{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:46:37Z","timestamp":1789141597639,"version":"build-2803163510"},"reference-count":95,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Exercise\u2010induced hypoalgesia (EIH) describes an acute reduction in pain following exercise. Individuals with low back pain (LBP) demonstrate variable EIH responses, such as increased pain sensitivity (hyperalgesia). Pain phenotyping, classifying individuals with pain sensitivity and psychological characteristics, may explain this variability. LBP phenotypes were classified using pain sensitivity, psychological variables, and EIH response to dynamic resistance exercise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this observational cohort study, 78 individuals with LBP (mean age\u2009=\u200921.7\u2009\u00b1\u20092.6\u2009years, 59% female) completed clinical pain ratings (Numeric Pain Rating Scale [NPRS]), temporal summation (TS), conditioned pain modulation (CPM), psychological questionnaires (Fear\u2010Avoidance Beliefs Questionnaire\u2010Physical Activity subscale [FABQ\u2010PA]), and a 45\u2010degree Roman chair back extension exercise. Pressure pain threshold (PPT) pre\u2010 and post\u2010exercise determined EIH. Ward's hierarchical cluster analysis was performed with five variables (NPRS, TS, CPM, FABQ\u2010PA, EIH). One\u2010way ANOVA examined differences in demographic, clinical, and psychosocial factors by cluster.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three distinct clusters emerged: (1) efficient pain modulation with low fear\u2010avoidance and high EIH (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940); (2) impaired pain modulation with moderate fear\u2010avoidance and hyperalgesia (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919); (3) moderate pain modulation with high fear\u2010avoidance and moderate EIH (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919). Clusters differed significantly by age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02,\n                      <jats:italic>\u03b7<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>p<\/jats:italic>\n                      <\/jats:sub>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.098), disability (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004,\n                      <jats:italic>\u03b7<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>p<\/jats:italic>\n                      <\/jats:sub>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.138), psychosocial burden (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03,\n                      <jats:italic>\u03b7<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>p<\/jats:italic>\n                      <\/jats:sub>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.086), and pain catastrophizing (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03,\n                      <jats:italic>\u03b7<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>p<\/jats:italic>\n                      <\/jats:sub>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.09).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Individuals with LBP exhibit heterogeneous pain phenotypes. Psychological factors may diminish EIH, and impaired modulation may produce hyperalgesia post\u2010exercise. Identifying pain phenotypes may enhance personalised rehabilitation strategies, optimising interventions for LBP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>This study provides novel evidence that biopsychosocial phenotypes influence pain responses to resistance exercise, offering a potential pathway to personalised rehabilitation for LBP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70136","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T09:30:33Z","timestamp":1758879033000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Identification of Pain Phenotypes in Individuals With Low Back Pain in Response to Dynamic Resistance Exercise"],"prefix":"10.1002","volume":"29","author":[{"given":"Kaitlyn M.","family":"Lyons","sequence":"first","affiliation":[{"name":"School of Kinesiology and Rehabilitation Sciences, College of Health Professions and Sciences, University of Central Florida  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Stout","sequence":"additional","affiliation":[{"name":"School of Kinesiology and Rehabilitation Sciences, College of Health Professions and Sciences, University of Central Florida  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt S.","family":"Stock","sequence":"additional","affiliation":[{"name":"School of Kinesiology and Rehabilitation Sciences, College of Health Professions and Sciences, University of Central Florida  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Hanney","sequence":"additional","affiliation":[{"name":"School of Kinesiology and Rehabilitation Sciences, College of Health Professions and Sciences, University of Central Florida  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9740-5917","authenticated-orcid":false,"given":"Abigail W.","family":"Anderson","sequence":"additional","affiliation":[{"name":"School of Kinesiology and Rehabilitation Sciences, College of Health Professions and Sciences, University of Central Florida  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny057"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000518"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2024.01.340"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20090058"},{"issue":"1","key":"e_1_2_8_6_1","first-page":"1","article-title":"Responsiveness of Pain Scales: A Comparison of Three Pain Intensity Measures in Chiropractic Patients","volume":"21","author":"Bolton J. 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