Clinical Research Directory

Inclusion Criteria: * Adults aged ≥ 18 to \< 60 years. * Diagnosed with nonspecific CLBP that has persisted for over three months. * Overweight males (not obese), with a BMI between 25.0 and 29.9 kg/m² (the standard WHO/CDC classification). Excludes normal weight (\<25 kg/m²) and obesity (≥30 kg/m²) to focus on the mechanical and metabolic consequences of excess weight and to avoid confounding by significant comorbidities, mobility restrictions, or modified exercise tolerance that may skew CPM results. * Pain level greater than 4 on the Numerical Pain Rating Scale (NPRS). * Signs and symptoms indicating that a CS measurement is required must be present, with a CSI score of 40 or higher. * Psychological status will be screened with the Depression Anxiety Stress Scales-21 (DASS-21) to confirm the absence of clinically significant symptoms of depression, anxiety, or stress. Eligible participants will be overweight males aged 18 to 60 years with nonspecific CLBP who score within the normal range on all DASS-21 subscales. Participants with severe psychological distress will be excluded, while mild to moderate symptoms will be statistically controlled. Exclusion Criteria: * CLBP due to a recognized specific pathology (e.g., infection, tumor, osteoporosis, fracture, structural deformity, or inflammatory disorders such as ankylosing spondylitis, radiculopathy, or cauda equina syndrome). * Contraindications for physical activity participation. * A history of spine surgery or spine diseases that cause symptoms. * The presence of acute pain within 48 hours prior to the study date. * A history of using corticosteroids or other pain-affecting medications within the past two weeks is also required. * Participants must not have other long-term pain conditions, high blood pressure, Raynaud's disease, frostbite, open wounds, broken bones, serious illnesses such as cancer, or mental health problems. * Visual and/or hearing impairments. These criteria apply uniformly to all four study arms: MCE, AW, MSE, and the patient education (control) arm. These specific criteria ensure that the study group is homogeneous, which is important for examining how exercise interventions affect overweight males with nonspecific CLBP who exhibit central sensitization.