Physical Activity In Chronic Pain Research Articles

Pain Intensity And Attribution Mediate The Impact Of Patient Weight And Gender On Activity Recommendations For Chronic Pain.

Background and purposeDespite the notable benefits of physical activity for chronic pain, a large proportion of patients with chronic pain report that they do not receive activity-related recommendations from their providers. Research suggests that patient factors such as weight and gender influence activity-related recommendations for chronic pain. Research also suggests that appraisals of the intensity and cause of pain may explain these weight and gender effects. We investigated the influence of patient weight and gender on observers’ likelihood of recommending activity-related treatments for pain. We also explored the mediating effects of observers’ ratings of pain severity and the extent to which pain was due to medical and lifestyle factors (pain attribution).Patients and methodsHealthy young adults (N=616; 76% female) viewed videos (Ghent Pain Videos of Daily Activities) and vignettes of 4 patients with chronic back pain performing a standardized functional task. Patients varied by gender (female, male) and weight (normal, obese), but were otherwise equivalent on demographic characteristics and pain behaviors. Participants rated how much pain they perceived the patients to be experiencing, the extent to which they attributed the pain to medical and lifestyle factors, and their likelihood of recommending exercise, physical therapy (PT), and rest.ResultsPatient weight and gender significantly interacted to influence exercise, PT, and rest recommendations. Both pain intensity and pain attribution mediated the relationships between patient weight and activity recommendations; however, these mediation effects differed across gender and recommendation type.ConclusionPatient weight and gender influenced laypeople’s activity recommendations for chronic pain. Moreover, the results suggest that observers’ perceptions of pain intensity and pain attributions are mechanisms underlying these effects. If these findings are replicated in providers, interventions may need to be developed to reduce provider biases and increase their recognition of the benefits of physical activity for chronic pain.

Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain.

ObjectiveIncreasing evidence purports exercise as a first-line therapeutic for the treatment of nearly all forms of chronic pain. However, knowledge of efficacious dosing respective to treatment modality and pain condition is virtually absent in the literature. The purpose of this analysis was to calculate the extent to which exercise treatment shows dose-dependent effects similar to what is seen with pharmacological treatments.MethodsA recently published comprehensive review of exercise and physical activity for chronic pain in adults was identified in May 2017. This report reviewed different physical activity and exercise interventions and their effectiveness in reducing pain severity and found overall modest effects of exercise in the treatment of pain. We analyzed this existing data set, focusing specifically on the dose of exercise intervention in these studies. We re-analyzed data from 75 studies looking at benefits of time of exercising per week, frequency of exercise per week, duration of intervention (in weeks), and estimated intensity of exercise.ResultsAnalysis revealed a significant positive correlation with exercise duration and analgesic effect on neck pain. Multiple linear regression modeling of these data predicted that increasing the frequency of exercise sessions per week is most likely to have a positive effect on chronic pain patients.DiscussionModest effects were observed with one significant correlation between duration and pain effect for neck pain. Overall, these results provide insufficient evidence to conclude the presence of a strong dose effect of exercise in pain, but our modeling data provide tes predictions that can be used to design future studies to explicitly test the question of dose in specific patient populations.

Patients with chronic pain may need extra support when prescribed physical activity in primary care: a qualitative study

Background: Physical activity plays an important role in the prevention and treatment of chronic musculoskeletal pain, but chronic pain may implicate a poor rehabilitation outcome. The concept of physical activity on prescription (PAP) is a therapeutic option for various diseases, but there is a lack of knowledge about how patients with chronic musculoskeletal pain experience receiving the prescription.Objectives: The objective of this study was to describe the experiences of and thoughts about receiving a prescription for physical activity of people with chronic musculoskeletal pain.Design: Interviews analysed using qualitative content analysis with an inductive approach.Setting: Three primary healthcare centres in a mixed rural and suburban area in the vicinity of a large city in western Sweden.Subjects: Fifteen individuals with chronic musculoskeletal pain.Results: Four categories were identified with the overarching theme “Physical activity in chronic pain requires extra support”. There were several barriers for increasing activity level and these patients suffered from the additional burden of pain. The categories were: “Important to identify needs”, “Barriers and facilitators for physical activity”, “Perceptions of PAP vary” and “Effects found of receiving PAP”.Conclusions: Despite the many positive experiences of receiving PAP, patients described confusion about the role and execution of PAP. Chronic pain is an additional barrier for increasing activity level, and it is crucial to consider these patients’ circumstances. This study suggests that patients with chronic musculoskeletal pain have a greater need for information and extra support to overcome existing barriers, before or when physical activity is prescribed.Key PointsPhysical activity is important for prevention and treatment of chronic pain and has earlier been shown to be increased by “physical activity on prescription”.Patients with chronic musculoskeletal pain required the prescriber to listen and take the patients’ circumstances, context, symptoms and current activity level into account to a greater extent.Patients with chronic musculoskeletal pain experienced more obstacles to increase their physical activity and, therefore, had a greater need for individually tailored information and support when prescribed physical activity.Patients with chronic musculoskeletal pain found it difficult to distinguish between physical activity on prescription and physiotherapy and perceived that also the physicians could not tell the difference.

Tracking, Analysis and Sonification of Movement and Breathing for Supporting Physical Activity in Chronic Pain Using The Go-with-the-flow Framework

Tracking, Analysis and Sonification of Movement and Breathing for Supporting Physical Activity in Chronic Pain Using The Go-with-the-flow Framework

Within-person relationships among pain intensity, mood and physical activity in chronic pain: a naturalistic approach

Fifty-seven chronic pain patients rated their pain intensity, mood and activity level, at a random time schedule, eight times a day during 6 consecutive days, according to the Experience Sampling Method (ESM). Within-person correlations among pain intensity, mood and activity level were calculated. We found pain intensity to be significantly associated with mood. However, the associations between pain intensity and activity level, and activity level and mood could not be supported. Further, we examined whether the relationship between pain intensity and mood was the result of a pattern across the day. Results showed that pain intensity and mood were worst in the morning and improved during the afternoon among participants whose pain intensity and mood were correlated significantly. We suggest that attentional as well as behavioural processes might explain the established day pattern of pain intensity and mood.