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HealthyNCT07775560

DNS: Face-to-face and Telerehabilitation

A study testing DNS Exercises via Telerehabilitation and Face-to-face DNS Exercises in people with Healthy, run by Istinye University at 1 site in Turkey (Türkiye).

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial 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. Read more about this study

Who is it for?
Ages 18 to 35 yearsHealthy volunteers can take part
Conditions the study is for
Healthy
What is being tested?
DNS Exercises via Telerehabilitation and Face-to-face DNS Exercises
Could I receive a placebo?
No, everyone receives an active treatment
How many people
34 participants
Where
1 siteTurkey (Türkiye)
Study dates
30 Mar 2026to 30 Dec 2026
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 to 35 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • 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.

Who cannot join

  • 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.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Turkey (Türkiye)1 site, 1 recruiting
  • Aleyna Çelik Fizyoterapi ve Danışmanlık Merkezi

    Istanbul, Uskudar

    Aleyna Çelik, PT, +905377827744, fzt.aleynacelik@gmail.com

    Recruiting

Other trials in Turkey (Türkiye)

About this study

Official title: Dynamic Neuromuscular Stabilization Exercises: A Comparative Study of Their Effectiveness Via Face-to-Face and Telerehabilitation Delivery

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.

Read the detailed description

Dynamic Neuromuscular Stabilization (DNS) is a manual and rehabilitative approach based on developmental kinesiology principles, aiming to optimize movement by integrating postural alignment, breathing patterns, and motor control. DNS emphasizes the coordination of body segments to maintain a neutral functional position, facilitate precise muscle contractions for both respiration and posture, and reflexively regulate the diaphragm and core stabilizers. It has been tested in various musculoskeletal and neurological conditions, improving breathing efficiency, posture, and core stability through targeted activation of deep stabilizing muscles.

Modern sedentary lifestyles, poor ergonomics, and emotional stress have been strongly associated with spinal misalignment and dysfunctional breathing. Literature highlights that even minor postural deviations significantly affect diaphragmatic mechanics and breathing function. Consequently, proper postural alignment and restoration of optimal diaphragmatic activity are essential for integrated stabilization and respiratory function. DNS-based training provides a clinically valuable tool to address these dysfunctions.

Although DNS has been studied in multiple clinical contexts, little is known about the potential differences between its face-to-face (yDNS) and telerehabilitation (tDNS) delivery methods. With the rise of remote rehabilitation practices during the COVID-19 pandemic, it remains unclear whether DNS, as a complex intervention, can be delivered effectively via telerehabilitation.

Objective:

This study aims to compare the effects of telerehabilitation-based DNS (tDNS) and face-to-face DNS (yDNS) on respiratory function, postural alignment, balance, and core stabilization in healthy young adults. The findings are expected to provide novel insights into the clinical applicability of DNS through both in-person and remote rehabilitation modalities.

Conditions
Healthy
Being tested
DNS Exercises via Telerehabilitation, Face-to-face DNS Exercises
Keywords
core stabilization, balance, posture, respiratory parameters

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • DNS Exercises via TelerehabilitationOther

    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.

  • Face-to-face DNS ExercisesOther

    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.

Study groups in NCT07775560
Study groupRoleWhat they receive
T-DNSExperimentalNot described
Receives: Other: DNS Exercises via Telerehabilitation
F-DNSExperimentalNot described
Receives: Other: Face-to-face DNS Exercises

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 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.

    Measured: Through study completion, an average of 1 year

  2. 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.

    Measured: Through study completion, an average of 1 year

  3. 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.

    Measured: Through study completion, an average of 1 year

  4. 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

    Measured: Through study completion, an average of 1 year

  5. 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.

    Measured: Through study completion, an average of 1 year

  6. 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.

    Measured: Through study completion, an average of 1 year

  7. 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.

    Measured: Through study completion, an average of 1 year

Secondary outcomes (3)
  1. Posture

    Postural alignment will be assessed using the PostureScreen Mobile® application (PostureCo; http://postureanalysis.com/mobile/). Participants will stand in a neutral position while photographs are captured from anterior, posterior (coronal plane) and lateral (sagittal plane) views. The application provides an on-screen target to ensure consistent image capture. Digitization will be performed by overlaying a grid on each image, allowing calculation of postural angles and assessment of body segment alignment relative to neutral posture. Output will include quantified postural variables and annotated images.

    Measured: Through study completion, an average of 1 year

  2. Deep Stabilization System (DSS) Function Assessment

    Deep Stabilization System (DSS) function will be assessed by a certified physiotherapist through palpation and visual observation. Six DSS tests will be administered in a fixed order: diaphragm, trunk flexion, back extension, hip flexion, intra-abdominal pressure, and side plank. Each test will be scored on a 5-point scale (1 = adequate activation; 5 = inadequate function). Tests will be repeated twice, and the consistent score will be used for analysis.

    Diaphragm Test: Participant seated upright with arms and legs relaxed; instructed to perform deep inhalation while the physiotherapist palpates laterodorsal regions of the abdominal wall and observes lateral rib movement.

    Trunk Flexion Test: Participant supine with arms relaxed alongside the body; instructed to flex the neck and trunk until the inferior angles of the scapulae lift off the table. Trunk and chest muscle activation will be visually assessed.

    Back Extension Test: Participant prone with

    Measured: Through study completion, an average of 1 year

  3. Treatment Satisfection

    Participant satisfaction with the intervention will be assessed at the end of the study using the Treatment Satisfection scale. The Treatment Satisfection is a patient-reported outcome measure that captures perceived changes in health status over time. In this study, a 7-point scale ranging from -3 to +3 will be used, where -3 indicates "much worse," 0 indicates "no change," and +3 indicates "completely recovered."

    Measured: Through study completion, an average of 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Aug 2026
  2. Study start30 Mar 2026
  3. Primary completion30 Dec 2026 (estimated)
  4. Study completion30 Dec 2026 (estimated)

Resources

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
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Investigator
Enrolment
34 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07775560
Sponsor's protocol ID
AIB-FTR-RA-01
Status last verified
Aug 2026
First submitted
26 Nov 2025
Last updated
20 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing DNS Exercises via Telerehabilitation and Face-to-face DNS Exercises in people with Healthy, run by Istinye University at 1 site in Turkey (Türkiye).

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 5 inclusion and 4 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: looking for participants now, as of the sponsor's last update on 20 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

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?

Contact Reyhan Aydın, PT (+905380732413, reyhanaydin@istinye.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Spirometric Pulmonary Function FEV1 (time frame: Through study completion, an average of 1 year). The study lists 7 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 20 Aug 2026.

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