• DNS Best for Stroke Rehab: Anticipatory Postural Adjustment and Falls with a 2 Year Follow-Up

  • A 2018 published study was of a group of adults with chronic hemiparesis due to stroke. The study randomly assigned half of the adults to a group receiving traditional stabilization/core physical therapy, while the other half received “DNS” (Dynamic Neuromuscular Stabilization) physical therapy. All of the adults had significant Anticipatory Postural Adjustment delays, and moderately elevated fear of falling measures. The 2 physical therapy treatment methods were applied in 20 sessions of the same duration, then compared to determine which treatment group improved best in key outcome measures of:

    1. EMG to measure Anticipatory Postural Adjustment time for trunk muscle response during rapid shoulder flexion. EMG measures were standardized for bilateral external oblique, transverse abdominis, internal oblique, and erector spinae.
    2. Berg Balance Scale
    3. Trunk Impairment Scale
    4. Falls Efficacy Scale (a measure of fear of falling vs. functional activities)


    1. The Anticipatory Postural Adjustment (trunk muscle response times) were better in the DNS group than in the conventional stabilization therapy group.
    2. Although the Berg Balance Scale, the Trunk Impairment Scale, and Falls Efficacy Scale scores were initially improved in both treatment groups, the Falls Efficacy Scale scores remained stable through the 2-year follow-up period only in the DNS group.


    This study of stroke patients indicates that DNS physical therapy methods prove more effective for improving trunk/postural function as it relates to reducing falls risk and fear of falling.

    Legacy Therapy and Wellness licensed physical therapists and clinicians all receive advanced training in DNS and practice DNS methods for postural/stability functions – including for patients who have a history of stroke, neurological conditions, low back pain, balance disorders, falls history and other conditions.

    To receive DNS physical therapy through Legacy, please contact us today at (334) 699-2348.


    Lee NG et al. Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke. Arch Phys Med Rehabil. 2018 Nov;99 (11):2168-2174.