Real-world Acute Associations Between Physical Activity And Bodily Pain In Older Adults With Musculoskeletal Pain

Musculoskeletal pain is common among older adults. While evidence suggests regular physical activity (PA) can reduce musculoskeletal pain, acute real-world associations between PA, sedentary behavior, and daily fluctuations in pain levels of older adults is not well understood. PURPOSE: Using a real-world approach in older adults with musculoskeletal pain, the purpose was to determine 1) within-person relationships between pain intensity and PA levels in the hour prior and 2) whether the within-person relationships were moderated by typical pain levels and kinesiophobia. METHODS: Participants (n = 46, age range 55-85 years) completed a series of questionnaires including the Graded Chronic Pain Scale (typical pain levels) and Tampa Scale of Kinesiophobia. Participants were then given an accelerometer to wear on their waist for 7 consecutive days to measure daily moderate-to-vigorous PA (MVPA) and sedentary time. During the same 7-day period, participants completed daily ecological momentary assessments (EMAs) of their bodily pain via a smartphone app. The EMAs were completed up to 6 times per day and consisted of rating current bodily pain on a 0-10 numeric scale. Linear mixed models examined within person associations between EMA pain intensity rating and the prior hour’s PA levels. Cross-level interactions were also examined to determine whether typical pain levels and kinesiophobia moderated the associations between PA and pain intensity. RESULTS: Greater sedentary minutes in the hour prior to the EMAs predicted greater pain intensity. The cross-level interaction of typical pain levels and sedentary minutes was significant. A positive relationship was shown between sedentary minutes and pain intensity at the mean of typical pain levels [β = .007, p = .0002] and higher typical pain levels [β = .017, p < .0001]. Kinesiophobia moderated the effect of hourly MVPA minutes on pain intensity ratings. For those with relatively lower kinesiophobia, greater minutes in MVPA predicted lower pain [β = -.026, p = .0002]; however, no relationship existed between MVPA and pain for those with higher kinesiophobia. CONCLUSION: Greater time spent being sedentary in the hour prior to the EMA was associated with higher pain levels. Further, kinesiophobia may interfere with the positive acute effects of MVPA on pain.