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Participants were allocated to a digitally-delivered progressive run-walk interval exercise training program (3 days\/week, 30 min\/session) or waitlist control. Magnetic resonance imaging at baseline, six, and 12 weeks quantified primary outcome IVD composition as whole-disc T2 (ms) from T11\/T12 to L5\/S1. Moderators included baseline degeneration (Pfirrmann grade; aggregated Pfirrmann score), sex, body mass index, and intervention factors (cumulative running volume, mean speed, and dominant surface). Linear mixed models were fitted at the IVD level to estimate group-by-time effects within each moderator-defined subgroup (\u03b1 = 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The highest aggregated Pfirrmann scores reflecting greater multi-level degeneration (estimated marginal mean net difference [95%CI]: 3.42 [0.22, 6.62] ms,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.036), cumulative running volumes between 28.6 and 46.1 kms (4.80 [2.51, 7.10] ms,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), mean running speeds between 10.5 and 11.7\u00a0km\/h (2.46 [0.14, 4.79] ms,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.038), and running on grass (2.93 [0.10, 5.76] ms,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.043) positively moderated between-group IVD T2 changes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this pre-planned secondary analysis of a randomised control trial of a run-walk program, our data suggest running speed, volume and surface, as well as more multi-level IVD degeneration, may be associated with more favourable 12-week IVD T2 changes. Findings are hypothesis-generating and may inform future trials designed to optimise IVD health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-026-09759-7","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T15:25:58Z","timestamp":1772724358000},"page":"3822-3838","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Running is associated with intervertebral disc adaptations: a pre-planned secondary analysis of the ASTEROID randomised controlled trial"],"prefix":"10.1007","volume":"35","author":[{"given":"Claire L","family":"Samanna","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Neason","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D","family":"Tagliaferri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel L","family":"Belav\u00fd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike H","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna Rae","family":"Nez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Buntine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clint T","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Scott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niamh L","family":"Mundell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Clarkson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J","family":"Owen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"9759_CR1","doi-asserted-by":"publisher","first-page":"2394","DOI":"10.3174\/ajnr.A4498","volume":"36","author":"W Brinjikji","year":"2015","unstructured":"Brinjikji W, Diehn FE, Jarvik JG et al (2015) MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis. 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