{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:24:47Z","timestamp":1788449087640,"version":"build-2803163510"},"reference-count":60,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"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":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neck pain (NP) is a common global health problem, and persistent symptoms are often linked to psychological stress. How individuals respond to pain during daily activities is captured by activity patterns (eustress persistence, distress persistence, activity pacing and fear avoidance). These behavioural responses reflect different ways of managing pain\u2010related activities and have been linked to variations in stress, pain intensity and disability. This study examined whether these factors serve as prognostic factors of pain and disability 1\u2009year after the onset of acute NP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this observational cohort study, 125 participants were assessed at \u2264\u20091\u2009month (T1), 3\u2009months (T2), 6\u2009months (T3) and 12\u2009months (T4) after acute NP onset. Stress was measured objectively (hair cortisol) and subjectively (Stress and Coping Inventory). Activity patterns were assessed with the Avoidance\u2010Endurance Fast Screen. Linear mixed\u2010effects models were fitted using frequentist and Bayesian approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pain intensity showed prognostic value at T1\u2013T3 for higher pain intensity and disability at T4. Subjective stress was associated with higher pain intensity only at T3, with disability at all measured time points (T1\u2013T3). Objective stress at T2 and T3 was associated with higher pain at T4, with disability only at T3. Among activity patterns, only distress persistence at T3 was associated with higher pain intensity at T4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Early pain intensity, longer\u2010lasting stress and distress persistence were associated with symptom persistence, although effect sizes were small. These results may support patient\u2010centred pain management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT05468684\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>This study identifies prognostic factors for pain and disability 1\u2009year after acute neck pain onset by combining pain intensity, subjective stress, hair cortisol and activity patterns across multiple time points. Early pain intensity and persistent stress showed prognostic value for long\u2010term outcomes. Importantly, distress persistence emerged as a prognostic activity pattern, extending the field beyond the predominant focus on fear avoidance. For physiotherapists, this highlights the value of monitoring pain, stress and behavioural responses to support informed, person\u2010centred care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70303","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T08:04:58Z","timestamp":1779523498000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Activity Patterns and Stress\u2014Prognostic Factors for Pain Persistence and Disability in Acute Neck Pain: A 1\u2010Year Prospective Cohort Study"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0989-527X","authenticated-orcid":false,"given":"Rita","family":"Morf","sequence":"first","affiliation":[{"name":"School of Health Sciences, Institute of Physiotherapy Zurich University of Applied Sciences (ZHAW)  Winterthur Switzerland"},{"name":"Faculty of Medicine University of Zurich (UZH)  Zurich Switzerland"},{"name":"Physiotherapy Medbase Winterthur  Winterthur Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0351-0968","authenticated-orcid":false,"given":"Leah","family":"Reicherzer","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Institute of Physiotherapy Zurich University of Applied Sciences (ZHAW)  Winterthur Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6886-4583","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Degenfellner","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Institute of Physiotherapy Zurich University of Applied Sciences (ZHAW)  Winterthur Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9455-6074","authenticated-orcid":false,"given":"Sabina","family":"Hotz\u2010Boendermaker","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Institute of Physiotherapy Zurich University of Applied Sciences (ZHAW)  Winterthur Switzerland"},{"name":"Pain in Motion Research Group  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/msc.1775"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102414535110"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248875"},{"key":"e_1_2_15_5_1","doi-asserted-by":"crossref","unstructured":"B\u00fcrkner P.\u2010C.2017.\u201cAdvanced Bayesian Multilevel Modeling With the R Package Brms (arXiv:1705.11123).\u201darXiv.https:\/\/doi.org\/10.48550\/arXiv.1705.11123.","DOI":"10.32614\/RJ-2018-017"},{"key":"e_1_2_15_6_1","doi-asserted-by":"crossref","unstructured":"Craig C. 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