Physical activity, self-efficacy and quality of life in patients with chronic pain, assessed during and 1 year after physiotherapy rehabilitation – a prospective follow-up study

Figures & data

Figure 1. Flowchart of patients in the study.

Table 1. Demographic data on the study population.

	All patients	Patients included in the 1-year follow-up
	n = 42	n = 28
Women/men, n (%)	30/12 (71/29)	19/9 (68/32)
Age, mean (max; min)	39 (24; 70)	41 (24; 70)
Years with pain, n (%)
<1 year	0	0
1–5 years	18 (44%)	11 (41%)
6–10 years	12 (29%)	9 (33%)
>10 years	11 (27%)	7 (26%)
Education
Elementary school (6-9 years)	2 (5%)	1 (4%)
High school	19 (46%)	11 (41%)
College/University	19 (46%)	14 (52%)
Other	1 (2%)	1 (4%)
Employment
Employment < 50%	5 (12%)	2 (7%)
Employment > 50%	14 (34%)	11 (41%)
Sick leave ≥ 50%	14 (34%)	9 (33%)
Job applicant	0	0
Early retirement benefit ≥ 50%	1 (2%)	0
Studying	5 (12%)	3 (11%)
Retired	2 (5%)	2 (7%)

Table 2. Number of patients fulfilling the recommendations for level of physical activity, n = 24.

	Baseline	Follow-up	p Value
Accelerometry
150 min/week, n (%)	19 (79)	19 (79)	1.0^a
30 min/day ≥ 5 days/week, n (%)	7 (29)	13 (54)	0.104^a
Self-reported physical activity 30 min/day ≥ 5 days/week, n (%)	7 (29)	12 (50)	0.302^a

^aCalculated using McNemar test.

Figure 2. Individual differences regarding minutes per week in vigorous physical activity (VPA) and moderate and vigorous physical activity (MVPA) between baseline and follow-up. Positive numbers indicate an increase during follow-up compared to baseline. *MVPA is calculated using MPA + 2*VPA.

Table 3. Level of physical activity, self-efficacy and health-related quality of life at baseline and 1-year follow-up.

	Baseline All patients, n = 42	Baseline Patients included in the follow-up, n = 28	1-year follow-up, n = 28	p Value
Level of physical activity
Accelerometry^a
MVPA, min/week
Mean (SD), median (min; max)	290 (167), 261 (39; 683)	284 (177), 244 (39; 683)	355 (231), 321 (22; 889)	0.130^b
VPA, min/week
Mean (SD), median (min; max)	14 (22), 5 (0; 91)	10 (19), 4 (0; 91)	38 (60), 18 (0; 230)	0.002^b*
Self-reported level of PA (0–18.9)
Mean (SD), median (min; max)	4.3 (3.5), 3 (0; 13.5)	4.6 (3.6), 3.4 (0; 13.5)	5.3 (4.4), 5.1 (0; 15.5)	0.321^b
SELF-EFFICACY
SEE (0–90)
Mean (SD), median (min; max)	49 (23), 47 (0; 90)	51 (26), 49 (0; 90)	55 (23), 54 (0; 90)	0.597^b
ASES (10–100)
Total score
Mean (SD), median (min; max)	66 (14), 69 (22; 90)	68 (14), 70 (22; 90)	66 (16), 67 (17; 94)	0.333^b
Pain
Mean (SD), median (min; max)	49 (18), 53 (10; 88)	50 (20), 53 (10; 88)	45 (22), 53 (10; 82)	0.157^b
Perceived function
Mean (SD), median (min; max)	82 (18), 86 (34;100)	86 (13), 88 (34;100)	84 (17), 86 (23;100)	0.083^b
Other symptoms
Mean (SD), median (min; max)	55 (18), 52 (12; 90)	56 (20), 60 (12; 90)	56 (21), 55 (10; 97)	0.801^b
HQoL
EQ-5D VAS (0–100)
Mean (SD), median (min; max)	47 (19), 45 (10; 84)	48 (19), 45 (10; 84)	52 (23), 60 (5; 85)	0.139^b
RAND-36 (0–100)
Mean (SD), median (min; max)
Bodily pain	28 (14), 27 (0; 52)	29 (15), 31(0; 52)	30 (18), 31 (0; 62)	0.613^b
General health perceptions	40 (18), 44 (10; 72)	39 (19), 44 (10; 72)	39 (22), 35 (0; 82)	0.927^b
Mental health	52 (20), 52 (12; 88)	55 (21), 54 (16; 88)	57 (22), 60 (20; 92)	0.818^b
Physical functioning	56 (21), 55 (20; 95)	55 (22), 55(20; 95)	55 (25), 58 (15; 90)	0.649^b
Vitality	26 (18), 25 (0; 70)	29 (20), 25 (0; 70)	33 (19), 30 (0; 70)	0.178^b
Physical role functioning	16 (25), 0 (0; 100)	20 (28), 0 (0; 100)	19 (30), 0 (0; 100)	0.718^b
Emotional role functioning	41 (40), 33 (0; 100)	44 (43), 33 (0; 100)	45 (46), 33 (0; 100)	0.868^b
Social role functioning	46 (23), 50 (0; 100)	49 (26), 50 (0; 100)	46 (25), 50 (0; 88)	0.615^b

