Chronic Low Back Pain (Non-specific, Uncomplicated)NCT07318454
Comparison of Abdominal Expansion and Abdominal Drawing-In Training With Manual and Verbal Cueing in Chronic Non-Specific Low Back Pain
A study testing Abdominal Drawing-In Manoeuvre Training and Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training in people with Chronic Low Back Pain (Non-specific, Uncomplicated), run by National Yang Ming Chiao Tung University.
Trial summary
This study aims to investigate the interactive effects of two core stability training strategies-abdominal drawing-in manoeuvre (ADIM) and Dynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE)-and two instructional approaches (verbal cueing and manual facilitation) on training outcomes in individuals… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Chronic Low Back Pain (Non-specific, Uncomplicated)
- What is being tested?
- Abdominal Drawing-In Manoeuvre Training and Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 96 participants
- Where
- No sites listed yet
- Study dates
- Jan 2027to Oct 2028
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults aged 18 years or older.
- Clinically diagnosed with chronic non-specific low back pain, with symptoms persisting for more than 12 weeks.
- Able to understand the study procedures and comply with the full intervention and assessment protocol.
Who cannot join
- History of surgery involving the lower back or lower extremities.
- Presence of neurological symptoms, such as numbness or tingling sensations.
- Signs or symptoms of nerve root compression.
- History of any surgical procedure within the past 3 months.
- Diagnosis of cancer.
- Presence of major medical or psychiatric disorders.
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- Presence of systemic inflammatory disease.
- Pregnancy.
- Structural scoliosis of the spine.
- Inability to ambulate or stand independently, or other conditions deemed unsuitable for participation.
- Participation in any movement control-based exercise training within the past year.
- Accumulated experience of more than 4 weeks of abdominal drawing-in manoeuvre (ADIM) training or Dynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE) training within the past year.
About this study
Official title: A Randomized Controlled Trial Comparing Abdominal Expansion and Abdominal Drawing-In Training With Manual and Verbal Cueing in Individuals With Chronic Non-Specific Low Back Pain
This study aims to investigate the interactive effects of two core stability training strategies-abdominal drawing-in manoeuvre (ADIM) and Dynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE)-and two instructional approaches (verbal cueing and manual facilitation) on training outcomes in individuals with chronic non-specific low back pain.
A 2×2 factorial randomized controlled trial design will be employed. Ninety-six participants with chronic non-specific low back pain will be randomly allocated, using block randomization, to one of four intervention groups in equal proportions. All groups will receive a 4-week intervention program, with training conducted twice per week.
Outcome measures will be assessed at four time points: before the intervention (baseline), immediately after the first training session, at the completion of the 4-week intervention, and at a 3-month follow-up, to evaluate short-term and mid-term effects as well as the sustainability of training outcomes.
- Being tested
- Abdominal Drawing-In Manoeuvre Training, Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Abdominal Drawing-In Manoeuvre TrainingBehavioural
Abdominal drawing-in manoeuvre (ADIM) training is a core stability exercise strategy emphasizing selective activation and coordination of the deep abdominal musculature to enhance local trunk stability. Participants receive individualized, one-on-one training delivered by licensed physical therapists, conducted twice weekly for 4 weeks. Training is performed across functional positions and task-specific movements, with instruction provided using either verbal cueing or manual facilitation according to group allocation.
Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion TrainingBehavioural
Dynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE) training focuses on coordinated breathing and abdominal expansion to facilitate intra-abdominal pressure regulation and integrated postural control. Participants receive individualized, one-on-one training delivered by licensed physical therapists, conducted twice weekly for 4 weeks. Training is performed across functional positions and task-specific movements, with instruction provided using either verbal cueing or manual facilitation according to group allocation.
| Study group | Role | What they receive |
|---|---|---|
| ADIM With Verbal Cueing | Experimental | Participants receive abdominal drawing-in manoeuvre training with verbal cueing, delivered twice weekly for 4 weeks. Receives: Behavioral: Abdominal Drawing-In Manoeuvre Training |
| ADIM With Manual Cueing | Experimental | Participants receive abdominal drawing-in manoeuvre training with manual facilitation, delivered twice weekly for 4 weeks. Receives: Behavioral: Abdominal Drawing-In Manoeuvre Training |
| DNS-AE With Verbal Cueing | Experimental | Participants receive Dynamic Neuromusculoskeletal Stabilization abdominal expansion training with verbal cueing, delivered twice weekly for 4 weeks. Receives: Behavioral: Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training |
| DNS-AE With Manual Cueing | Experimental | Participants receive Dynamic Neuromusculoskeletal Stabilization abdominal expansion training with manual facilitation, delivered twice weekly for 4 weeks. Receives: Behavioral: Dynamic Neuromusculoskeletal Stabilization Abdominal Expansion Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain intensity
Pain intensity assessed using the Visual Analogue Scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable, with higher scores indicating greater pain intensity.
