Effect of 8 Weeks of Modified Dynamic Neuromuscular Stabilization Exercises on Core Region Function and Shoulder Pain in Patients with Incomplete Paraplegic Spinal Cord Injury

Abstract

Background: Spinal cord injury (SCI) often results in reduced core region function and shoulder pain among wheelchair users. This study aimed to investigate the effectiveness of modified dynamic neuromuscular stabilization (DNS) exercises on core region function and shoulder pain in patients with incomplete paraplegic SCI. Methods: In this semi-experimental study, ten male patients with SCI were purposefully selected based on inclusion criteria and participated as an experimental group. Core region function and shoulder pain were measured before intervention using the modified plank test, an abdominal pressure cuff device, and the Wheelchair Users' Shoulder Pain Index (WUSPI) questionnaire. Participants first completed an eight-week non-exercise period, followed by an intermediate assessment. They then engaged in eight weeks of modified DNS exercises, after which measurements were repeated. Data were analyzed using SPSS version 26, with repeated measures ANOVA applied (P≤0.05). Results: Significant improvements were observed in core function, transverse abdominal muscle strength, and shoulder pain (measured by WUSPI scores) after the exercise period compared to the non-exercise phase. These improvements were statistically significant (P≤0.05). Conclusion: The findings suggest that modified DNS exercises can be an effective and low-cost addition to the physical rehabilitation of patients with incomplete paraplegic SCI. © 2025 Shiraz University of Medical Sciences. All rights reserved.