{"id":"https://openalex.org/W7225375365","doi":"https://doi.org/10.3390/healthcare14213799","title":"Baseline Psychological Factors and Subsequent Exercise Adherence in Individuals with Chronic Low Back Pain","display_name":"Baseline Psychological Factors and Subsequent Exercise Adherence in Individuals with Chronic Low Back Pain","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225375365","doi":"https://doi.org/10.3390/healthcare14213799"},"language":"en","primary_location":{"id":"doi:10.3390/healthcare14213799","doi":"https://doi.org/10.3390/healthcare14213799","is_oa":true,"landing_page_url":"https://doi.org/10.3390/healthcare14213799","pdf_url":null,"source":{"id":"https://openalex.org/S4210214101","display_name":"Healthcare","issn_l":"2227-9032","issn":["2227-9032"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-40","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Healthcare","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/healthcare14213799","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5025435051","display_name":"Kyriakos Petropoulakos","orcid":"https://orcid.org/0000-0002-0359-6730","observed_orcids":["https://orcid.org/0000-0002-0359-6730"]},"institutions":[{"id":"https://openalex.org/I145722265","display_name":"University of Thessaly","ror":"https://ror.org/04v4g9h31","country_code":"GR","type":"education","lineage":["https://openalex.org/I145722265"]}],"countries":["GR"],"is_corresponding":true,"raw_author_name":"Kyriakos Petropoulakos","raw_affiliation_strings":["Human Performance and Rehabilitation Research Laboratory, School of Health Sciences, University of Thessaly, 35132 Lamia, Greece"],"raw_orcid":"https://orcid.org/0000-0002-0359-6730","affiliations":[{"raw_affiliation_string":"Human Performance and Rehabilitation Research Laboratory, School of Health Sciences, University of Thessaly, 35132 Lamia, Greece","institution_ids":["https://openalex.org/I145722265"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061102814","display_name":"Zacharias Dimitriadis","orcid":"https://orcid.org/0000-0002-2254-5402","observed_orcids":["https://orcid.org/0000-0002-2254-5402"]},"institutions":[{"id":"https://openalex.org/I145722265","display_name":"University of Thessaly","ror":"https://ror.org/04v4g9h31","country_code":"GR","type":"education","lineage":["https://openalex.org/I145722265"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Zacharias Dimitriadis","raw_affiliation_strings":["Health Assessment and Quality of Life Research Laboratory, University of Thessaly, 35100 Lamia, Greece"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Assessment and Quality of Life Research Laboratory, University of Thessaly, 35100 Lamia, Greece","institution_ids":["https://openalex.org/I145722265"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5064138906","display_name":"Evdokia V. Billis","orcid":"https://orcid.org/0000-0002-5828-809X","observed_orcids":["https://orcid.org/0000-0002-5828-809X"]},"institutions":[{"id":"https://openalex.org/I174878644","display_name":"University of Patras","ror":"https://ror.org/017wvtq80","country_code":"GR","type":"education","lineage":["https://openalex.org/I174878644"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Evdokia Billis","raw_affiliation_strings":["Faculty of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece"],"raw_orcid":"https://orcid.org/0000-0002-5828-809X","affiliations":[{"raw_affiliation_string":"Faculty of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece","institution_ids":["https://openalex.org/I174878644"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5050483700","display_name":"Konstantinos Meliggas","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I145722265","display_name":"University of Thessaly","ror":"https://ror.org/04v4g9h31","country_code":"GR","type":"education","lineage":["https://openalex.org/I145722265"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Konstantinos Meliggas","raw_affiliation_strings":["Human Performance and Rehabilitation Research Laboratory, School of Health Sciences, University of Thessaly, 35132 Lamia, Greece"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Human Performance and Rehabilitation Research Laboratory, School of Health Sciences, University of Thessaly, 35132 Lamia, Greece","institution_ids":["https://openalex.org/I145722265"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5072509504","display_name":"Ioannis