1. What data in particular will be shared?
   Response - Individual participant data that underlie the results reported in this article, after de-identification (text, tables, figures, and appendices).
   


2. What additional supporting information will be shared?
   Response -  Study Protocol
   Response -  Statistical Analysis Plan
   Response - Informed Consent Form
   Response -  Analytic Code
   
   
3. Who will be able to view these files?
   Response - Anyone
   


4. For what types of analyses will this data be available?
   Response - To achieve aims in the approved proposal.
   


5. By what mechanism will data be made available?
   Response - Data are available indefinitely at (Link to be included ctri.nic.in).
   


6. For how long will this data be available start date provided 28-01-2028 and end date provided 28-01-2045?
   Response - Immediately following publication. No end date.
   


7. Any URL or additional information regarding plan/policy for sharing IPD? 
   Additional Information - NIL

Low back pain (LBP) continues to be one of the leading causes of disability worldwide, imposing a significant burden on individuals and healthcare systems, especially in low- and middle-income countries. Epidemiological studies estimate that up to 84 percent of individuals will experience LBP at some point in their lives, with nearly 23 percent progressing to chronic low back pain (CLBP), defined as pain persisting for more than three months. CLBP is frequently associated with impaired mobility, reduced quality of life, and diminished functional capacity. Postural adaptations are commonly observed in individuals with CLBP, often as compensatory mechanisms to manage pain or mechanical instability. Conversely, poor posture and altered spinal mechanics may contribute to the onset and persistence of LBP by disrupting normal spinal alignment and flexibility. Structural changes in spinal curvature, particularly in the lumbar and thoracic regions, can increase biomechanical stress on vertebrae, intervertebral discs, and lumbopelvic structures, potentially leading to intersegmental instability and accelerated degeneration.

Spinal alignment is influenced not only by intrinsic factors, such as disc degeneration or muscle strength, but also by extrinsic factors, including lifting or holding external loads. Although the human spine typically maintains sagittal balance through compensatory mechanisms in static standing, these adaptations may be compromised during load-bearing activities, especially in those with CLBP. This becomes even more relevant in older adults who are more likely to experience age-related disc degeneration and sarcopenia, further impairing the spine’s ability to adapt to mechanical stress.