Pain-related Activity Patterns: Measurement, Interrelationships, and Associations With Psychosocial Functioning
Abstract
OBJECTIVES: Changes in activity frequently occur as a consequence of ongoing pain. Three activity patterns commonly observed among individuals with ongoing pain are avoidance, overdoing, and pacing. We conducted 2 studies investigating these activity patterns, their interrelationships, and their associations with key psychosocial factors. Study 1 describes the development of a measure, the Patterns of Activity-Pain (POAM-P), to assess these activity patterns; Study 2 examines the psychosocial correlates of these activity patterns. METHODS: In study 1, a sample of 393 individuals with chronic pain responded to a pool of 51 items assessing activity as part of their pretreatment assessment. Item analyses were conducted to create a 30-item measure with 3, 10-item scales assessing avoidance, overdoing, and pacing. In study 2, a sample of 164 individuals attending a follow-up program 3 months after treatment completed the POAM-P along with measures of affect, pain control, and disability. RESULTS: scales demonstrated excellent internal consistency and correlations with other measures provided initial support for construct validity. Avoidance and overdoing were associated with negative psychosocial outcomes whereas pacing was associated with positive outcomes. In contrast to previous studies, pacing and avoidance were unrelated. DISCUSSION: The POAM-P has excellent psychometric properties and may be useful in clinical practice to identify activity patterns associated with poorer functioning and to evaluate interventions intended to modify these activity patterns. The present results support previous findings linking avoidance and various negative outcomes. These results also provide evidence that pacing may be related to positive outcomes after treatment.
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The most common activity changes are avoidance, overdoing, and pacing.
“The most common activity changes are avoidance, overdoing, and pacing ( Cane et al., 2013 ).”
From Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability. (2022) · cites this paper as Cane et al., 2013
The negative correlation between avoidance and depression and anxiety found in this study differs from the results of the original and French adaptation studies of the scale.
“This relationship was different from the results of original and French adaptation studies”
From Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability. (2022) · cites this paper as Cane et al., 2013
The positive correlation between overdoing and depression and anxiety supports the original study result of the scale but does not support the French adaptation study result.
“This correlation supports the original study result of the scale but does not support the French adaptation study result.”
From Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability. (2022) · cites this paper as Cane et al., 2013
Internal structure validity of the POAM-P was not examined in the original study of the scale or in the Dutch adaptation, French adaptation and Spanish translation studies.
“internal structure validity was not examined in the original study of the scale or in the Dutch adaptation, French adaptation, and Spanish translation studies”
From Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability. (2022) · cites this paper as Cane et al., 2013
In the reliability analysis of the original POAM-P, Cronbach alpha values for internal consistency were .86 for avoidance, .90 for overdoing and .94 for pacing.
“In the reliability analysis of the original scale, Cronbach alpha values for internal consistency were found to be .86 for avoidance, .90 for overdoing, and .94 for pacing”
From Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability. (2022) · cites this paper as Cane et al., 2013
The negative correlation between pacing and depression and anxiety found in this study supports the original and French adaptation study results.
“This result supports the original and French adaptation study results.”
From Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability. (2022) · cites this paper as Cane et al., 2013
In previous studies, more use of pacing has been associated with positive psychosocial outcomes in the form of lower affective distress and greater perceived pain control.
“in previous studies, more use of pacing has been associated with positive psychosocial outcomes in the form of lower affective distress and greater perceived pain control”
From Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability. (2022) · cites this paper as Cane et al., 2013
The ICC scores with test-retest reliability were not examined in the original study, the Dutch version or the Spanish translation of the POAM-P.
“The ICC scores with the test-retest reliability was not examined in the original study, the Dutch version, or the Spanish translation.”
From Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability. (2022) · cites this paper as Cane et al., 2013
The activity change patterns of patients have been determined according to the highest score from the subgroups of the original scale.
“The activity change patterns of the patients have been determined according to the highest score from the subgroups of the original scale”
From Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability. (2022) · cites this paper as Cane et al., 2013
The cut-off scores of the sub-groups of the original English POAM-P were also not calculated.
“The cut-off scores of the sub-groups of this scale, which was originally English, were also not calculated”
From Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability. (2022) · cites this paper as Cane et al., 2013
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- Authors
- Cane, D., Nielson, W. R., McCarthy, M., & Mazmanian, D.
- Affiliations
- Capital District Health Authority (CA)
- St Joseph's Health Care (CA)
- Lakehead University (CA)
- Corresponding author
- Cane, Douglas
- McCarthy, Mary
- Venue
- The Clinical Journal of Pain
- Published
- 2013-05
- Volume
- 29
- Issue
- 5
- Pages
- 435-442
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2005875475
- Cited by
- 89
- References
- 19
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 14 · 2023: 11 · 2022: 4 · 2021: 8 · 2020: 7 · 2019: 6 · 2018: 6 · 2017: 3 · 2016: 4 · 2015: 8 · 2014: 3 · 2013: 1 · 2012: 1
- FWCI
- 3.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- chronic pain, activity patterns, avoidance, pacing, psychosocial factors, pain management, disability, affect, psychometric validation
- MeSH terms
- Activities of Daily Living, Adult, Disability Evaluation, Female, Humans, Male, Motor Activity, Nova Scotia, Pain Measurement, Personality Disorders, Psychology, Risk Factors, Comorbidity, Prevalence, Chronic Pain
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