{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:22:58Z","timestamp":1785435778396,"version":"3.56.0"},"reference-count":51,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002946","name":"German Aerospace Center","doi-asserted-by":"crossref","award":["01EC1906C"],"award-info":[{"award-number":["01EC1906C"]}],"id":[{"id":"10.13039\/501100002946","id-type":"DOI","asserted-by":"crossref"}]},{"award":["01EC1906C"],"award-info":[{"award-number":["01EC1906C"]}],"id":[{"id":"https:\/\/ror.org\/04bwf3e34","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Purpose: This study explores how older adults with chronic back pain (CBP) evaluate different user interface (UI) designs and gamification elements for an ultrasound-based wearable providing real-time biofeedback during segmental stabilization exercises (SSE). The aim is to identify design preferences and motivational factors to enhance usability, engagement, and adherence in this specific population. Methods: We conducted a mixed-methods study with 15 older adults (aged \u2265 65) experiencing CBP. Participants interacted with three UI mockups (simple, anatomical, and playful) via a Wizard-of-Oz simulation and evaluated additional motivational elements (e.g., points, badges, progress charts). Semi-structured interviews and the Technology Usage Inventory (TUI) subscales were used to assess usability, acceptance, and intention to use. Results: Participants preferred the simple and anatomical UI designs, citing clarity, professionalism, and ease of interpretation. The playful design was viewed as less appropriate due to perceived infantilization. Game elements such as progress tracking, points, and levels were positively received, while competitive features like leaderboards were viewed critically. Most participants expressed interest in integrating pain education, favoring multimedia formats. Conclusions: Digital health tools for older adults must prioritize intuitive, medically reliable interfaces and allow personalization of motivational and educational components. The findings highlight the need for age-appropriate UI design and suggest that well-balanced gamification and educational features may enhance perceived acceptance and have the potential to support long-term use, which should be evaluated in longitudinal studies.<\/jats:p>","DOI":"10.3390\/geriatrics11030059","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T15:45:34Z","timestamp":1779291934000},"page":"59","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-Based Wearable for Older Chronic Back Pain Patients: A Requirement Analysis of a User Interface for Biofeedback"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0020-2617","authenticated-orcid":false,"given":"Luis","family":"Perotti","sequence":"first","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13347 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1584-687X","authenticated-orcid":false,"given":"Oskar","family":"Stamm","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13347 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7227-2799","authenticated-orcid":false,"given":"Susan","family":"Vorwerg-Gall","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13347 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Mesletzky","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13347 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7132-7778","authenticated-orcid":false,"given":"Drin","family":"Ferizaj","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13347 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Di\u00dfmann","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13347 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Stube-Lahmann","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13347 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0690-9384","authenticated-orcid":false,"given":"Marc","family":"Fournelle","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Fraunhofer Institute for Biomedical Engineering, 66280 Sulzbach, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Lahmann","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13347 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"M\u00fcller-Werdan","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Medical Gerontology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13347 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"ref_1","first-page":"2","article-title":"BURDEN 2020 Study Group Pr\u00e4valenz von R\u00fccken- und Nackenschmerzen in Deutschland. Ergebnisse der Krankheitslast-Studie BURDEN 2020","volume":"6","author":"Krause","year":"2021","journal-title":"J. Health Monit."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1191\/0269215506cr977oa","article-title":"Segmental Stabilizing Exercises and Low Back Pain. What Is the Evidence? A Systematic Review of Randomized Controlled Trials","volume":"20","author":"Rackwitz","year":"2006","journal-title":"Clin. Rehabil."