Measured: At baseline, after the first week of intervention, at the end of the 4-week intervention and at 3-month follow-up
Movement control performance
Movement control performance assessed using the Nine-Item Movement Control Test Battery, which evaluates movement quality during standardized functional movement tasks. Each item is scored according to predefined error-based criteria, and item scores are summed to produce a total score ranging from 0 to 93, with higher scores indicating poorer movement control performance.
Measured: At baseline, after the first week of intervention, and at the end of the 4-week intervention.
Secondary outcomes (10)
Disability related to low back pain
Disability assessed using the Oswestry Disability Index (ODI), with total scores ranging from 0 %to 100%, where higher scores indicate greater disability.
Measured: At baseline, at the end of the 4-week intervention, and at 3-month follow-up.
Patient-specific functional ability
Functional ability assessed using the Patient-Specific Functional Scale (PSFS), with scores ranging from 0 to 10, where 0 indicates inability to perform the activity and 10 indicates the ability to perform the activity at the pre-injury or normal level, with higher scores indicating better functional ability.
Measured: At baseline, at the end of the 4-week intervention, and at 3-month follow-up.
Perceived movement difficulty assessed using the Perceived Difficulty Index (PDI).
Perceived difficulty during movement performance assessed using the Perceived Difficulty Index (PDI). Participants rate the level of difficulty experienced during the movement tasks on a numeric rating scale ranging from 0 to 10, where 0 indicates no perceived difficulty and 10 indicates extreme difficulty, with higher scores indicating greater perceived difficulty.
Measured: At baseline, after the first week of intervention, and at the end of the 4-week intervention.
Central sensitization symptoms
Symptoms related to central sensitization assessed using the Central Sensitization Inventory (CSI), with total scores ranging from 0 to 100, where higher scores indicate greater symptom severity related to central sensitization.
Measured: At baseline and at the end of the 4-week intervention.
Fear-avoidance beliefs
Fear-avoidance beliefs assessed using the Fear-Avoidance Beliefs Questionnaire (FABQ), with total scores ranging from 0 to 96, where higher scores indicate greater fear-avoidance beliefs.
Measured: At baseline and at the end of the 4-week intervention.
Pain catastrophizing
Pain catastrophizing assessed using the Pain Catastrophizing Scale (PCS), with total scores ranging from 0 to 52, where higher scores indicate greater pain catastrophizing.
Measured: At baseline and at the end of the 4-week intervention.
Pressure pain threshold
Pressure pain threshold (PPT) assessed using a pressure algometer.
Measured: At baseline and at the end of the 4-week intervention.
Global perceived change
Overall perceived change assessed using the Global Rating of Change (GROC) scale, ranging from -7 to +7, where negative scores indicate perceived worsening, 0 indicates no change, and positive scores indicate perceived improvement, with higher scores indicating greater perceived improvement.
Measured: At the end of the 4-week intervention and at 3-month follow-up.
Learning acquisition during training
Learning acquisition assessed by the instructor after each training session using a numeric rating scale from 0 to 10.
Measured: After each training session during the 4-week intervention.
Kinesiophobia
Kinesiophobia assessed using the Tampa Scale of Kinesiophobia (TSK-17), ranging from 17 to 68, where higher scores indicate greater fear of movement (kinesiophobia).
Measured: At baseline, after the first week of intervention, at the end of the 4-week intervention and at 3-month follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Jan 2026
- Study startJan 2027 (estimated)
- Primary completionJul 2028 (estimated)
- Study completionOct 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic Low Back Pain (Non-specific, Uncomplicated)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 96 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Yang Ming Chiao Tung University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Wendy Tzyy-Jiuan Wang, National Yang Ming Chiao Tung University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07318454
- Sponsor's protocol ID
- NYCU114229AE-S3
- Status last verified
- Oct 2026
- First submitted
- 23 Dec 2025
- Last updated
- 16 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No