Dynamic Neuromuscular Stabilization (DNS Basic Course A)

Dynamic Neuromuscular Stabilization (DNS) is a rehabilitation strategy based upon the inter-relationship of developing child and neuro-physiological maturation of postural-locomotor system. Kolar’s approach to DNS explains the importance of muscular interactions and their proper recruitment for dynamic stability of spine and utilizes a series of systematic dynamic tests.

DNS diagnosis is based on comparing the patient’s stabilizing pattern with stabilization developmental pattern of a healthy baby. The treatment approach is based on reflex locomotion principles and ontogenetic postural locomotor patterns. The brain must be properly stimulated and conditioned to automatically activate optimal movement patterns that are necessary for co-activation of stabilizers.

The ultimate strategy is to teach the brain to maintain central control and stability of the movement restored during the therapy. This can be achieved by activation of the stabilizers when placing the patient in the primal developmental positions. The primary goal of this treatment approach is to optimize distribution of internal forces of the muscles acting on each segment of the spine and/or any other joint.

DNS can be used in infants to:

• Stimulate the achievement of important development milestones at appropriate times

• Stimulate symmetrical development

• Improve the quality of movement

• Educate the parents to properly handle infants

DNS can be used in neurological patients for:

• Postural training

• Sensory-motor integration

• Achieve independence in ADLs and improve QoL

General and Specific objectives

• Improve understanding of the basic principles of developmental kinesiology with an emphasis on development during the first year of life

• Identify and describe key milestones in human development

• Introduce the 3 levels of sensorimotor control in functional assessment and treatment

• Demonstrate the relationship between development during the first year of life and pathology of the locomotor system in adulthood

• Introduce new terminology pertinent to rehabilitation such as functional joint centration, punctum fixum, punctum mobile and the integrated stabilizing system of the spine

• Define ideal postural stabilization from a developmental perspective: intra-abdominal pressure regulation, dual role of the diaphragm in stabilization and respiration, stabilization via co-contraction

• Identify common stereotypes of faulty postural stabilization (“open scissors syndrome”, forward drown posture, backward drown posture, “hour glass syndrome”)

• Explain and demonstrate biomechanics of undifferentiated, ipsilateral and contralateral postural-locomotion patterns; closed and opened kinematic chains, stepping forward and supporting function

• Evaluate and correct poor respiratory patterns

• Demonstrate the correlation between poor respiration patterns and functional pathology of the locomotor system

• Assess the integrated stabilizing system of the spine both visually and utilizing dynamic functional tests

• Integrate corrective exercises based on the DNS functional tests and developmental positions: exercise in undifferentiated static positions; position transfer during locomotor function; exercise progression using unstable surfaces; increased difficulty of the exercises utilizing resistance, dual tasking and other challenges

• Clarify how DNS corrective exercises can integrate with other exercise strategies

• Cover the basics of application of DNS concept in sport training

• Provide basic clinical management explanation for clinicians to better integrate the DNS approach in their regular practice, including patient education