{"id":"https://openalex.org/W7220359834","doi":"https://doi.org/10.7759/cureus.117483","title":"A Prospective Interventional Study Comparing a Multimodal Intervention Incorporating Behavior, Exercise, Nutrition, Medication, and Posture With Exercise and Medication in Patients With Chronic Nonspecific Low Back Pain","display_name":"A Prospective Interventional Study Comparing a Multimodal Intervention Incorporating Behavior, Exercise, Nutrition, Medication, and Posture With Exercise and Medication in Patients With Chronic Nonspecific Low Back Pain","publication_year":2026,"publication_date":"2026-10-05","ids":{"openalex":"https://openalex.org/W7220359834","doi":"https://doi.org/10.7759/cureus.117483","pmid":"https://pubmed.ncbi.nlm.nih.gov/42985311","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13733605"},"language":"en","primary_location":{"id":"doi:10.7759/cureus.117483","doi":"https://doi.org/10.7759/cureus.117483","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117483","pdf_url":"https://www.cureus.com/articles/534549-a-prospective-interventional-study-comparing-a-multimodal-intervention-incorporating-behavior-exercise-nutrition-medication-and-posture-with-exercise-and-medication-in-patients-with-chronic-nonspecific-low-back-pain.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.cureus.com/articles/534549-a-prospective-interventional-study-comparing-a-multimodal-intervention-incorporating-behavior-exercise-nutrition-medication-and-posture-with-exercise-and-medication-in-patients-with-chronic-nonspecific-low-back-pain.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5157544007","display_name":"Sameep  H Koshti","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Sameep  H Koshti","raw_affiliation_strings":["Neurosurgery, Park Hospital, Panipat, IND"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Neurosurgery, Park Hospital, Panipat, IND","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5157393733","display_name":"Amit Soni","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1291450037","display_name":"Medanta The Medicity","ror":"https://ror.org/047dyfk64","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I1291450037"]},{"id":"https://openalex.org/I4210115207","display_name":"Medanta The Medicity","ror":"https://ror.org/023vqza20","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I1291450037","https://openalex.org/I4210115207"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Amit Soni","raw_affiliation_strings":["Neurorehabilitation, Medanta - The Medicity, Gurgaon, IND"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Neurorehabilitation, Medanta - The Medicity, Gurgaon, IND","institution_ids":["https://openalex.org/I1291450037","https://openalex.org/I4210115207"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5017789399","display_name":"Himanshu Champaneri","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I307255591","display_name":"Max Healthcare","ror":"https://ror.org/02vdjrg05","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I307255591"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Himanshu Champaneri","raw_affiliation_strings":["Neurosurgery, Max Hospital, Gurgaon, IND"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Neurosurgery, Max Hospital, Gurgaon, IND","institution_ids":["https://openalex.org/I307255591"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037248744","display_name":"Deepak Bhangale","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1291450037","display_name":"Medanta The Medicity","ror":"https://ror.org/047dyfk64","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I1291450037"]},{"id":"https://openalex.org/I4210115207","display_name":"Medanta The Medicity","ror":"https://ror.org/023vqza20","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I1291450037","https://openalex.org/I4210115207"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Deepak K Bhangale","raw_affiliation_strings":["Neurosurgery, Medanta - The Medicity, Gurgaon, IND"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Neurosurgery, Medanta - The Medicity, Gurgaon, IND","institution_ids":["https://openalex.org/I1291450037","https://openalex.org/I4210115207"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5157373357","display_name":"Amit Agrawal","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210106490","display_name":"All India Institute of Medical Sciences Bhopal","ror":"https://ror.org/01rs0zz87","country_code":"IN","type":"education","lineage":["https://openalex.org/I4210106490"]}],"countries":["IN"],"is_corresponding":true,"raw_author_name":"Amit Agrawal","raw_affiliation_strings":["Neurosurgery, All India Institute of Medical Sciences, Bhopal, IND"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Neurosurgery, All India Institute of Medical Sciences, Bhopal, IND","institution_ids":["https://openalex.org/I4210106490"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5157584466","display_name":"Sudhir Dubey","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1291450037","display_name":"Medanta The Medicity","ror":"https://ror.org/047dyfk64","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I1291450037"]},{"id":"https://openalex.org/I4210115207","display_name":"Medanta