{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:54:20Z","timestamp":1789430060901,"version":"build-2803163510"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Activity\u2010based treatments play an integral role in managing musculoskeletal conditions including low back pain. However, while therapeutic exercise has been shown to reduce pain in such conditions, certain individuals experience a paradoxical pain increase in response to exercise. The physiological processes underlying this sensitivity to physical activity (SPA) are not fully understood, however stress and inflammation have been shown to contribute to SPA. The present cross\u2010sectional study investigated whether physiological indicators of stress (cortisol) and inflammation (IL\u20106) help explain SPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010seven patients with chronic low back pain and 21 healthy controls completed a 1\u2010h exercise session of standardized physical tasks. SPA was calculated from the difference between post\u2010 and pre\u2010exercise pain levels. Participant's saliva was collected at several timepoints for cortisol and IL\u20106 levels quantification. Their waking cortisol response was calculated to reflect their cortisol regulation. Reactivity of IL\u20106 and cortisol was calculated to reflect changes in these measures during exercise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>IL\u20106 reactivity was significantly and positively correlated with SPA among participants with low back pain. In contrast, neither cortisol waking response nor cortisol reactivity was significantly correlated within the low back pain group. No significant differences in IL\u20106 reactivity, cortisol reactivity or cortisol waking response were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings are the first to link SPA to an objective biomarker among people with low back pain. These findings help describe the physiological mechanisms of SPA and can support new clinical research that targets the inflammatory response of patients with chronic low\u2010back pain and elevated SPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This study reveals a correlation between SPA and an objective salivary biomarker of IL\u20106 in people with low back pain, improving our understanding of this clinically relevant subjective experience.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.2167","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T18:19:45Z","timestamp":1692641985000},"page":"120-132","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Are biomarkers associated with sensitivity to physical activity?"],"prefix":"10.1002","volume":"28","author":[{"given":"D.","family":"Flegg","sequence":"first","affiliation":[{"name":"School of Physical and Occupational Therapy McGill University  Montreal Quebec Canada"},{"name":"Alan Edwards Centre for Research on Pain McGill University  Montreal Quebec Canada"},{"name":"Department of Internal Medicine, Faculty of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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