A. Poulis","orcid":"https://orcid.org/0000-0002-0871-6260","observed_orcids":["https://orcid.org/0000-0002-0871-6260"]},"institutions":[{"id":"https://openalex.org/I145722265","display_name":"University of Thessaly","ror":"https://ror.org/04v4g9h31","country_code":"GR","type":"education","lineage":["https://openalex.org/I145722265"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Ioannis Poulis","raw_affiliation_strings":["Human Performance and Rehabilitation Research Laboratory, School of Health Sciences, University of Thessaly, 35132 Lamia, Greece"],"raw_orcid":"https://orcid.org/0000-0002-0871-6260","affiliations":[{"raw_affiliation_string":"Human Performance and Rehabilitation Research Laboratory, School of Health Sciences, University of Thessaly, 35132 Lamia, Greece","institution_ids":["https://openalex.org/I145722265"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5048715308","display_name":"Savvas L. Spanos","orcid":"https://orcid.org/0000-0001-5458-8485","observed_orcids":["https://orcid.org/0000-0001-5458-8485"]},"institutions":[{"id":"https://openalex.org/I145722265","display_name":"University of Thessaly","ror":"https://ror.org/04v4g9h31","country_code":"GR","type":"education","lineage":["https://openalex.org/I145722265"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Savvas Spanos","raw_affiliation_strings":["Human Performance and Rehabilitation Research Laboratory, School of Health Sciences, University of Thessaly, 35132 Lamia, Greece"],"raw_orcid":"https://orcid.org/0000-0001-5458-8485","affiliations":[{"raw_affiliation_string":"Human Performance and Rehabilitation Research Laboratory, School of Health Sciences, University of Thessaly, 35132 Lamia, Greece","institution_ids":["https://openalex.org/I145722265"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5025435051"],"corresponding_institution_ids":["https://openalex.org/I145722265"],"apc_list":{"value":2700,"currency":"CHF","value_usd":3258},"apc_paid":{"value":2700,"currency":"CHF","value_usd":3258},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"14","issue":"21","first_page":"3799","last_page":"3799"},"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/T10352","display_name":"Physical Activity and Health","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"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/T11620","display_name":"Medication Adherence and Compliance","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2714","display_name":"Family Practice"},"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-low-back-pain","display_name":"chronic low back pain","score":0.9869999885559082},{"id":"https://openalex.org/keywords/exercise-adherence","display_name":"exercise adherence","score":0.9959999918937683},{"id":"https://openalex.org/keywords/kinesiophobia","display_name":"kinesiophobia","score":0.902999997138977},{"id":"https://openalex.org/keywords/pain-catastrophizing","display_name":"pain catastrophizing","score":0.9869999885559082},{"id":"https://openalex.org/keywords/depression","display_name":"depression","score":0.9639999866485596},{"id":"https://openalex.org/keywords/anxiety","display_name":"anxiety","score":1.0},{"id":"https://openalex.org/keywords/stress","display_name":"stress","score":0.9179999828338623},{"id":"https://openalex.org/keywords/psychological-factors","display_name":"psychological factors","score":0.7649999856948853},{"id":"https://openalex.org/keywords/exercise-intervention","display_name":"exercise intervention","score":0.5329999923706055}],"concepts":[{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.6452000141143799},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6175000071525574},{"id":"https://openalex.org/C558461103","wikidata":"https://www.wikidata.org/wiki/Q154430","display_name":"Anxiety","level":2,"score":0.5888000130653381},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.5605000257492065},{"id":"https://openalex.org/C2780907711","wikidata":"https://www.wikidata.org/wiki/Q852163","display_name":"Low back pain","level":3,"score":0.5260000228881836},{"id":"https://openalex.org/C112143881","wikidata":"https://www.wikidata.org/wiki/Q7124833","display_name":"Pain catastrophizing","level":3,"score":0.5238999724388123},{"id":"https://openalex.org/C2776867660","wikidata":"https://www.wikidata.org/wiki/Q1814941","display_name":"Depression (economics)","level":2,"score":0.5109000205993652},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.4481000006198883},{"id":"https://openalex.org/C139265228","wikidata":"https://www.wikidata.org/wiki/Q5283089","display_name":"Distress","level":2,"score":0.4478999972343445},{"id":"https://openalex.org/C83849319","wikidata":"https://www.wikidata.org/wiki/Q7295720","display_name":"Rating scale","level":2,"score":0.39089998602867126},{"id":"https://openalex.org/C2778739829","wikidata":"https://www.wikidata.org/wiki/Q17027611","display_name":"Hospital Anxiety and Depression Scale","level":3,"score":0.39079999923706055},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.390500009059906},{"id":"https://openalex.org/C2779870332","wikidata":"https://www.wikidata.org/wiki/Q7166982","display_name":"Perceived Stress Scale","level":3,"score":0.3815999925136566},{"id":"https://openalex.org/C2776501849","wikidata":"https://www.wikidata.org/wiki/Q5781808","display_name":"Back pain","level":3,"score":0.33799999952316284},{"id":"https://openalex.org/C2781118164","wikidata":"https://www.wikidata.org/wiki/Q1088113","display_name":"Chronic pain","level":2,"score":0.31869998574256897},{"id":"https://openalex.org/C171606756","wikidata":"https://www.wikidata.org/wiki/Q506132","display_name":"Psychometrics","level":2,"score":0.29089999198913574},{"id":"https://openalex.org/C2780665704","wikidata":"https://www.wikidata.org/wiki/Q959298","display_name":"Intervention (counseling)","level":2,"score":0.28870001435279846},{"id":"https://openalex.org/C18747219","wikidata":"https://www.wikidata.org/wiki/Q620994","display_name":"Standard error","level":2,"score":0.2863999903202057},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.2791999876499176},{"id":"https://openalex.org/C12725497","wikidata":"https://www.wikidata.org/wiki/Q810247","display_name":"Baseline (sea)","level":2,"score":0.27489998936653137},{"id":"https://openalex.org/C99508421","wikidata":"https://www.wikidata.org/wiki/Q2678675","display_name":"Physical medicine and rehabilitation","level":1,"score":0.26649999618530273},{"id":"https://openalex.org/C2779408567","wikidata":"https://www.wikidata.org/wiki/Q543906","display_name":"Anxiety sensitivity","level":3,"score":0.2567000091075897},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.2533000111579895},{"id":"https://openalex.org/C152877465","wikidata":"https://www.wikidata.org/wiki/Q208042","display_name":"Regression analysis","level":2,"score":0.2524000108242035},{"id":"https://openalex.org/C53059260","wikidata":"https://www.wikidata.org/wiki/Q374758","display_name":"Multilevel model","level":2,"score":0.2508000135421753}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3390/healthcare14213799","doi":"https://doi.org/10.3390/healthcare14213799","is_oa":true,"landing_page_url":"https://doi.org/10.3390/healthcare14213799","pdf_url":null,"source":{"id":"https://openalex.org/S4210214101","display_name":"Healthcare","issn_l":"2227-9032","issn":["2227-9032"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-40","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Healthcare","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3390/healthcare14213799","doi":"https://doi.org/10.3390/healthcare14213799","is_oa":true,"landing_page_url":"https://doi.org/10.3390/healthcare14213799","pdf_url":null,"source":{"id":"https://openalex.org/S4210214101","display_name":"Healthcare","issn_l":"2227-9032","issn":["2227-9032"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-40","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Healthcare","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":43,"referenced_works":["https://openalex.org/W1986901061","https://openalex.org/W1991759276","https://openalex.org/W2083164476","https://openalex.org/W2091637698","https://openalex.org/W2099093791","https://openalex.org/W2110112325","https://openalex.org/W2134049139","https://openalex.org/W2137057302","https://openalex.org/W2141674457","https://openalex.org/W2160662805","https://openalex.org/W2275737843","https://openalex.org/W2331975774","https://openalex.org/W2332019618","https://openalex.org/W2556100627","https://openalex.org/W2600637640","https://openalex.org/W2605520973","https://openalex.org/W2790410554","https://openalex.org/W2803191377","https://openalex.org/W2890974221","https://openalex.org/W2894890448","https://openalex.org/W2896476100","https://openalex.org