By Rosemary Frei, MSc
Winnipeg, Manitoba—For the first time, a study has confirmed that acceptance of pain among patients with rheumatoid arthritis (RA) is a strong predictor of their engaging in the recommended 150 minutes or more of weekly moderate-to-vigorous physical activity for this patient population. Pain intensity does not appear to be a significant predictor for physical activity level in these patients.
The findings of this poster were presented at the 2013 Canadian Pain Society annual meeting by investigators from the University of Saskatchewan and the University of Northern Colorado.
“The finding of pain acceptance predicting physical activity above the recommended levels for arthritis self-management helps to explain why arthritis pain is not always significantly associated with physical activity,” said lead investigator Nancy Gyurcsik, PhD, an associate professor in the College of Kinesiology at the University of Saskatchewan. “If we can ramp up people’s pain acceptance, this may be an avenue to help people who have pain from their arthritis to engage in physical activity at the recommended dose for disease benefits,” she added.
Pain acceptance is not “sucking it up,” Dr Gyurcsik said, but rather “learning to let go of attempts to control or struggle with pain, be more mindful, and pursue what is important in their lives, such as being active.”
The study is an extension of earlier published work by Dr Gyurcsik and her collaborators (J Health Psychol. 2011;16:530-539). In that study, they reported that among a group of 118 women with RA who completed 2 online surveys, women with more pain acceptance reported lower pain intensity, more self-regulatory efficacy—in this case, the ability to overcome barriers to being active and to reach physical activity goals—and more moderate or vigorous physical activity.
Using the information from the same group of women (but for 117 rather than the 118 patients), Dr Gyurcsik and her colleagues used a hierarchical multiple regression analysis to focus on predictors of physical activity. They used a scale of pain intensity and asked the women to describe the intensity of their pain on a typical day, during a flare, not during a flare, and at the moment they were completing the survey. The subjects also completed a Chronic Pain Acceptance Questionnaire. Then, 14 days later, they self-reported the average weekly time they spent engaging in moderate-to-vigorous physical activity in each of the previous 2 weeks.
The women engaged in an average of 175 minutes of moderate-to-vigorous physical activity weekly. The US Department of Health and Human Services recommends that all adults, including patients with RA, get at least 150 minutes of moderate-to-high–intensity aerobic activity weekly.
The women in the study had an average pain intensity score of 5.42 (of a maximum of 10) and an average pain acceptance score of 68.52 (of a maximum of 120).
Based on their data, the researchers determined that pain intensity was not an independent predictor of physical activity, but that pain acceptance was.