^an = 24; bWilcoxon signed-rank tests were used for comparison between groups.

*p-value significant at the 0.05 level.

ASES: Arthritis Self-Efficacy Scale; EQ-5D VAS: Euroqol Five Dimensions visual analogue scale; HRQoL: health-related quality of life; MVPA: moderate to vigorous physical activity (calculated using VPA*2 + MVPA); PA: physical activity; RAND-36 = Swedish version of the 36-item Short Form Health Survey (SF-36); SD: standard deviation; SEE: Self-efficacy for Exercise Scale; VPA: vigorous physical activity.

Higher scores on self-assessed level of PA, and on the SEE and the ASES, correspond to higher PA and higher self-efficacy, respectively. The cut-off for current recommendations for PA is ≥5 points on the scale ranging from 0 to 18.9 points.

Higher scores in the questionnaires EQ-5D VAS and RAND-36 indicate better HRQoL.

Table 4. Correlations between moderate and vigorous physical activity (MVPA), vigorous physical activity (VPA), self-efficacy and health-related quality of life (HRQoL) at baseline, and accelerator-measured level of MVPA and VPA at follow-up.

Baseline values	Correlation to MVPA		Correlation to VPA
	coefficient (rs)	p Value	coefficient (rs)	p Value
Level of PA
Accelerometer MVPA, min/week	0.64	0.001*	_	_
Accelerometer VPA, min/week	_	_	0.55	0.002*
Self-reported PA	0.43	0.037*	0.49	0.015*
Self-efficacy
SEE	0.04	0.870	0.04	0.839
ASES
Total score	0.23	0.279	0.10	0.635
Pain	0.23	0.275	0.12	0.588
Perceived function	0.61	0.002*	0.57	0.004*
Other symptoms	−0.14	0.507	−0.27	0.208
Health-related quality of life
RAND-36
Bodily pain	0.27	0.206	0.35	0.094
General health perceptions	0.01	0.960	0.16	0.471
Mental health	0.06	0.800	−0.09	0.671
Physical functioning	0.73	0.000*	0.75	0.000*
Vitality	0.01	0.964	−0.05	0.819
Physical role functioning	0.37	0.076	0.31	0.144
Emotional role functioning	−0.02	0.918	−0.12	0.587
Social role functioning	−0.27	0.201	−0.34	0.101

*p-value significant at the 0.05 level.

Spearman’s rank correlation coefficient was used to calculate rs.

MVPA: Moderate-to-vigorous physical activity, is calculated using the equation MPA + 2*VPA, where MPA: moderate physical activity, and VPA: vigorous physical activity. ASES: Arthritis Self-efficacy Scale; PA: physical activity; RAND-36 = Swedish version of the 36-item Short Form Health Survey (SF-36); SEE: Self-efficacy for Exercise Scale.