Associations Between Patterns of Daily Stepping Behavior, Health-Related Quality of Life, and Pain Symptoms Among Older Adults with Chronic Pain: A Secondary Analysis of Two Randomized Controlled Trials

Abstract

Purpose

One’s amount, intensity, and distribution of physical activity may have implications for whether it has positive or negative effects on pain and quality of life for older adults living with chronic pain. Thus, we investigated baseline patterns of stepping related to pain symptoms and health-related quality of life at baseline and over a 12-week follow-up period.

Patients and Methods

Participants were low-active older adults (69.54±6.74 years) with obesity and chronic pain who enrolled in one of two randomized controlled trials. Participants completed measures of pain intensity, interference, and health-related quality of life and wore an accelerometer for 7 days at baseline and week 12. Functional principal components analysis identified patterns of within-day stepping behavior at baseline, and linear regressions were used to investigate how these component scores related to pain and health-related quality of life at baseline and over 12 weeks.

Results

Two patterns were extracted; one describing more vs less stepping and the second capturing movement later vs earlier in the day. More baseline stepping was associated with better physical functioning (B=0.148, p<0.001) and energy (B=0.073, p=0.033), while a later start in the day was associated with worse social functioning (B=−0.193, p=0.031). More stepping at baseline predicted positive changes in physical functioning (B=0.094, p=0.019), emotional role limitations (B=0.132, p=0.049), energy (B=0.112, p<0.001), social functioning (B=0.086, p=0.043), pain (B=0.086, p=0.009), general health (B=0.081, p=0.003) and pain intensity (B=−0.039, p=0.003). A later start to the day was associated with worsening physical functioning (B=−0.229, p<0.001), physical (B=−0.282, p=0.047) and emotional role limitations (B=−0.254, p=0.048), general health (B=−0.108, p=0.041), and pain interference (B=0.055, p=0.043).

Conclusion

Findings suggest there is value in activity patterns as an indicator for additional behavioral intervention, as those who move little and/or delay daily movement are likely to experience subsequent decrements in quality of life and pain symptoms.

Keywords:

• pain
• patterns
• physical activity
• accelerometry
• quality of life

Data Sharing Statement

Data collected for this study, including individual deidentified participant data and a data dictionary defining each field in the set, will be made available to others with an academic affiliation upon reasonable request from the corresponding author.

Acknowledgments

This work was supported by the National Institute on Aging [R21 AG058249-01], the Wake Forest University Claude D. Pepper Older Americans Independence Center [P30-AG21332], and the Wells Fargo Faculty Scholarship at Wake Forest University. We would like to thank our participants for the time dedicated to this research. Additionally, we would like to thank Charlotte Crotts for her assistance in the conduct of the trials.

Disclosure

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.