{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:15:01Z","timestamp":1785366901320,"version":"3.55.0"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Direcci\u00f3n General de Investigaciones of Universidad Santiago de Cali","award":["DGI-01-2026"],"award-info":[{"award-number":["DGI-01-2026"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Fibromyalgia (FM) is a chronic condition characterized by widespread pain and cognitive dysfunction, with pharmacological treatments offering limited efficacy. Although Pain Neuroscience Education (PNE) and therapeutic exercise are evidence-based interventions, accessibility and adherence remain major challenges particularly in underserved regions such as Latin America. This trial investigates the effectiveness of a 12-week tele-rehabilitation program (FIBROIA) that integrates Artificial Intelligence (AI)-guided exercise with PNE to enhance access to comprehensive multimodal care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This multicentre, randomized, assessor-blinded, parallel-group controlled trial will enroll fifty adults meeting the 2016 ACR criteria for FM. Participants will be randomly assigned (1:1) to either the intervention group or enhanced usual care. The intervention consists of three personalized exercise sessions per week delivered through the Rehbody AI platform, which provides real-time biomechanical feedback, along with a weekly PNE module designed to reconceptualize pain. The primary outcome is the change in pain intensity, measured using the Visual Analogue Scale (VAS), at week 13 (\u00b17 days), immediately following completion of the 12-week program. Secondary outcomes include the Fibromyalgia Impact Questionnaire\u2013Revised (FIQ-R), lower-limb strength assessed by the 30-Second Sit-to-Stand test, and health-related quality of life measured with the EQ-5D-3L. Statistical analyses will follow an intention-to-treat (ITT) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The FIBROIA protocol addresses the urgent need for scalable, evidence-based interventions in resource-limited settings. By combining AI-driven biomechanical feedback with cognitive reappraisal through PNE, this study seeks to reduce fear-avoidance behaviors and improve exercise adherence. This integrative approach aims to overcome the limitations of passive tele-rehabilitation by simulating asynchronous professional supervision, thereby ensuring both safety and technical precision in movement execution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>If effective, this protocol will offer a robust, technology-enabled framework for remote FM management. The results could help establish a new clinical standard for accessible, patient-centered rehabilitation, bridging the gap between high-level evidence and real-world practice across diverse socioeconomic contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT06672419\" xlink:type=\"simple\">NCT06672419<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  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