},{"key":"ref_3","first-page":"245","article-title":"Core Stability Exercise in Chronic Low Back Pain","volume":"34","author":"Hodges","year":"2003","journal-title":"Orthop. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.math.2011.05.007","article-title":"The Relationship of Transversus Abdominis and Lumbar Multifidus Clinical Muscle Tests in Patients with Chronic Low Back Pain","volume":"16","author":"Hides","year":"2011","journal-title":"Man. Ther."},{"key":"ref_5","unstructured":"Richardson, C., Hodges, P.W., Hides, J., and Richardson, C. (2004). Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain, Churchill Livingstone. [2nd ed.]."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4085\/1062-6050-51.11.16","article-title":"Core Stability Exercise Versus General Exercise for Chronic Low Back Pain","volume":"52","author":"Coulombe","year":"2017","journal-title":"J. Athl. Train."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Perotti, L., Stamm, O., Mesletzky, L., Vorwerg, S., Fournelle, M., and M\u00fcller-Werdan, U. (2023). Needs and Attitudes of Older Chronic Back Pain Patients towards a Wearable for Ultrasound Biofeedback during Stabilization Exercises: A Qualitative Analysis. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20064927"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Valent\u00edn-Mazarracin, I., Nogaledo-Mart\u00edn, M., L\u00f3pez-de-Uralde-Villanueva, I., Fern\u00e1ndez-de-las-Pe\u00f1as, C., Stokes, M., Arias-Bur\u00eda, J.L., D\u00edaz-Arribas, M.J., and Plaza-Manzano, G. (2021). Reproducibility and Concurrent Validity of Manual Palpation with Rehabilitative Ultrasound Imaging for Assessing Deep Abdominal Muscle Activity: Analysis with Preferential Ratios. Diagnostics, 11.","DOI":"10.3390\/diagnostics11020298"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"627","DOI":"10.2519\/jospt.2007.2555","article-title":"Ultrasound Imaging as a Feedback Tool in the Rehabilitation of Trunk Muscle Dysfunction for People with Low Back Pain","volume":"37","author":"Henry","year":"2007","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lin, S., Zhu, B., Zheng, Y., Huang, G., Zeng, Q., and Wang, C. (2021). Effect of Real-Time Ultrasound Imaging for Biofeedback on Trunk Muscle Contraction in Healthy Subjects: A Preliminary Study. BMC Musculoskelet. Disord., 22.","DOI":"10.1186\/s12891-021-04006-0"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"338","DOI":"10.2519\/jospt.2005.35.6.338","article-title":"The Use of Real-Time Ultrasound Feedback in Teaching Abdominal Hollowing Exercises to Healthy Subjects","volume":"35","author":"Henry","year":"2005","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_12","unstructured":"Duffy, V.G., Gao, Q., Zhou, J., Antona, M., and Stephanidis, C. (2022). Expert Requirements for an Ultrasound-Based Wearable Using Deep Learning for Exercise Feedback in Older Chronic Back Pain Patients. Proceedings of the HCI International 2022\u2014Late Breaking Papers: HCI for Health, Well-Being, Universal Access and Healthy Aging, Springer Nature."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e75591","DOI":"10.2196\/75591","article-title":"Barriers to Digital Health Adoption in Older Adults: Scoping Review Informed by Innovation Resistance Theory","volume":"28","author":"Birati","year":"2026","journal-title":"J. Med. Internet Res."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Isaradech, N., and Sirikul, W. (2025). Digital Health Tools Applications in Frail Older Adults\u2014A Review Article. Front. Digit. Health, 7.","DOI":"10.3389\/fdgth.2025.1495135"},{"key":"ref_15","first-page":"142","article-title":"User Interfaces for Older Adults","volume":"Volume 8010","author":"Stephanidis","year":"2013","journal-title":"Universal Access in Human-Computer Interaction. User and Context Diversity"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.promfg.2015.07.337","article-title":"A Real Time Biofeedback System Using Visual User Interface for Physical Rehabilitation","volume":"3","author":"Barandas","year":"2015","journal-title":"Procedia Manuf."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Deterding, S., Dixon, D., Khaled, R., and Nacke, L. (2011). From Game Design Elements to Gamefulness: Defining \u201cGamification\u201d. Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments, Tampere Finland, 28\u201330 September 2011, ACM.","DOI":"10.1145\/2181037.2181040"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e360","DOI":"10.1093\/geront\/gnaa047","article-title":"Gamification for Older Adults: A Systematic Literature Review","volume":"61","author":"Koivisto","year":"2021","journal-title":"Gerontol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jbi.2017.05.011","article-title":"A Systematic Review of Gamification in E-Health","volume":"71","author":"Sardi","year":"2017","journal-title":"J. Biomed. Inform."