Examination of self-regulatory efficacy and pain among individuals challenged by arthritis flares.

Abstract

Public health guidelines for physical activity (PA) for individuals with arthritis are 150 min/week. Self-regulatory efficacy to plan and schedule activity (SRE-SP) was greater for individuals meeting guidelines in studies when symptoms were usual. Extreme symptoms of a flare presumably challenge or block PA adherence. We found it surprising that the question of whether pain intensity and SRE-SP differ within the same person as a function of symptom severity (i.e., flare vs. no-flare) and PA level has not been addressed. Participants (N = 53) reported SRE-SP and SRE to overcome arthritis barriers (SRE-AB) during the following month, average usual and flare-pain intensity, and PA volume in the past 6 months. Mixed-model ANOVAs compared those meeting or not meeting PA guidelines in both flare and no-flare conditions. Main effects for SRE (SP and AB) were significant for within flare/no-flare comparisons (p < .001) and for SRE-SP were significant between PA groups (p < .05). Individuals meeting PA guidelines have the advantage of greater SRE-SP to motivate adherence than those of the less active. All participants' activity was less efficacious during a flare. For pain intensity, a within-subjects flare versus no-flare effect (p < .001) confirmed that flares are perceived as more of an obstacle or challenge for engaging in PA. Regardless of meeting or not meeting PA guidelines, participants reported lower SRE and higher pain intensity during a flare. PA adherence during a flare may require self-regulation of PA to be active, and in particular, to be able to meet recommended guidelines, relative to symptom severity.