Comparison of dynamic neuromuscular stabilization exercises with and without the feldenkrais method on pain, balance, and hip muscle strength in elderly women with chronic non-specific low back pain

Geriatr Nurs. 2026 Feb 2;69:103804. doi: 10.1016/j.gerinurse.2026.103804. Online ahead of print.

ABSTRACT

INTRODUCTION: Low back pain (LBP) is a well-recognized and major cause of disability worldwide. This study aimed to compare the effects of dynamic neuromuscular stabilization (DNS) exercises with and without the Feldenkrais method (FM) on pain, balance, and hip muscle strength in elderly women with chronic non-specific LBP (CNLBP).

METHOD: In this randomized controlled trial, 40 women aged 60-80 years with CNLBP were randomly allocated to either the DNS exercise (DNSE) group or the combined DNS and Feldenkrais method exercise (DNS-FME) group for an 8-week intervention. Three participants dropped out, leaving 37 completers (18 in the DNSE group and 19 in the DNS-FME group). Baseline and post-intervention assessments were conducted 1-3 days before the first session and 1-3 days after the final session, respectively. Outcome measures included pain intensity, Berg Balance Scale score, and hip muscle strength. Data were analyzed using repeated-measures ANOVA, with statistical significance set (p < 0.05).

RESULTS: After the 8-week intervention, significant group-by-time interactions were observed for all outcome variables (p < 0.05). Post-hoc analysis with Bonferroni correction revealed that the DNS-FME group exhibited significantly greater reductions in pain intensity (p < 0.001) as well as significantly greater improvements in hip adductor strength (p < 0.001) and hip abductor strength (p < 0.001) compared to the DNSE group. Although balance improvements were noted in both groups, the between-group difference did not reach statistical significance.

CONCLUSION: The addition of the Feldenkrais method to dynamic neuromuscular stabilization exercises provides superior benefits in pain reduction and hip muscle strengthening in elderly women with chronic non-specific low back pain. Both interventions improve balance, but combined training may offer greater clinical advantages. These findings support integrating sensorimotor awareness techniques into rehabilitation programs for older adults with low back pain.

PMID:41633229 | DOI:10.1016/j.gerinurse.2026.103804