},{"key":"ref_20","first-page":"1671","article-title":"The evolving landscape of gamification for older adults: Evidence from a systematic review","volume":"25","author":"Hong","year":"2026","journal-title":"Gerontechnology"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kappen, D.L., Mirza-Babaei, P., and Nacke, L.E. (2020). Technology Facilitates Physical Activity Through Gamification: A Thematic Analysis of an 8-Week Study. Front. Comput. Sci., 2.","DOI":"10.3389\/fcomp.2020.530309"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1016\/j.apmr.2011.07.198","article-title":"The Effect of Neuroscience Education on Pain, Disability, Anxiety, and Stress in Chronic Musculoskeletal Pain","volume":"92","author":"Louw","year":"2011","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1002\/ejp.1314","article-title":"A Systematic Review and Meta-analysis of Pain Neuroscience Education for Chronic Low Back Pain: Short-and Long-term Outcomes of Pain and Disability","volume":"23","author":"Wood","year":"2019","journal-title":"Eur. J. Pain"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"s192","DOI":"10.1007\/s00586-006-1072-1","article-title":"Chapter 4European Guidelinesfor the Management of Chronicnonspecific Low Back Pain","volume":"15","author":"Airaksinen","year":"2006","journal-title":"Eur. Spine J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1007\/s11548-024-03204-0","article-title":"Contraction Assessment of Abdominal Muscles Using Automated Segmentation Designed for Wearable Ultrasound Applications","volume":"19","author":"Strohm","year":"2024","journal-title":"Int. J. Comput. Assist. Radiol. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Bikner-Ahsbahs, A., Knipping, C., and Presmeg, N. (2015). Qualitative Content Analysis: Theoretical Background and Procedures. Approaches to Qualitative Research in Mathematics Education: Examples of Methodology and Methods, Springer. Advances in Mathematics Education.","DOI":"10.1007\/978-94-017-9181-6"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Guest, G., Namey, E., and Chen, M. (2020). A Simple Method to Assess and Report Thematic Saturation in Qualitative Research. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0232076"},{"key":"ref_28","unstructured":"Kothgassner, O.D., Felnhofer, A., Hauk, N., Kastenhofer, E., Gomm, J., and Kryspin-Exner, I. (2013). Technology Usage Inventory (TUI): Manual, FFG. Available online: https:\/\/www.researchgate.net\/publication\/259292979_Technology_Usage_Inventory_TUI_Manual."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1080\/10447318.2018.1456150","article-title":"A Personal Resource for Technology Interaction: Development and Validation of the Affinity for Technology Interaction (ATI) Scale","volume":"35","author":"Franke","year":"2019","journal-title":"Int. J. Hum. Comput. Interact."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Cechetti, N.P., Biduki, D., and De Marchi, A.C.B. (2017). Gamification Strategies for Mobile Device Applications: A Systematic Review. Proceedings of the 2017 12th Iberian Conference on Information Systems and Technologies (CISTI), Lisbon, Portugal, 21\u201324 June 2017, IEEE.","DOI":"10.23919\/CISTI.2017.7975943"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1300\/J084v17n04_04","article-title":"Infantilization as Elder Mistreatment: Evidence from Five Adult Day Centers","volume":"17","author":"Salari","year":"2005","journal-title":"J. Elder Abus. Negl."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Zhou, C., Yuan, F., Huang, T., Zhang, Y., and Kaner, J. (2022). The Impact of Interface Design Element Features on Task Performance in Older Adults: Evidence from Eye-Tracking and EEG Signals. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19159251"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"136","DOI":"10.59953\/paperasia.v40i5b.232","article-title":"A Study of Key Factors Influencing the Usability of Smartphone Graphical User Interfaces for Older Adults","volume":"40","author":"Zhang","year":"2024","journal-title":"PaperASIA"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1518\/001872008X288394","article-title":"Multiple Resources and Mental Workload","volume":"50","author":"Wickens","year":"2008","journal-title":"Hum. Factors"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"102334","DOI":"10.1016\/j.jelekin.2019.07.004","article-title":"The Effect of Tactile and Verbal Guidance during Scapulothoracic Exercises: An EMG and Kinematic Investigation","volume":"62","author":"Staker","year":"2022","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1123\/jsr.2016-0233","article-title":"The Influence of Verbal and Tactile Feedback on Electromyographic Amplitude of the Shoulder Musculature During Common Therapeutic Exercises","volume":"27","author":"Jones","year":"2018","journal-title":"J. Sport Rehabil."