Abstract
Cognitive behavioral therapy (CBT) aims to increase participation in physical activities but few studies have demonstrated improvements in subjective measures of activity limitations in adolescents with chronic pain. Actigraphy uses motion-monitoring to measure activity, and may provide useful objective data about treatment effects. Activity outcomes were assessed in adolescents participating in a randomized trial of web-based CBT for chronic headache, abdominal, or musculoskeletal pain. We also examined associations among subjective and objective measures of physical activity. Thirty-one participants underwent actigraphy monitoring before randomization and after the 8-10 week treatment phase. Adolescents were 71% female (M age = 14.9 years) and were randomly assigned to two conditions: CBT (n = 17), or standard medical care (SMC, n = 14). Activity levels were assessed using the Actiwatch 64® device, yielding three scores: mean activity level, peak activity level, and minutes spent in sedentary activity. Adolescents also completed questionnaires and diaries regarding pain, activity limitations, physical activities, and fear and avoidance of physical activity. To date, pre-post treatment actigraphy data are available for 20 participants. Preliminary analyses demonstrated a significant time effect for increased peak activity level, reductions in sedentary activity, and decreased fear of activity. A time by group effect showed greater reductions in sedentary activity in the CBT group compared to the SMC group (48 min vs. 62 min, p = .10). Associations between subjective and objective measures of physical activity were moderate. Peak activity levels were related to adolescent self-report of activity limitations as assessed by the Child Activity Limitations Interview (r = -.42). Fear and avoidance of physical activity was not related to actigraphy measures of activity. Future directions include analysis of actigraphy outcome data from remaining participants. We will also test predictors of changes in activity level with treatment. This abstract will also be presented as an Oral Paper Presentation. Refer to the daily Schedule-At-A-Glance for presentation time and location.
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