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DAILY MOVEMENT PATTERNS AND RELATED CHANGES IN PAIN AND QUALITY OF LIFE IN OLDER ADULTS

Abstract

BACKGROUND: PA is a potential non-pharmaceutical treatment to improve pain symptoms and quality of life; however, little is known about the effect of daily movement patterns on these outcomes. This study aimed to investigate the relationship between phenotypes of baseline daily movement patterns and changes in pain and Health-Related Quality of Life (HRQOL). METHODS: Participants were low-active older adults with chronic pain and obesity who were enrolled in one of two randomized controlled pilot trials wherein participants were assigned to a 12-week remote group-mediated behavioral PA intervention (MORPH I & II), or a control group. PA was measured with an ActivPAL 4 triaxial accelerometer for 7 consecutive days at baseline. The 36-item Short Form quality of life scale (SF-36) was to measure HRQOL. Pain intensity and interference were assessed using the PROMIS 3-item pain intensity scale and the PROMIS 8-item pain interference scale. A functional principal components analysis (FPCA) was performed to identify phenotypes of daily movement patterns, and component scores were entered into a series of linear regressions to predict related changes in pain and HRQOL subdomains. Statistical significance was established at p < .05. RESULTS: Participants (N=68) were 69.54 ± 6.74 years on average. Two components were retained based on the FCPA scree plot. Component 1 (52.8%) scores differentiated subjects engaging in more vs less activity across the day. Component 2 (16.1%) scores captured those who took more vs less time to begin moving in the day. “High movers” (i.e., higher component 1 scores) demonstrated more positive changes in HRQOL subdomains (physical function, emotional role limitation, energy/fatigue, social functioning, pain, and general health), and reductions in pain intensity. “Late starters” (i.e., lower component 2 scores) demonstrated worsening scores in unique HRQOL subdomains (physical function, physical role limitation, and general health) and worsening pain interference. CONCLUSIONS: Results highlight that amount and distribution of activity differentially relate to changes in pain and quality of life among older adults with chronic pain. Future intervention development may benefit from targeting overall movement while providing additional support with those who struggle to move early in the day due to pain.

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