ArticleJournal of pain research2026
Exploring the Impact of Behavioral Engagement Indicators on Pain Outcomes in AI-Enabled Musculoskeletal Rehabilitation: A Real-World Investigation.
Article in Journal of pain research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
Purpose: This study aimed to examine whether behavioral engagement indicators reflecting timing, routine formation, and continuity predict last pain scores of an artificial intelligence (AI)-enabled rehabilitation program in individuals with chronic musculoskeletal (MSK) spinal pain. Methods: This ad-hoc analysis of a real-world clinical registry (June 19, 2020 to November 8, 2024) across the United States (N=19,866) included adults with chronic MSK spinal pain undergoing AI-assisted, fully-remote rehabilitation delivered under physical therapists oversight and combining exercise with real-time biofeedback asynchronously monitored, education, and behavior change (lasting up to 12 weeks). Primary outcome was the last pain score, reported through an 11-point Numeric Pain Rating Scale. Behavioral engagement candidate predictors (derived from session log data) comprised early-phase (first three weeks) - treatment initiation (days until first session), early routine formation (consistent weekday session completion), and early continuity (no missed weeks) - and full-period indicators - weekday routine consistency and existence of one-week interruption of sessions (≥7 consecutive days without sessions). Structural equation modeling assessed associations with pain outcomes, adjusted for confounders. Moderation analyses evaluated subgroup differences for baseline pain severity, age, race/ethnicity, and BMI strata. Results: All early-phase behavioral engagement indicators - timely treatment initiation, routine formation, and engagement continuity - were associated with lower last pain scores, albeit at very small effect sizes (Cohen's f Conclusion: Behavioral engagement indicators capturing treatment initiation, routine formation, and continuity were significantly associated with pain outcomes after AI-enabled MSK rehabilitation, albeit at small magnitude. Behavioral engagement may represent potentially modifiable targets for intervention, requiring further validation.
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