{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T06:00:39Z","timestamp":1780207239752,"version":"3.54.0"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":149,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Pain Research and Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The rising incidence of chronic nonspecific low back pain (CNLBP) is placing an ever\u2010growing burden on healthcare systems. This study aims to investigate the multidimensional impairment characteristics of core muscle structure and function, neuromuscular control, and psychological status in patients with CNLBP and to analyze the correlations among key indicators, thereby providing a basis for individualized clinical assessment and targeted intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 56 CNLBP patients from the outpatient department of Rehabilitation Medicine at Xijing Hospital of Fourth Military Medical University were enrolled between June 2024 and January 2025. Additionally, 30 healthy volunteers were recruited as controls. Demographic data were collected. Assessments were conducted across four dimensions: pain and function, muscle morphology, neuromuscular control, and sleep and psychological status. Differences in indicators between groups were compared, and correlation analyses among indicators were performed within the CNLBP group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the CNLBP group, the pressure pain threshold (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012), maximum voluntary extension of back extensors (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), cross\u2010sectional area (CSA) of the multifidus muscle (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), thickness change rate of the multifidus muscle (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and flexion\u2013relaxation ratio (FRR) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were significantly lower than those in the healthy control group. In contrast, the finger\u2010to\u2010floor distance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040), Pittsburgh Sleep Quality Index score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), Generalized Anxiety Disorder\u20107 score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), and Patient Health Questionnaire\u20109 score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021) were significantly higher. Correlation analysis within the CNLBP group revealed that the FRR was negatively correlated with the NRS score (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.283,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038) and the Oswestry Disability Index (ODI) score (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.345,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). The thickness change rate of the multifidus muscle was negatively correlated with the ODI score (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.285,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037), but its correlation with the Numeric Rating Scale (NRS) score was not significant (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.172,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.214). The CSA of the multifidus muscle showed no significant correlation with the FRR (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.061,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.655). In contrast, a significant positive correlation was identified between the FRR and the rate of thickness change in the multifidus (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.301,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study confirms that CNLBP involves multidimensional impairments, including pain perception and function, multifidus muscle morphology and activation function, neuromuscular regulation of the erector spinae, and sleep quality and psychological status. The identified correlations between FRR and both NRS and ODI scores provide a crucial basis for formulating individualized rehabilitation plans and for subsequent longitudinal research.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Chinese Registry of Clinical Trials: ChiCTR2400093968\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/prm\/4984566","type":"journal-article","created":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T05:05:01Z","timestamp":1780203901000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidimensional Dysfunction in Chronic Nonspecific Low Back Pain: A Correlational Study of Key Clinical Measures"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8232-3909","authenticated-orcid":false,"given":"Zhao","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fen","family":"Ju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8979-623X","authenticated-orcid":false,"given":"Dexin","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuheng","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2590-8643","authenticated-orcid":false,"given":"Chenguang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"crossref","first-page":"e316","DOI":"10.1016\/S2665-9913(23)00098-X","article-title":"Global, Regional, and National Burden of Low Back Pain, 1990-2020, Its Attributable Risk Factors, and Projections to 2050: A Systematic Analysis of the Global Burden of Disease Study 2021","volume":"5","author":"Gbd L. B. P. C.","year":"2023","journal-title":"Lancet. Rheumatology"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-023-00495-0"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11082175"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0301726"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2024.1351913"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-65983-5"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-006-1072-1"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-024-05125-9"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2023.09.005"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2025.1525952"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/jsp2.70086"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2014.04.009"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1249\/mss.0000000000002514"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.3233\/bmr-200101"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18105400"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci12010095"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-022-06116-z"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.2147\/jpr.s386879"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-16617-4"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.02010"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-58955-2"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000016173"},{"key":"e_1_2_13_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13102-022-00406-4"},{"key":"e_1_2_13_24_2","first-page":"1285","article-title":"Application of Surface Electromyography Flexion-Relaxation Phenomenon in Muscle Function Assessment of Low Back Pain Patients","volume":"31","author":"Zhao F.","year":"2019","journal-title":"Modern Practical Medicine"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.1589\/jpts.26.1899"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-023-06783-2"},{"key":"e_1_2_13_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-025-02283-2"},{"key":"e_1_2_13_28_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2023.1254248"},{"key":"e_1_2_13_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.11.052"},{"key":"e_1_2_13_30_2","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/9932336"},{"key":"e_1_2_13_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000004514"},{"key":"e_1_2_13_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12938-018-0443-2"},{"key":"e_1_2_13_33_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0244111"},{"key":"e_1_2_13_34_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-52900-z"},{"key":"e_1_2_13_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13102-024-00948-9"},{"key":"e_1_2_13_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2023.04.005"},{"key":"e_1_2_13_37_2","doi-asserted-by":"publisher","DOI":"10.2147\/jpr.s496917"},{"key":"e_1_2_13_38_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.864046"},{"key":"e_1_2_13_39_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-023-03237-3"},{"key":"e_1_2_13_40_2","doi-asserted-by":"publisher","DOI":"10.2196\/45406"},{"key":"e_1_2_13_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultras.2023.107187"}],"container-title":["Pain Research and Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/prm\/4984566","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/prm\/4984566","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/prm\/4984566","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T05:05:08Z","timestamp":1780203908000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/prm\/4984566"}},"subtitle":[],"editor":[{"given":"Harleen","family":"Khatra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/prm\/4984566"],"URL":"https:\/\/doi.org\/10.1155\/prm\/4984566","archive":["Portico"],"relation":{},"ISSN":["1203-6765","1918-1523"],"issn-type":[{"value":"1203-6765","type":"print"},{"value":"1918-1523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"4984566"}}