/W2900919048","https://openalex.org/W2906112237","https://openalex.org/W2963392931","https://openalex.org/W3024174363","https://openalex.org/W3136294665","https://openalex.org/W3206914660","https://openalex.org/W4292528167","https://openalex.org/W4312129738","https://openalex.org/W4321611948","https://openalex.org/W4380089064","https://openalex.org/W4388523538","https://openalex.org/W4391605235","https://openalex.org/W4392584889","https://openalex.org/W4394909846","https://openalex.org/W4402189373","https://openalex.org/W4406527729","https://openalex.org/W4408315879","https://openalex.org/W4410741932","https://openalex.org/W4414023178","https://openalex.org/W4415164587","https://openalex.org/W4415583279","https://openalex.org/W7168543651"],"related_works":["https://openalex.org/W3206914660","https://openalex.org/W2413686076","https://openalex.org/W2598164010","https://openalex.org/W2614523674","https://openalex.org/W4394909846","https://openalex.org/W1991759276","https://openalex.org/W4396656360","https://openalex.org/W2230906583","https://openalex.org/W3125476360","https://openalex.org/W6920677413"],"abstract_inverted_index":{"Background/Objectives:":[0],"The":[1,154,181,218],"independent":[2,179],"associations":[3,25,233],"between":[4],"baseline":[5,114],"psychological":[6],"factors":[7],"and":[8,53,72,107,193,223,226,234],"subsequent":[9,215],"exercise":[10,41],"adherence":[11],"in":[12,246],"chronic":[13],"low":[14],"back":[15],"pain":[16],"remain":[17],"uncertain.":[18],"This":[19],"exploratory":[20],"secondary":[21],"analysis":[22],"examined":[23],"these":[24],"while":[26],"accounting":[27],"for":[28,69,100],"intervention":[29],"allocation.":[30],"Methods:":[31],"Sixty":[32],"participants":[33],"from":[34],"a":[35],"randomized":[36],"trial":[37],"completed":[38],"an":[39],"eight-week":[40],"program":[42],"with":[43,118,137,214],"or":[44,244],"without":[45],"the":[46,58,66,75,84,131,210],"Move":[47],"Quiz":[48],"app.":[49],"Baseline":[50],"depression,":[51],"anxiety":[52],"stress":[54],"were":[55],"assessed":[56],"using":[57,65,74,83],"Depression":[59],"Anxiety":[60],"Stress":[61],"Scales-21":[62],"(DASS-21),":[63],"kinesiophobia":[64],"Tampa":[67],"Scale":[68,78,88],"Kinesiophobia":[70,208],"(TSK)":[71],"catastrophizing":[73,225],"Pain":[76],"Catastrophizing":[77],"(PCS).":[79],"Adherence":[80,86],"was":[81,157],"self-reported":[82,216,221],"Exercise":[85],"Rating":[87],"(EARS)":[89],"at":[90],"Week":[91],"8.":[92],"Analyses":[93],"included":[94],"Spearman":[95],"correlations,":[96],"simultaneous":[97],"regression":[98],"adjusted":[99],"allocation,":[101],"HC3":[102,143,165],"robust":[103],"inference,":[104],"sensitivity":[105],"analyses":[106],"leave-one-out":[108],"cross-validation":[109],"(LOOCV).":[110],"Results:":[111],"All":[112],"five":[113],"scores":[115],"correlated":[116],"inversely":[117],"EARS":[119,139,200],"(Spearman":[120],"rs":[121],"=":[122,141,163,172,187,191,198],"\u22120.55":[123],"to":[124,149,169],"\u22120.78;":[125],"all":[126],"p":[127,151,171],"<":[128,152],"0.001).":[129,153],"In":[130],"allocation-adjusted":[132],"model,":[133],"TSK":[134],"remained":[135],"associated":[136],"lower":[138],"(B":[140,162],"\u22120.228,":[142],"95%":[144,166],"confidence":[145],"interval":[146],"[CI]":[147],"\u22120.323":[148],"\u22120.133;":[150],"PCS":[155],"estimate":[156],"negative":[158],"but":[159],"less":[160],"certain":[161],"\u22120.082,":[164],"CI":[167],"\u22120.167":[168],"0.003;":[170],"0.058);":[173],"DASS-21":[174],"subscales":[175],"showed":[176,209],"no":[177],"clear":[178],"associations.":[180],"model":[182,236],"including":[183],"allocation":[184],"had":[185],"R2":[186,190],"0.807,":[188],"LOOCV":[189],"0.757":[192],"root":[194],"mean":[195],"squared":[196],"error":[197],"1.75":[199],"points.":[201],"These":[202],"are":[203],"internal":[204,235],"performance":[205,237],"estimates.":[206],"Conclusions:":[207],"most":[211],"consistent":[212],"association":[213],"adherence.":[217],"small":[219],"sample,":[220],"outcome":[222],"uncertain":[224],"distress":[227],"findings":[228],"support":[229],"cautious":[230],"interpretation.":[231],"Statistical":[232],"do":[238],"not":[239],"establish":[240],"causality,":[241],"clinical":[242],"utility":[243],"accuracy":[245],"independently":[247],"recruited":[248],"patients.":[249]},"counts_by_year":[],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-11-07T00:00:00"}