Personalized vs. standard back pain rehab: which works better for seniors?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * ≥ 60 years * Chronic Non-Specific Low Back Pain (CNSLBP) * Pain duration ≥ 12 weeks * No identifiable specific spinal pathology * Pain Location * Pain localized between the 12th rib and gluteal folds * With or without non-dermatomal referred pain not extending below the knee * Pain Intensity * Mean pain intensity ≥ 4/10 on the Numeric Rating Scale (NRS) over the past 7 days * Functional Disability * Oswestry Disability Index (ODI) ≥ 20% (moderate disability or higher) * Mechanical Pain Characteristics * Presence of ≥ 2 of the following: * Pain aggravated by movement, loading, or prolonged postures * Pain relieved by rest or positional change * Morning stiffness \< 30 minutes * Absence of constant, non-mechanical night pain Functional Capacity * Able to ambulate independently (with or without assistive device) * Able to actively participate in an exercise-based rehabilitation program * Clinical Stability * Stable medication regimen (analgesics, anti-inflammatories, or related drugs) for ≥ 4 weeks * No planned changes in pharmacological treatment during the study period * Cognitive \& Communication Ability * Able to understand study procedures and follow instructions * MMSE ≥ 24 (or equivalent cognitive screening) * Consent * Provides written informed consent Exclusion Criteria: * 1\. Specific Spinal Pathology ("Red Flags") * Suspected or confirmed: * Spinal fracture * Malignancy * Spinal infection * Inflammatory spondyloarthropathy Clinical indicators: Unexplained weight loss Fever or systemic illness History of significant trauma 2\. Radicular or Neurological Involvement * Radiculopathy defined by ANY of: * Dermatomal pain radiating below the knee * Progressive motor weakness * Objective neurological deficit (sensory, reflex, or motor) 3\. Lumbar Spinal Stenosis (Severe) * Neurogenic claudication limiting walking to \< 100 meters, OR * Symptoms not relieved by rest or flexion 4\. Prior Surgical or Structural Conditions Lumbar spine surgery within the past 12 months 5\. Medical Contraindications to Exercise * Severe osteoporosis with high fracture risk * Uncontrolled cardiovascular, respiratory, or metabolic disease * Any condition precluding safe participation in rehabilitation 6\. Cognitive or Behavioral Barriers * Severe cognitive impairment (MMSE \< 24) * Inability to comply with study procedures 7\. Confounding Treatment Factors * Participation in structured physiotherapy or rehabilitation within the past 3 months * Planned concurrent rehabilitation during the study 8\. Psychosocial Confounders Ongoing litigation or compensation claims related to low back pain