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The Association Between 24-h Physical Behavior Compositions and Persistent Musculoskeletal Pain.

Melker S Johansson^1,2, Andreas Holtermann^1,3, Karen Søgaard¹

¹Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.

Scandinavian Journal of Medicine & Science in Sports

|October 17, 2025

Summary

This summary is machine-generated.

Individuals with musculoskeletal pain benefit from specific daily physical activity patterns. Optimizing sedentary behavior and activity during work and leisure can reduce pain probability.

Keywords:

compositional data analysis leisure‐time physical activity occupational physical activity persistent musculoskeletal pain physical behaviors

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Area of Science:

Musculoskeletal health
Behavioral science
Epidemiology

Background:

Broad physical activity recommendations for musculoskeletal pain are difficult to implement.
Understanding specific 24-hour physical behavior patterns is crucial for targeted interventions.

Purpose of the Study:

To identify 24-hour physical behavior compositions associated with musculoskeletal pain.
To inform the development of domain-specific guidelines for managing musculoskeletal pain.

Main Methods:

Cross-sectional study of 817 participants from the Copenhagen City Heart Study.
Objective measurement of physical behaviors (sedentary, standing, light, moderate-to-vigorous physical activity, time in bed) using accelerometers over 7 days.
Logistic regression models to predict pain probability based on physical behavior compositions.

Main Results:

40% of participants reported persistent musculoskeletal pain.
Distinct 24-hour physical behavior patterns were observed for low and high pain probability groups.
A 'sweet spot' composition (less leisure sedentary time, more work sedentary time) was linked to lower pain probability.
A 'sour spot' composition (more leisure sedentary time, less work sedentary time) was linked to higher pain probability.

Conclusions:

Specific 24-hour physical behavior compositions are associated with musculoskeletal pain.
Findings can guide the creation of actionable, domain-specific guidelines for musculoskeletal pain management.
Targeted interventions based on these patterns may improve musculoskeletal health, though causality needs further investigation.