Effect of dynamic neuromuscular stabilization on fatigue and spasticity in people with multiple sclerosis: a randomized controlled trial (ORP-37)

Document Type : Oral Presentation


Physical Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran


Objective: To compare the effects of core stabilization (CS) and dynamic neuromuscular stabilization (DNS) on fatigue and spasticity in People with Multiple Sclerosis (PWMS).
Design: Two-group randomized controlled trial.
Setting: general community and referral center.
Participants: A total of 66 PWMS, between 30 and 60 years old, and an expanded disability status scale (EDSS) between 2 and 6, participated in this study.
Interventions: Participants were randomly assigned to CS (n = 33) and DNS (n = 33) groups. Both groups received a total of 24 sessions of CS or DNS exercises, 60 minutes per session, three times a week during the 8 weeks.
Outcome measures: Fatigue was measured as the primary outcome measure.  Spasticity was measured as a secondary outcome.
Results: The DNS group had significant improvement in The five-item Modified Fatigue Impact Scale (MFIS-5) and Multiple Sclerosis Spasticity Scale 88 (MSSS88) in PWMS compared with the CS group, (P < 0.0001) after 8 weeks of intervention and 18 weeks of follow-up.  Significant improvements were seen in all outcome measures in both groups after 8 weeks of intervention.
Conclusion: This is the first clinical evidence to support the importance of  DNS  exercise in reducing fatigue and spasticity in PWMS. This study provides clinical evidence that DNS may be more effective for PWMS than CS.


  • Receive Date: 04 December 2023
  • Accept Date: 04 December 2023