The Medicity","ror":"https://ror.org/023vqza20","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I1291450037","https://openalex.org/I4210115207"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Sudhir Dubey","raw_affiliation_strings":["Neurosurgery, Medanta - The Medicity, Gurgaon, IND"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Neurosurgery, Medanta - The Medicity, Gurgaon, IND","institution_ids":["https://openalex.org/I1291450037","https://openalex.org/I4210115207"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5157373357"],"corresponding_institution_ids":["https://openalex.org/I4210106490"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.78084833,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"18","issue":"10","first_page":"e117483","last_page":"e117483"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10084","display_name":"Musculoskeletal pain and rehabilitation","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/3612","display_name":"Physical Therapy, Sports Therapy and Rehabilitation"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10084","display_name":"Musculoskeletal pain and rehabilitation","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/3612","display_name":"Physical Therapy, Sports Therapy and Rehabilitation"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10238","display_name":"Spine and Intervertebral Disc Pathology","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11840","display_name":"Pain Management and Treatment","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2703","display_name":"Anesthesiology and Pain Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/chronic-non-specific-low-back-pain","display_name":"chronic non-specific low back pain","score":0.9990000128746033},{"id":"https://openalex.org/keywords/multimodal-intervention","display_name":"multimodal intervention","score":0.8939999938011169},{"id":"https://openalex.org/keywords/behavioral-therapy","display_name":"behavior therapy","score":0.8029999732971191},{"id":"https://openalex.org/keywords/exercise-therapy","display_name":"exercise therapy","score":0.8980000019073486},{"id":"https://openalex.org/keywords/diet-optimization","display_name":"diet optimization","score":0.8790000081062317},{"id":"https://openalex.org/keywords/postural-training","display_name":"postural training","score":0.7409999966621399},{"id":"https://openalex.org/keywords/drug-therapy","display_name":"pharmacotherapy","score":0.7210000157356262},{"id":"https://openalex.org/keywords/holistic-pain-management","display_name":"holistic pain management","score":0.8569999933242798},{"id":"https://openalex.org/keywords/anxiety","display_name":"anxiety","score":0.6349999904632568},{"id":"https://openalex.org/keywords/pain-intensity","display_name":"pain intensity","score":0.621999979019165},{"id":"https://openalex.org/keywords/multidisciplinary-treatment","display_name":"multidisciplinary treatment","score":0.6340000033378601}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9829999804496765},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.7516999840736389},{"id":"https://openalex.org/C2780907711","wikidata":"https://www.wikidata.org/wiki/Q852163","display_name":"Low back pain","level":3,"score":0.6739000082015991},{"id":"https://openalex.org/C2780665704","wikidata":"https://www.wikidata.org/wiki/Q959298","display_name":"Intervention (counseling)","level":2,"score":0.5645999908447266},{"id":"https://openalex.org/C99508421","wikidata":"https://www.wikidata.org/wiki/Q2678675","display_name":"Physical medicine and rehabilitation","level":1,"score":0.5034999847412109},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.48559999465942383},{"id":"https://openalex.org/C4441509","wikidata":"https://www.wikidata.org/wiki/Q6418787","display_name":"Multimodal therapy","level":2,"score":0.3790999948978424},{"id":"https://openalex.org/C111278954","wikidata":"https://www.wikidata.org/wiki/Q17069312","display_name":"Minimal clinically important difference","level":3,"score":0.30300000309944153},{"id":"https://openalex.org/C2776501849","wikidata":"https://www.wikidata.org/wiki/Q5781808","display_name":"Back pain","level":3,"score":0.27379998564720154},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.26260000467300415},{"id":"https://openalex.org/C2777771302","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Exercise therapy","level":3,"score":0.2612000107765198},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.25060001015663147}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.7759/cureus.117483","doi":"https://doi.org/10.7759/cureus.117483","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117483","pdf_url":"https://www.cureus.com/articles/534549-a-prospective-interventional-study-comparing-a-multimodal-intervention-incorporating-behavior-exercise-nutrition-medication-and-posture-with-exercise-and-medication-in-patients-with-chronic-nonspecific-low-back-pain.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13733605","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13733605/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13733605/pdf/cureus-0018-00000117483.