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Cited by 44Musculoskeletal pain and rehabilitationOccupational Therapy Practice and ResearchPhysical Activity and Health

Activity pacing in daily life: A within-day analysis

Open access
Murphy, Susan Lynn, Kratz, Anna Louise·2014·Pain
DOI 10.1016/j.pain.2014.09.028PMC PMC4353388
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Abstract

Activity pacing is a widely used self-management strategy, but we lack a clear understanding of its nature and usefulness. One source of confusion is a lack of clarity about the use of pacing in everyday life (ie, naturalistic pacing) in people not trained on how to pace activities. It is unknown whether people engage in more pacing when pain is high (pain-contingent) or when fatigue is high (fatigue-contingent). Conversely, it is not known whether naturalistic pacing results in reduced symptoms. We conducted a multilevel daily process study in which participants with osteoarthritis (N=162) reported pain and fatigue severity and frequency of pacing behaviors 5times per day over 5days. We hypothesized that increased pain and fatigue would predict increased pacing and that pacing would have a short-term benefit in terms of decreased pain and fatigue. Multilevel modeling results showed that, as expected, both momentary pain and fatigue were positively associated with subsequent pacing behaviors. Contrary to our hypothesis, increased pacing was associated with higher subsequent levels of pain and fatigue. Naturalistic pacing seems symptom-contingent and not reinforced by symptom reduction. Naturalistic pacing may be distinct from trained or programmatic pacing in terms of outcomes, and further research into naturalistic pacing may provide an important foundation for how best to deliver activity pacing interventions.

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  • Different fatigue patterns by age may be due to increased use of planning and activity pacing in older individuals, to account for greater fatigability.

    “Different fatigue patterns by age may be due to increased use of planning and activity pacing70 in older individuals, to account for greater fatigability71.”

    From Ecological momentary assessment of pain, fatigue, depressive, and cognitive symptoms reveals significant daily variability in multiple sclerosis (2017) · cites this paper as [71]

    The Results (Primary Analyses; page not provided) associate older age with more pacing behavior in adults with osteoarthritis, although the age association was marginal in the fatigue model (p = .06). The paper does not establish increased use of planning or show that pacing explains age-related fatigue patterns. (LLM, conf=0.84)

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Authors
Murphy, S. L., & Kratz, A. L.
Affiliations
University of Michigan (US)
Corresponding author
Murphy, Susan Lynn
ORCID
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2014-12
Volume
155
Issue
12
Pages
2630-2637
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/j.pain.2014.09.028
PMC
PMC4353388
OpenAlex
W2054696006
Cited by
44
References
6
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2023: 3 · 2021: 4 · 2020: 10 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 4 · 2015: 4
FWCI
3.16
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
Rehabilitation and Research Branch of the Veterans Affairs Office of Research Development (1I01RX000410)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
activity pacing, osteoarthritis, fatigue, self-management, within-day variation, symptom relief
MeSH terms
Activities of Daily Living, Aged, Fatigue, Female, Humans, Male, Middle Aged, Motor Activity, Osteoarthritis, Pain, Psychiatric Status Rating Scales, Self Care, Self Report

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