movement quality during standardized functional movement tasks. Each item is scored according to predefined error-based criteria, and item scores are summed to produce a total score ranging from 0 to 93, with higher scores indicating poorer movement control performance.
Measured: At baseline, after the first week of intervention, and at the end of the 4-week intervention.
Secondary outcomes (10)
Disability related to low back pain
Disability assessed using the Oswestry Disability Index (ODI), with total scores ranging from 0 %to 100%, where higher scores indicate greater disability.
Measured: At baseline, at the end of the 4-week intervention, and at 3-month follow-up.
Patient-specific functional ability
Functional ability assessed using the Patient-Specific Functional Scale (PSFS), with scores ranging from 0 to 10, where 0 indicates inability to perform the activity and 10 indicates the ability to perform the activity at the pre-injury or normal level, with higher scores indicating better functional ability.
Measured: At baseline, at the end of the 4-week intervention, and at 3-month follow-up.
Perceived movement difficulty assessed using the Perceived Difficulty Index (PDI).
Perceived difficulty during movement performance assessed using the Perceived Difficulty Index (PDI). Participants rate the level of difficulty experienced during the movement tasks on a numeric rating scale ranging from 0 to 10, where 0 indicates no perceived difficulty and 10 indicates extreme difficulty, with higher scores indicating greater perceived difficulty.
Measured: At baseline, after the first week of intervention, and at the end of the 4-week intervention.
Central sensitization symptoms
Symptoms related to central sensitization assessed using the Central Sensitization Inventory (CSI), with total scores ranging from 0 to 100, where higher scores indicate greater symptom severity related to central sensitization.
Measured: At baseline and at the end of the 4-week intervention.
Fear-avoidance beliefs
Fear-avoidance beliefs assessed using the Fear-Avoidance Beliefs Questionnaire (FABQ), with total scores ranging from 0 to 96, where higher scores indicate greater fear-avoidance beliefs.
Measured: At baseline and at the end of the 4-week intervention.
Pain catastrophizing
Pain catastrophizing assessed using the Pain Catastrophizing Scale (PCS), with total scores ranging from 0 to 52, where higher scores indicate greater pain catastrophizing.
Measured: At baseline and at the end of the 4-week intervention.
Pressure pain threshold
Pressure pain threshold (PPT) assessed using a pressure algometer.
Measured: At baseline and at the end of the 4-week intervention.
Global perceived change
Overall perceived change assessed using the Global Rating of Change (GROC) scale, ranging from -7 to +7, where negative scores indicate perceived worsening, 0 indicates no change, and positive scores indicate perceived improvement, with higher scores indicating greater perceived improvement.
Measured: At the end of the 4-week intervention and at 3-month follow-up.
Learning acquisition during training
Learning acquisition assessed by the instructor after each training session using a numeric rating scale from 0 to 10.
Measured: After each training session during the 4-week intervention.
Kinesiophobia
Kinesiophobia assessed using the Tampa Scale of Kinesiophobia (TSK-17), ranging from 17 to 68, where higher scores indicate greater fear of movement (kinesiophobia).
Measured: At baseline, after the first week of intervention, at the end of the 4-week intervention and at 3-month follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Jan 2026
- Study startJan 2027 (estimated)
- Primary completionJul 2028 (estimated)
- Study completionOct 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic Low Back Pain (Non-specific, Uncomplicated)Studies of the same condition, open and under way.
- More trials run by National Yang Ming Chiao Tung UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 96 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Yang Ming Chiao Tung University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Wendy Tzyy-Jiuan Wang, National Yang Ming Chiao Tung University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07318454
- Sponsor's protocol ID
- NYCU114229AE-S3
- Status last verified
- Oct 2026
- First submitted
- 23 Dec 2025
- Last updated
- 16 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 16 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Controlled Trial Comparing Abdominal Expansion and Abdominal Drawing-In Training With Manual and Verbal Cueing in Individuals With Chronic Non-Specific Low Back Pain
- ClinicalTrials.gov ID
- NCT07318454
- Acronym / sponsor ID
- NYCU114229AE-S3
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 96 participants (estimated)
- Lead sponsor
- National Yang Ming Chiao Tung UniversityUniversity, hospital or other
- Study start
- Jan 2027 (estimated)
- Primary completion
- Jul 2028 (estimated)
- Study completion
- Oct 2028 (estimated)
- First posted
- 6 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to investigate the interactive effects of two core stability training strategies-abdominal drawing-in manoeuvre (ADIM) and Dynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE)-and two instructional approaches (verbal cueing and manual facilitation) on training outcomes in individuals with chronic non-specific low back pain.
A 2×2 factorial randomized controlled trial design will be employed. Ninety-six participants with chronic non-specific low back pain will be randomly allocated, using block randomization, to one of four intervention groups in equal proportions. All groups will receive a 4-week intervention program, with training conducted twice per week.