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1093\/geroni\/igaa057.627","article-title":"Exploring Technology Perceptions and Intentions to Use in Older Adults","volume":"4","author":"Williams","year":"2020","journal-title":"Innov. Aging"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e39890","DOI":"10.2196\/39890","article-title":"The Factors Influencing Older Adults\u2019 Decisions Surrounding Adoption of Technology: Quantitative Experimental Study","volume":"5","author":"Moxley","year":"2022","journal-title":"JMIR Aging"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1016\/j.chb.2010.06.020","article-title":"Older Adults Talk Technology: Technology Usage and Attitudes","volume":"26","author":"Mitzner","year":"2010","journal-title":"Comput. Hum. Behav."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Abdelrahman, N.G., Haque, R., Polverento, M.E., Wendling, A., Goetz, C.M., and Arnetz, B.B. (2020). Brain Health: Attitudes towards Technology Adoption in Older Adults. Healthcare, 9.","DOI":"10.3390\/healthcare9010023"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Tizuka, M.M., Clua, E.W.G., and De Castro Salgado, L.C. (2020). Investigating M-Health Gamification Rewards Elements for Adults 50+. Proceedings of the 2020 IEEE 8th International Conference on Serious Games and Applications for Health (SeGAH), Vancouver, BC, Canada, 12\u201314 August 2020, IEEE.","DOI":"10.1109\/SeGAH49190.2020.9201658"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Liu, Y., Alexandrova, T., and Nakajima, T. (2011). Gamifying Intelligent Environments. Proceedings of the 2011 international ACM Workshop on Ubiquitous Meta User Interfaces, Scottsdale AZ, USA, 1 December 2011, ACM.","DOI":"10.1145\/2072652.2072655"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.tele.2019.04.007","article-title":"Developing and Implementing a Gamification Method to Improve User Engagement: A Case Study with an m-Health Application for Hypertension Monitoring","volume":"41","author":"Cechetti","year":"2019","journal-title":"Telemat. Inform."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Kappen, D.L., Mirza-Babaei, P., and Nacke, L.E. (2017). Gamification through the Application of Motivational Affordances for Physical Activity Technology. Proceedings of the Annual Symposium on Computer-Human Interaction in Play, Amsterdam, The Netherlands, 15\u201318 October 2017, Association for Computing Machinery.","DOI":"10.1145\/3116595.3116604"},{"key":"ref_45","unstructured":"(2026, May 06). Overview. Chronic Pain (Primary and Secondary) in over 16s: Assessment of All Chronic Pain and Management of Chronic Primary Pain. Guidance. NICE. Available online: https:\/\/www.nice.org.uk\/guidance\/ng193."},{"key":"ref_46","unstructured":"(2026, May 06). Overview. Low Back Pain and Sciatica in over 16s: Assessment and Management. Guidance. NICE. Available online: https:\/\/www.nice.org.uk\/guidance\/ng59."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e36690","DOI":"10.2196\/36690","article-title":"The Influence of Wearables on Health Care Outcomes in Chronic Disease: Systematic Review","volume":"24","author":"Mattison","year":"2022","journal-title":"J. Med. Internet Res."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Gal\u00e1n-Mart\u00edn, M.A., Montero-Cuadrado, F., Lluch-Girbes, E., Coca-L\u00f3pez, M.C., Mayo-Iscar, A., and Cuesta-Vargas, A. (2019). Pain Neuroscience Education and Physical Exercise for Patients with Chronic Spinal Pain in Primary Healthcare: A Randomised Trial Protocol. BMC Musculoskelet. Disord., 20.","DOI":"10.1186\/s12891-019-2889-1"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.math.2010.03.003","article-title":"Pain Biology Education and Exercise Classes Compared to Pain Biology Education Alone for Individuals with Chronic Low Back Pain: A Pilot Randomised Controlled Trial","volume":"15","author":"Ryan","year":"2010","journal-title":"Man. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1136\/bmj.310.6973.151","article-title":"Randomised Controlled Trial for Evaluation of Fitness Programme for Patients with Chronic Low Back Pain","volume":"310","author":"Frost","year":"1995","journal-title":"BMJ"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3233\/BMR-181305","article-title":"The Effectiveness of Patient Education in Improving Pain, Disability and Quality of Life among Older People with Low Back Pain: A Systematic Review","volume":"33","author":"Zahari","year":"2020","journal-title":"J. Back Musculoskelet. Rehabil."}],"container-title":["Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3417\/11\/3\/59\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T04:13:54Z","timestamp":1779423234000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3417\/11\/3\/59"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,15]]},"references-count":51,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["geriatrics11030059"],"URL":"https:\/\/doi.org\/10.3390\/geriatrics11030059","relation":{},"ISSN":["2308-3417"],"issn-type":[{"value":"2308-3417","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,15]]}}}