Abstract

Background. Nonspecific Low Back Pain (NLBP) is one of the leading causes of functional impairment and disability worldwide, imposing substantial challenges to public health and socioeconomic systems. Dynamic Neuromuscular Stabilization (DNS), a rehabilitation approach grounded in developmental movement patterns and neuromuscular control theory, has recently been applied in the management of NLBP. However, systematic evidence quantitatively evaluating the therapeutic effectiveness of DNS remains limited. This study aimed to synthesize findings from randomized controlled trials (RCTs) through meta-analysis to determine the efficacy of DNS training in alleviating NLBP.

Methods. A systematic search of PubMed, Web of Science (WoS), Scopus, Cochrane Library, and China National Knowledge Infrastructure (CNKI) was conducted to identify RCTs published up to September 22, 2025. The search and screening process adhered to PRISMA guidelines, and the protocol was registered in PROSPERO (CRD420251152728). Two independent researchers performed study selection and data extraction from September 23 to October 5, 2025. A total of eight studies involving 289 participants were included. Meta-analysis, subgroup analysis, and sensitivity analysis were performed using Review Manager 5.4 and Stata 17.0. Publication bias was assessed using Begg’s test.

Results. The pooled analysis demonstrated that DNS training significantly reduced pain in patients with NLBP (Standardized Mean Difference = -1.17, 95% CI -1.85 to -0.48). Subgroup analyses indicated that variations in intervention strategies (DNS alone vs. combined interventions), intervention duration (4, 6, or 8 weeks), intervention frequency (<4 sessions/week vs. ≥4 sessions/week), and intervention intensity (<45 minutes/session vs. ≥45 minutes/session) failed to sufficiently account for the substantial heterogeneity observed across studies. Begg’s test did not reveal significant publication bias (p = 0.063). Sensitivity analysis confirmed the robustness of the findings, as sequential exclusion of individual studies did not substantially alter the pooled effect.

Conclusions. DNS training significantly alleviates pain symptoms in patients with NLBP and shows promising potential for clinical application. Nevertheless, the included studies were limited by small sample sizes, heterogeneous intervention protocols, and varying methodological quality. Future research should focus on large-scale, high-quality RCTs and promote the standardization of DNS intervention protocols to further validate and expand its clinical application in NLBP rehabilitation.