{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T08:42:28Z","timestamp":1792399348028,"version":"4.4.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K14153"],"award-info":[{"award-number":["25K14153"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>To explore patterns of treatment response to pain neuroscience education combined with physical activity (PNE\u2010PA) and to examine baseline characteristics associated with these patterns in older women with chronic low back pain (CLBP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In a community\u2010based quasi\u2010randomized trial, older women with CLBP were analyzed in a PNE\u2010PA program (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200943) or a biomechanical (BM) comparison group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913). Physical function, physical activity (daily step counts by pedometer), pain intensity, disability, and pain\u2010related psychological outcomes were assessed at baseline and 12 weeks. Between\u2010group effects were examined using rank\u2010based analysis of covariance adjusting for baseline values, age, and body mass index. Within the PNE\u2010PA arm, k\u2010means clustering on changes in 30\u2010s chair\u2010stand performance and pain catastrophizing (PCS) was used to identify response profiles, with baseline characteristics compared across clusters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with BM, PNE\u2010PA produced larger adjusted improvements in chair\u2010stand repetitions, daily step counts, and PCS scores; no significant between\u2010group differences were observed for other outcomes. Three clusters were identified: minimal responders (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915), physical\u2010function responders (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918), and psychological responders (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910). Physical\u2010function responders showed greater chair\u2010stand gains with lower baseline lower\u2010limb function; psychological responders exhibited larger PCS reductions and lower baseline physical performance, together with higher PCS scores. Cluster separation was modest, and the gap statistic favored a single cluster, indicating descriptive, hypothesis\u2010generating patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Older women with CLBP receiving PNE\u2010PA showed heterogeneous changes in physical function and pain\u2010related cognitions. Lower baseline mobility and higher catastrophizing were associated with larger domain\u2010specific improvements, although these associations may partly reflect regression to the mean. Identifying baseline physical and psychological profiles may inform more targeted group\u2010based programs for older adults with CLBP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73241","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:38:19Z","timestamp":1790339899000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cluster\u2010Defined Response Patterns Following Pain Neuroscience Education With Physical Activity in Older Women With Chronic Low Back Pain: A Quasi\u2010Randomized Exploratory Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5131-9834","authenticated-orcid":false,"given":"Teppei","family":"Abiko","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences and Medicine Bond University Gold Coast Queensland Australia"},{"name":"Department of Physical Therapy, Faculty of Health Sciences 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