Pain, Fatigue, and Physical Activity in Osteoarthritis: The Moderating Effects of Pain- and Fatigue-Related Activity Interference

Susan L Murphy; Stacey Schepens Niemiec; Angela K Lyden; Anna L Kratz

doi:10.1016/j.apmr.2015.05.025

Pain, Fatigue, and Physical Activity in Osteoarthritis: The Moderating Effects of Pain- and Fatigue-Related Activity Interference

Arch Phys Med Rehabil. 2016 Sep;97(9 Suppl):S201-9. doi: 10.1016/j.apmr.2015.05.025. Epub 2016 May 17.

Authors

Susan L Murphy¹, Stacey Schepens Niemiec², Angela K Lyden³, Anna L Kratz⁴

Affiliations

¹ Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI; VA Ann Arbor Health Care System (Geriatric Research, Education, and Clinical Center), Ann Arbor, MI. Electronic address: sumurphy@umich.edu.
² Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA.
³ Department of Anesthesiology, University of Michigan, Ann Arbor, MI.
⁴ Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.

PMID: 27207435
DOI: 10.1016/j.apmr.2015.05.025

Abstract

Objective: To examine how self-reported pain- and fatigue-related activity interference relates to symptoms and physical activity (PA) in daily life among people with knee or hip osteoarthritis.

Design: Cross-sectional study with a 7-day repeated-measures assessment period.

Setting: General community.

Participants: Participants (N=154; mean age, 65y; 60% women [n=92]) with knee or hip osteoarthritis and pain lasting ≥3 months.

Interventions: Not applicable.

Main outcome measures: Pain- or fatigue-related activity interference items on the Brief Pain Inventory or Brief Fatigue Inventory, respectively, from baseline survey, momentary pain and fatigue severity (measured 5times/d for 7d), and PA measured with a wrist-worn accelerometer over 7 days. We hypothesized that perception of pain- and fatigue-related activity interference would moderate the association between symptoms (pain or fatigue) and PA. People with higher pain- or fatigue-related activity interference were thought to have stronger negative associations between momentary ratings of pain and fatigue and PA than did those with lower activity interference.

Results: Pain-related activity interference moderated the association between momentary pain and PA, but only in the first part of the day. Contrary to expectation, during early to midday (from wake-up time through 3 pm), low pain-related interference was associated with stronger positive associations between pain and PA but high pain-related interference was associated with a small negative association between pain and PA. Fatigue-related activity interference did not moderate the relation between fatigue and activity over the course of a day.

Conclusions: Depending on a person's reported level of pain-related activity interference, associations between pain and PA were different earlier in the day. Only those with high pain-related activity interference had lower levels of PA as pain increased and only in the morning. High pain-related activity interference may be important to address, particularly to maintain PA early in the day despite pain.

Trial registration: ClinicalTrials.gov NCT01192516.

Keywords: Accelerometry; Chronic pain; Fatigue; Osteoarthritis; Rehabilitation.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't

MeSH terms

Accelerometry
Aged
Aged, 80 and over
Cross-Sectional Studies
Exercise*
Fatigue / etiology*
Female
Humans
Male
Middle Aged
Osteoarthritis, Hip / complications*
Osteoarthritis, Knee / complications*
Pain / etiology*
Pain Measurement
Pain Perception
Surveys and Questionnaires
Time Factors

Associated data

ClinicalTrials.gov/NCT01192516

Abstract

Publication types

MeSH terms

Associated data

Grants and funding