Effects of Dynamic Neuromuscular Stabilization (DNS) for adults with chronic non-specific low back pain in activities of daily living

Each participant will be given standard physiotherapy care as described in the guideline for the control group with an added component of the DNS Approach with the guideline below. The choice of the standard physiotherapy care will be according to the discretion of the treating physiotherapist. DNS Approach guideline. The aim of the treatment is to achieve good intra-abdominal pressure and ribcage centration. This is observed as a cylindrical shape of abdominal region and non anteriorly flared ribcage. This intervention will be performed via verbal cues, manual guidance and visual feedback to correct the spine, ribcage, pelvic, scapula alignment and abdominal wall shape. This intervention will be done in developmental kinesiology positions in relation to position of spine (Horizontal/vertical/angled). *Operational definition of angled position is any position between horizontal and vertical) *The actual developmental kinesiology position adopted during intervention for that day will vary according to the individuals' limitation of pain, weakness or tightness. The physiotherapist will manually guide (verbally/visual feedback/ tactile facilitation) the participant to achieve ideal pattern of muscle activation in stabilising the body in the developmental kinesiology position adopted with the aim mentioned above (good IAP & ribcage centration)in the exercise. The component of body awareness to have adequate appropriate muscle relaxation is integrated according to DNS approach via participant's conscious awareness to the identified muscle area informed by the therapist during the DNS exercise. This intervention will also be performed in a dynamic movement which resembles the ADL task being measured. The participant will be given the home programme advise of the same DNS exercise done in the session.The home programme requires approximately 10-20 minutes per session of DNS home programme when self-done at home. Each session will take approximately 40-45 minutes. In the case whereby the participant has aggravated pain, the standard physiotherapy care component will take approximately 30 minutes while the DNS component will take approximately 15 minutes. In the case whereby the pain is minimal, the standard physiotherapy care component will take approximately 15 minutes while the DNS component will take approximately 30 minutes. Each physiotherapy treatment session will have the standard physiotherapy care and DNS component. Each participant will receive 8 physiotherapy sessions. The frequency of sessions are as follow: 2 sessions per week for 2 weeks(4 sessions) 1 session per week for 2 weeks(2 sessions) 1 session per 2 weeks in 1 month(2 sessions) Each physiotherapy session is a one-to-one session at the physiotherapy department. Each session is conducted by a physiotherapist who is a fully certified DNS Practitioner. Each participant will be treated by the same physiotherapist throughout the 8 sessions. There are no strategies used to monitor adherence to intervention other than standard documentation of each session by the physiotherapist and subjective checking of adherence of participants to the advise given from the participants. The DNS is received in addition to standard care.