Task-based measures of sensitivity to physical activity predict daily-life pain and mood among people living with back pain.

Abstract

Clinical interventions aim to improve the daily-life experiences of patients. However, past research has highlighted important discrepancies between commonly used assessments (e.g., retrospective questionnaires) and patients' daily-life experiences of pain. These gaps may contribute to flawed clinical decision-making and ineffective care. Recent work suggests that real-time, task-based clinical assessments may help reduce these discrepancies by adding predictive value in explaining daily-life pain experiences. This study aimed to investigate these relationships by evaluating whether task-based measures of sensitivity to physical activity (SPA) predict daily-life pain and mood, beyond traditional pain-related questionnaires. Adults with back pain (<six-month onset) answered pain-related questionnaires and completed a standardized lifting task. SPA-Pain, SPA-Sensory, and SPA-Mood were respectively assessed as task-evoked changes in pain intensity, pressure pain threshold (back, hands), situational catastrophizing. Over the next nine days, daily-life pain and mood were assessed using smartphone-based ecological momentary assessment (EMA-Pain and EMA-Mood, respectively) with stratified random sampling. Data analyses estimated fixed effects (b) using multilevel linear modelling with random intercepts. Median EMA completion per participant was 66.67% (n=67 participants). After controlling for covariates, SPA-Pain was associated with EMA-Pain (b=0.235, p=0.002) and SPA-Psych approached significance with EMA-Mood (b=-0.159, p=0.052). Task-based assessment of SPA helps explain daily-life pain and mood among adults with back pain, beyond traditional questionnaires. Adding task-based assessment of SPA may achieve a more complete picture of pain and mood in daily life, offering clinicians better guidance when prescribing activity-based interventions that are designed to modify daily life behaviour, such as graded activity.