{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:37:44Z","timestamp":1792841864338,"version":"4.5.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low back pain (LBP) is associated with psychological and breathing symptoms, such as dysfunctional breathing (DB) and hyperventilation syndrome (HVS), possibly more evident in females through autonomic\u2013anxiety mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To estimate the frequency of a positive screening result for a probable HVS\/DB symptom profile among females with LBP using the Nijmegen Questionnaire (NQ), compare features and autonomic\u2013anxiety symptoms across screening-defined groups (HVS\n                      <jats:sup>+<\/jats:sup>\n                      \/HVS\n                      <jats:sup>\u2013<\/jats:sup>\n                      ), and explore associations between features and the NQ total score (NQ_total) and an autonomic\u2013anxiety subscale (NQ_AA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This exploratory secondary analysis included 87 females with LBP from a cross-sectional primary care study, assessing age, body mass index (BMI), pain duration, pain intensity, and NQ scores; NQ \u226520 was used as a pragmatic screening threshold. Group differences and associations were analysed using nonparametric tests, with multivariable regression for NQ_AA and exploratory PCA to examine symptom structure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-one per cent of participants screened positive for a probable HVS\/DB symptom profile. The HVS\u2009+\u2009group had significantly higher NQ_total and NQ_AA scores, with no differences in age, BMI, pain duration, or pain intensity. The only consistent finding was a modest positive association between pain intensity and NQ_AA, which remained the sole independent correlate despite the model explaining little variance. PCA suggested a two-component structure, separating respiratory and autonomic\u2013anxiety symptoms, explaining 40.7% of variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A probable HVS\/DB symptom profile was common in the sample and primarily reflected a higher autonomic\u2013anxiety symptom burden. NQ may provide complementary information during assessment, but findings should be interpreted cautiously and require further confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538127261469318","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:49:40Z","timestamp":1784123380000},"page":"2136-2145","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Autonomic\u2013anxiety symptoms of dysfunctional breathing in females with low back pain: A Nijmegen questionnaire-based secondary analysis in primary care"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2517-3082","authenticated-orcid":false,"given":"Iva","family":"Lon\u010dari\u0107 Kele\u010di\u0107","sequence":"first","affiliation":[{"name":"Libertas International University"},{"name":"Physical Therapy Department, University Clinical Hospital Centre Zagreb, Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3589-8299","authenticated-orcid":false,"given":"Elvir","family":"Gosi\u0107","sequence":"additional","affiliation":[{"name":"Physical Therapy and Rehabilitation Department, Health Centre of Primorsko-Goranska County, Rijeka, Croatia"},{"name":"Faculty of Kinesiology, University of Zagreb"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasna","family":"Mesari\u0107","sequence":"additional","affiliation":[{"name":"Libertas International University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.5935\/2595-0118.20240023-en"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.906461"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12151465"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11222928"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/14799731251315483"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.52403\/ijhsr.20220220"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.5114\/fmpcr.2024.144917"},{"key":"e_1_3_3_9_2","article-title":"Breathlessness in primary care\u2014prevalence and physiotherapy management of breathing pattern disorders","volume":"54","author":"De Vos R","year":"2019","unstructured":"De Vos R, Lanning E, Longstaff J, et al. 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