Temporal Associations of Physical Activity With Subsequent Knee Pain in Individuals With Knee Osteoarthritis: An Ecological Momentary Assessment Study

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-04-25 DOI:10.1002/ejp.70026

Alison H. Chang, Emma Hertel, Malene Kjær Bruun, Erika Maria Kristensen, Kristian Kjær-Staal Petersen, Michael Skovdal Rathleff

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引用次数: 0

Abstract

Background

Physical activity (PA) is a first-line treatment for knee osteoarthritis and provides benefits for functional improvement and pain relief. However, movement-evoked pain often hinders PA participation and long-term adherence. The relationship between PA and pain is not fully understood and may vary across individuals. We examined the temporal associations between PA and subsequent knee pain in individuals with knee osteoarthritis.

Methods

In a 10-day ecological momentary assessment (EMA) cohort study, PA was recorded using an Actigraph accelerometer; momentary knee pain intensity was rated on a numeric rating scale in responses to four daily text prompts. Linear mixed-effects models examined within-day and between-day associations between PA and knee pain, adjusting for age, sex and BMI.

Results

The sample included up to 454 observations across 10 days from 17 participants (age = 64 ± 7 years, BMI = 27 ± 4 kg/m², 61% women), each consisting of a temporal pair of PA minutes and subsequent momentary pain. Within-day, greater moderate-to-vigorous PA (MVPA) minutes were associated with a subsequent increase in knee pain (adjusted β = 0.112, 95% CI: 0.023, 0.201, p = 0.014); while light-intensity PA showed no association with subsequent pain (adjusted β = −0.003, 95% CI: −0.011, 0.005, p = 0.461). Current-day MVPA and light-intensity PA minutes were not associated with next-day knee pain.

Conclusions

While MVPA may temporarily increase knee pain, its impact was transient. Light-intensity PA showed no association with pain, suggesting it may be a suitable alternative for those with movement-evoked pain. Understanding these temporal patterns can help guide tailored pain management and PA adherence strategies. Further research is needed to confirm these preliminary findings.

Significance Statement

Understanding the dynamic relationship between PA and knee pain is crucial for optimising the management of knee OA. This exploratory study offers new insights by leveraging high-frequency data to examine the intra- and inter-day associations of MVPA and light-intensity PA with subsequent knee pain. The preliminary findings demonstrate that MVPA may lead to transient pain increases, while light-intensity PA is not associated with pain intensity. Identifying these PA-pain temporal patterns can inform personalised strategies for pain management and improving long-term activity adherence.

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膝关节骨性关节炎患者体力活动与随后膝关节疼痛的时间关联：一项生态瞬时评估研究

体育活动（PA）是膝关节骨性关节炎的一线治疗方法，对功能改善和疼痛缓解有好处。然而，运动引起的疼痛经常阻碍PA的参与和长期坚持。PA和疼痛之间的关系尚不完全清楚，可能因个体而异。我们研究了膝关节骨性关节炎患者PA与随后的膝关节疼痛之间的时间关联。方法在一项为期10天的生态瞬时评估（EMA）队列研究中，使用Actigraph加速计记录PA；在回答四个每日文本提示时，对瞬时膝关节疼痛强度进行了数值评定。线性混合效应模型检查了PA和膝关节疼痛之间的日内和日之间的关联，调整了年龄、性别和BMI。结果样本包括17名参与者（年龄= 64±7岁，BMI = 27±4 kg/m2, 61%为女性）在10天内观察到的454次观察，每次观察由一对时间PA分钟和随后的瞬间疼痛组成。在一天内，较大的中度至剧烈PA （MVPA）分钟与随后的膝关节疼痛增加相关（调整后的β = 0.112, 95% CI: 0.023, 0.201, p = 0.014）；而光强度PA与随后的疼痛无关联（调整后的β = - 0.003, 95% CI: - 0.011, 0.005, p = 0.461）。当日MVPA和低强度PA分钟与次日膝关节疼痛无关。结论虽然MVPA可能会暂时增加膝关节疼痛，但其影响是短暂的。低强度PA与疼痛没有关联，这表明它可能是运动诱发疼痛的合适选择。了解这些时间模式可以帮助指导量身定制的疼痛管理和PA坚持策略。需要进一步的研究来证实这些初步发现。了解膝关节关节炎与膝关节疼痛之间的动态关系对于优化膝关节OA的治疗至关重要。这项探索性研究通过利用高频数据来检查MVPA和轻强度PA与随后的膝关节疼痛的日内和日间关联，提供了新的见解。初步结果表明，MVPA可能导致短暂性疼痛增加，而轻强度PA与疼痛强度无关。识别这些PA-pain时间模式可以为疼痛管理和提高长期活动依从性提供个性化策略。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.