Dynamic Neuromuscular Stabilization (DNS) Clinical 'A' Course

What Is DNS

Dynamic Neuromuscular Stabilization (DNS), according to Professor Kolar, is a functional diagnostic and treatment approach that is based on the principles of Developmental Kinesiology (DK). 

“The nervous system establishes programs that control human posture, movement, and gait. This ‘motor control’ is largely established during the first critical years of life. Therefore, the Prague School emphasizes neurodevelopmental aspects of motor control in order to assess and restore dysfunction of the locomotor system and associated syndromes.”

The Prague School of Rehabilitation and Manual Medicine was established by key neurologists/physiatrists, each of whom were considered leaders in their respective fields of medicine and helped shape the 20th Century rehabilitation movement: Professors Vaclav Vojta, Karel Lewit, Vladimir Janda, and Frantisek Vele.

Based upon the groundbreaking neurodevelopmental and rehabilitation principles described by these mentors, Pavel Kolar has organized the next generation of clinical protocols that are designed to restore and stabilize locomotor function. This rehabilitation approach is called Dynamic Neuromuscular Stabilization (DNS).

DNS is not a technique and it is not list of generic “cookie-cutter” protocols. DNS is the lens through which we evaluate the quality and efficacy of postural stabilization and the efficiency of movement strategies that underlie much of the musculoskeletal syndromes that plague healthcare. The DNS concept compares a patient’s posture, strategies for stabilization and functional movements to developmental models of neurologically healthy infants. Comparing our patients to an ideal standard helps us to identify discrepancies that need to be addressed with therapy. Emphasis is placed on promoting appropriate muscle synergies with precise positioning of each joint and coordination of the stabilizing musculature of the trunk, which includes the abdominal, pelvic, and back muscles. Learning the correct breathing techniques during exercise is also a vital component of DNS therapy, as it is important for the patient to become aware of and master correct breath coordination and efficient movement patterns. The goal of therapy is to balance the effect of the internal forces of the muscles acting on the spine and joints. DNS therapy is primarily an educational process that teaches the patient how to optimally activate the spinal and joint stabilizers in static positions, as well as, during movement. Over time, the patient learns to recognize and correct errors during their activities of daily living.

Course Objectives:

1. Introduce the fundamentals of developmental kinesiology and ontogenesis with a heavy emphasis on defining, assessing, and restoring optimal sagittal stabilization through the non-differentiated developmental positions.
2. Identify and describe key milestones in human development
3. Introduce the three level of sensorimotor control in functional assessment and treatment
4. Demonstrate the relationship between development during the first year of life and pathology of the locomotor system in adulthood
5. Introduce new terminology pertinent to rehabilitation such as functional joint centration, punctum fixum, punctum mobile and the integrated stabilizing system of the spine
6. 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
7. Identify common stereotypes of faulty postural stabilization (“open scissors syndrome”, forward drown posture, backward drown posture, “hour glass syndrome”)
8. Explain and demonstrate biomechanics of undifferentiated, ipsilateral and contralateral postural-locomotion patterns; closed and opened kinematic chains, stepping forward and supporting function
9. Evaluate and correct poor respiratory patterns
10. Demonstrate the correlation between poor respiration patterns and functional pathology of the locomotor system
11. Assess the integrated stabilizing system of the spine both visually and utilizing dynamic functional tests
12. 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
13. Clarify how DNS corrective exercises can integrate with other exercise strategies
14. Cover the basics of application of DNS concept in sport training
15. Provide basic clinical management explanation for clinicians to better integrate the DNS approach in their regular practice, including patient education
16. Optimally prepare students for the next level of training (Course “B”)