Outcome measures will be assessed at four time points: before the intervention (baseline), immediately after the first training session, at the completion of the 4-week intervention, and at a 3-month follow-up, to evaluate short-term and mid-term effects as well as the sustainability of training outcomes.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| ADIM With Verbal Cueing | Experimental | Behavioral: Abdominal Drawing-In Manoeuvre TrainingParticipants receive abdominal drawing-in manoeuvre training with verbal cueing, delivered twice weekly for 4 weeks. |
| ADIM With Manual Cueing | Experimental | Behavioral: Abdominal Drawing-In Manoeuvre TrainingParticipants receive abdominal drawing-in manoeuvre training with manual facilitation, delivered twice weekly for 4 weeks. |
| DNS-AE With Verbal Cueing | Experimental | Behavioral: Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion TrainingParticipants receive Dynamic Neuromusculoskeletal Stabilization abdominal expansion training with verbal cueing, delivered twice weekly for 4 weeks. |
| DNS-AE With Manual Cueing | Experimental | Behavioral: Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion TrainingParticipants receive Dynamic Neuromusculoskeletal Stabilization abdominal expansion training with manual facilitation, delivered twice weekly for 4 weeks. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Adults aged 18 years or older.
- Clinically diagnosed with chronic non-specific low back pain, with symptoms persisting for more than 12 weeks.
- Able to understand the study procedures and comply with the full intervention and assessment protocol.
Key exclusion criteria (12 listed)
- History of surgery involving the lower back or lower extremities.
- Presence of neurological symptoms, such as numbness or tingling sensations.
- Signs or symptoms of nerve root compression.
- History of any surgical procedure within the past 3 months.
- Diagnosis of cancer.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Abdominal Drawing-In Manoeuvre TrainingAbdominal drawing-in manoeuvre (ADIM) training is a core stability exercise strategy emphasizing selective activation and coordination of the deep abdominal musculature to enhance local trunk stability. Participants receive individualized, one-on-one training delivered by licensed physical therapists, conducted twice weekly for 4 weeks. Training is performed across functional positions and task-specific movements, with instruction provided using either verbal cueing or manual facilitation according to group allocation. | Behavioural | ADIM With Manual Cueing, ADIM With Verbal Cueing |
| Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion TrainingDynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE) training focuses on coordinated breathing and abdominal expansion to facilitate intra-abdominal pressure regulation and integrated postural control. Participants receive individualized, one-on-one training delivered by licensed physical therapists, conducted twice weekly for 4 weeks. Training is performed across functional positions and task-specific movements, with instruction provided using either verbal cueing or manual facilitation according to group allocation. | Behavioural | DNS-AE With Manual Cueing, DNS-AE With Verbal Cueing |
Primary outcome
Pain intensity
Time frame: At baseline, after the first week of intervention, at the end of the 4-week intervention and at 3-month follow-up
Pain intensity assessed using the Visual Analogue Scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable, with higher scores indicating greater pain intensity.
Movement control performance
Time frame: At baseline, after the first week of intervention, and at the end of the 4-week intervention.
Movement control performance assessed using the Nine-Item Movement Control Test Battery, which evaluates movement quality during standardized functional movement tasks. Each item is scored according to predefined error-based criteria, and item scores are summed to produce a total score ranging from 0 to 93, with higher scores indicating poorer movement control performance.
10 secondary outcomes
Disability related to low back pain
Time frame: At baseline, at the end of the 4-week intervention, and at 3-month follow-up.
Patient-specific functional ability
Time frame: At baseline, at the end of the 4-week intervention, and at 3-month follow-up.
Perceived movement difficulty assessed using the Perceived Difficulty Index (PDI).
Time frame: At baseline, after the first week of intervention, and at the end of the 4-week intervention.
Central sensitization symptoms
Time frame: At baseline and at the end of the 4-week intervention.
Fear-avoidance beliefs
Time frame: At baseline and at the end of the 4-week intervention.
Pain catastrophizing
Time frame: At baseline and at the end of the 4-week intervention.
Pressure pain threshold
Time frame: At baseline and at the end of the 4-week intervention.
Global perceived change
Time frame: At the end of the 4-week intervention and at 3-month follow-up.
Learning acquisition during training
Time frame: After each training session during the 4-week intervention.
Kinesiophobia
Time frame: At baseline, after the first week of intervention, at the end of the 4-week intervention and at 3-month follow-up
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Oct 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A study testing Abdominal Drawing-In Manoeuvre Training and Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training in people with Chronic Low Back Pain (Non-specific, Uncomplicated), run by National Yang Ming Chiao Tung University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 16 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain intensity (time frame: At baseline, after the first week of intervention, at the end of the 4-week intervention and at 3-month follow-up). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Oct 2026.