{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T06:04:33Z","timestamp":1789365873466,"version":"build-2803163510"},"reference-count":55,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"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":["British Journal of Pain"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic musculoskeletal pain (CMP) is a heterogeneous condition in which overall treatment effects may obscure differences across patient subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To identify distinct baseline symptom profiles and examine their association with baseline-adjusted post-treatment outcomes, responder status, exploratory multidomain negative change, and response trajectorie\n                      <jats:bold>s<\/jats:bold>\n                      following a structured active pain coping program in primary care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a prospective observational cohort study (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 169). Participants were enrolled in a 12-week physical therapy program combining pain neuroscience education (PNE) and therapeutic exercise. Two-step cluster analysis identified baseline profiles from pain catastrophizing (PCS), kinesiophobia (TSK-11), disability (RMDQ), and central sensitization (CSI). Pre\u2013post changes, ANCOVA-adjusted endpoints, responder rates, and K-means response trajectories were examined.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two profiles emerged: Moderate (57.4%) and Severe (42.6%). Participants in both profiles improved significantly, with larger absolute reductions in the Severe profile (PCS responders: 77.6% vs 47.8%). After adjusting for baseline values, between-group differences were non-significant (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2265 0.05) across all domains, with similar adjusted endpoint levels in both profiles. The exploratory multidomain negative-change criterion was met by 21.6% of participants and was concentrated in the Moderate profile (88%; OR = 3.99, 95% CI: 1.36\u201311.70). Response-pattern analysis identified three trajectories: Global Responders (broad improvement across domains; 7.1%), Limited Responders (modest symptom change with worsening mental health; 45.9%), and Moderate Responders (intermediate improvements; 46.9%); the distribution of these trajectories was significantly associated with baseline profile. Only 31.0% of participants met the prespecified ideal responder criterion (simultaneous improvement in symptoms and quality of life).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both profiles converged toward comparable functional endpoints, making baseline severity a poor gatekeeping criterion for access to this care. Nonetheless, exploratory multidomain negative change was more frequent in the Moderate profile, and concurrent symptom and quality-of-life recovery was uncommon, underscoring the need for systematic mid-treatment monitoring and outcome definitions that extend beyond symptom scores.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20494637261487995","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:05:41Z","timestamp":1789103141000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Baseline symptom severity profiles and response to physiotherapy treatment in chronic musculoskeletal pain: A cluster analysis in primary care"],"prefix":"10.1177","author":[{"given":"Juan Manuel","family":"Gonz\u00e1lez-Flores","sequence":"first","affiliation":[{"name":"Suerte de Saavedra Primary Health Care Center"},{"name":"University of Extremadura"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Espejo-Ant\u00fanez","sequence":"additional","affiliation":[{"name":"University of Extremadura"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda de los \u00c1ngeles","family":"Cardero-Dur\u00e1n","sequence":"additional","affiliation":[{"name":"University of Extremadura"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefa","family":"Costillo-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Suerte de Saavedra Primary Health Care Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0952-6327","authenticated-orcid":false,"given":"Carlos","family":"Fern\u00e1ndez-Morales","sequence":"additional","affiliation":[{"name":"University of Extremadura"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000003406"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00098-X"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000003958"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000003072"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000602"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000244"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2025.104792"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-017-1411-x"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2007.09.005"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.13723.2"},{"key":"e_1_3_4_12_2","volume-title":"WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings","author":"World Health Organization","year":"2023","unstructured":"World Health Organization. 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