Effects of Self-Myofascial Release and Dynamic Neuromuscular Stabilization Exercises on Pain, Balance, Muscle Function, and the Autonomic Nervous System in Women with Chronic Low Back Pain

BACKGROUND This study investigated the combined effects of self-myofascial release (SMR) and dynamic neuromuscular stabilization (DNS) exercises on pain, balance, muscle function, and autonomic nervous system regulation in women with chronic low back pain. MATERIAL AND METHODS Forty women with chronic low back pain, recruited from an exercise center in Seongnam City, were randomly assigned to an experimental group (n=20) or a control group (n=20). The experimental group performed 20 minutes of SMR followed by 30 minutes of DNS exercises, while the control group performed 30 minutes of DNS alone. Both groups participated in biweekly sessions for 6 weeks. Outcome measures included the visual analog scale (VAS) for pain, functional reach test (FRT) for static balance, Y-balance test for dynamic balance, the supine bridge test for muscle endurance, the sit-and-reach test for flexibility, and Myoton PRO assessments for muscle tone and stiffness. Functional disability was evaluated using the Korean version of the Oswestry Disability Index (ODI), and autonomic nervous system regulation was assessed using the standard deviation of normal-to-normal intervals (SDNN) via the SA-3000new pulse wave meter. This trial was registered with the Clinical Research Information Service (CRIS; KCT0010401). RESULTS Both groups showed significant improvements in all post-intervention outcome measures (p<0.05). However, the experimental group showed significantly greater improvements in pain, balance, muscle function, flexibility, muscle tone, disability, and SDNN (p<0.05). CONCLUSIONS The integration of SMR with DNS exercises provided superior benefits compared to DNS alone. This combined approach may serve as an effective clinical strategy to reduce pain, improve function, and enhance autonomic regulation in women with chronic low back pain.