Introduction
In the modern era, the shift towards a sedentary lifestyle has led to an increase in musculoskeletal issues and postural irregularities across all age groups. Office workers, who spend significant portions of their workday sitting, often experience discomfort such as neck, back, and shoulder which can be attributed to prolonged sitting and maintaining a static or incorrect posture. Engaging in physical activity has been associated with numerous health benefits, including improved musculoskeletal functioning and body composition, making it crucial for promoting a healthy lifestyle. Dynamic neuromuscular stabilization training (DNS) has consistently demonstrated notable improvements in core muscle activation, body posture, functional movements, and pain reduction along with psychological benefits subsequent to exercise. Considering that sedentary individuals may lack motivation for physical activities, creative game-based exercises incorporated into a comprehensive corrective exercise program may require further investigation for their potential in improving both physical performance and mental well-being.
Aim
This study aims to explore the impact of combined DNS exercises and creative multi-skill games on musculoskeletal pain, core muscle endurance, body posture, functional movements, physical activity levels, and symptoms of anxiety among inactive middle-aged female office workers.

Method
Utilizing a single-blind randomized trial design, a total of 44 inactive middle-aged female office workers aged 45-59 will be randomly allocated to either DNS exercises and dynamic multi-skill exercise group (n=22) or walking group (n=22) engaging in low to moderate intensity physical activities (50 o 60% MHR) as a form of simple physical activity.
The outcome measures will be musculoskeletal pain (Nordic musculoskeletal questionnaire), core muscle endurance (McGill's torso muscular endurance test), body posture (2D camera and ImageJ), functional movements (functional Movement Screen; FMS), physical activity levels (International Physical Activity Questionnaire; IPAQ), and symptoms of anxiety (State-Trait Anxiety Inventory; STAI). The intervention will consist of: 8 weeks training, two days/per week, 60 hour per session. All the outcome measures will be assessed at baseline, week 4, week 8). The detraining effects (no intervention) were also assessed after a 4-week period. A one-way repeated measures ANOVA was used to conduct the statistical analysis. The significance level was defined as p ≤ 0.05.

Discussion
It is anticipated that the combined neuromuscular and dynamic exercises, along with creative activities, will contribute to reduced musculoskeletal pain, enhanced body posture, and improved core muscle endurance. Furthermore, this intervention protocol is expected to significantly impact on improving functional movements, physical activity levels, and reducing anxiety among inactive middle-aged female office workers.