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Text"},{"id":"pmid:42985311","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42985311","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.7759/cureus.117483","doi":"https://doi.org/10.7759/cureus.117483","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117483","pdf_url":"https://www.cureus.com/articles/534549-a-prospective-interventional-study-comparing-a-multimodal-intervention-incorporating-behavior-exercise-nutrition-medication-and-posture-with-exercise-and-medication-in-patients-with-chronic-nonspecific-low-back-pain.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/randomized-controlled-trial","display_name":"Randomized Controlled Trial"},{"id":"https://openalex.org/study-designs/clinical-trial","display_name":"Clinical Trial"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7220359834.pdf","grobid_xml":"https://content.openalex.org/works/W7220359834.grobid-xml"},"referenced_works_count":27,"referenced_works":["https://openalex.org/W1966659653","https://openalex.org/W1993390942","https://openalex.org/W2003618393","https://openalex.org/W2022235629","https://openalex.org/W2035490520","https://openalex.org/W2079322037","https://openalex.org/W2099905478","https://openalex.org/W2107871413","https://openalex.org/W2143221646","https://openalex.org/W2171920390","https://openalex.org/W2229245058","https://openalex.org/W2528626986","https://openalex.org/W2568605285","https://openalex.org/W2588410069","https://openalex.org/W2606583214","https://openalex.org/W2623719136","https://openalex.org/W2804254863","https://openalex.org/W2804723528","https://openalex.org/W3014709179","https://openalex.org/W3135590382","https://openalex.org/W3137947687","https://openalex.org/W3143249574","https://openalex.org/W4309606995","https://openalex.org/W4383500249","https://openalex.org/W4388626066","https://openalex.org/W4388735425","https://openalex.org/W4410905424"],"related_works":["https://openalex.org/W4412978711","https://openalex.org/W2726372302","https://openalex.org/W4306362395","https://openalex.org/W4405705300","https://openalex.org/W2337558733","https://openalex.org/W4403302674","https://openalex.org/W4391955232","https://openalex.org/W7213337987","https://openalex.org/W4393318060","https://openalex.org/W4415563654"],"abstract_inverted_index":{"Background":[0],"and":[1,15,52,61,125,152,226,232],"objectives":[2],"Chronic":[3],"nonspecific":[4,261],"low":[5],"back":[6],"pain":[7,109,128,156,256],"(CNLBP)":[8],"is":[9,33,245],"a":[10,19,41,56,83,92,210,235,250],"leading":[11],"cause":[12],"of":[13,40,209,217,221],"disability,":[14],"its":[16],"management":[17,216],"remains":[18],"significant":[20,151,179],"challenge.":[21],"While":[22],"non-pharmacological":[23],"interventions":[24],"like":[25],"exercise":[26,231],"are":[27],"recommended,":[28],"the":[29,38,105,115,144,159,171,197,203,207,215],"optimal":[30],"treatment":[31,243],"strategy":[32,213],"unclear.":[34],"This":[35,68],"study":[36,71,205],"compared":[37,157],"effectiveness":[39],"comprehensive,":[42,241],"five-modality":[43,93,145,242],"holistic":[44,94,198],"program":[45,95,244],"(behavior":[46],"therapy,":[47,223],"exercise,":[48],"nutrition":[49,224],"optimization,":[50,225],"drugs,":[51],"posture":[53,227],"training)":[54],"with":[55,65,75,188,196,259],"standard":[57,251],"two-modality":[58,84,160,252],"intervention":[59,85,253],"(exercise":[60],"drugs)":[62],"for":[63,170,214,254],"patients":[64,74,187,258],"CNLBP.":[66,76,218],"Methods":[67],"prospective":[69],"interventional":[70],"included":[72],"123":[73],"Participants":[77],"were":[78,130],"randomly":[79],"allocated":[80],"to":[81,158],"either":[82],"(Group":[86,96,147,162],"1;":[87],"n":[88,98],"=":[89,99],"60)":[90],"or":[91],"2;":[97],"63).":[100],"The":[101,164,219],"primary":[102],"outcome":[103],"was":[104,177],"between-group":[106,165],"difference":[107,166],"in":[108,122,155,167,257],"(Visual":[110],"Analogue":[111],"Scale,":[112],"VAS)":[113],"at":[114],"six-month":[116],"follow-up.":[117],"Secondary":[118],"endpoints,":[119],"including":[120],"changes":[121],"anxiety":[123,191],"scores":[124],"analysis":[126,184],"by":[127],"location,":[129],"treated":[131],"as":[132],"exploratory.":[133],"Results":[134],"After":[135],"six":[136],"months,":[137],"both":[138],"groups":[139],"showed":[140,192],"clinical":[141],"improvement.":[142],"However,":[143],"group":[146,161],"2)":[148],"demonstrated":[149],"statistically":[150,178],"superior":[153],"improvements":[154],"1).":[163],"mean":[168],"improvement":[169,195],"VAS":[172],"score":[173],"(3.65":[174],"vs.":[175],"1.55)":[176],"(p":[180],"<":[181],"0.001).":[182],"Subgroup":[183],"revealed":[185],"that":[186],"higher":[189],"baseline":[190],"significantly":[193,246],"greater":[194],"approach.":[199,239],"Conclusions":[200],"Findings":[201],"from":[202],"current":[204],"support":[206],"adoption":[208],"holistic,":[211],"multidisciplinary":[212],"integration":[220],"behavior":[222],"training":[228],"alongside":[229],"conventional":[230],"medication":[233],"provides":[234],"superior,":[236],"long-term":[237],"therapeutic":[238],"A":[240],"more":[247],"effective":[248],"than":[249],"improving":[255],"chronic":[260],"spinal":[262],"pain.":[263]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-10-06T00:00:00"}