Activity pacing in daily life: A within-day analysis

Area of Science:

• Rehabilitation science
• Behavioral medicine
• Chronic pain management

Background:

• Activity pacing is a common self-management strategy for chronic conditions.
• Understanding naturalistic pacing (unstructured, everyday pacing) is crucial but limited.
• The relationship between naturalistic pacing and symptom changes is not well understood.

Purpose of the Study:

• To investigate the nature of naturalistic activity pacing in individuals with osteoarthritis.
• To determine if pain or fatigue drives naturalistic pacing.
• To examine the short-term effects of naturalistic pacing on pain and fatigue.

Main Methods:

• A multilevel daily process study design was employed.
• 162 participants with osteoarthritis completed 5 daily assessments over 5 days.
• Participants reported pain, fatigue, and pacing behavior frequency at each assessment point.

Main Results:

• Momentary pain and fatigue were positively associated with subsequent pacing behaviors.
• Contrary to the hypothesis, increased pacing was associated with higher subsequent levels of pain and fatigue.
• Naturalistic pacing appears to be symptom-contingent rather than symptom-reducing.

Conclusions:

• Naturalistic activity pacing in osteoarthritis is primarily driven by symptom severity.
• Unlike trained pacing, naturalistic pacing does not appear to provide symptom relief.
• Further research on naturalistic pacing is needed to inform the development of effective activity pacing interventions.