Sedentary behaviour and chronic pain: building a profile of behaviours and clinical associations

Abstract

Background: Many people adopt extensive sedentary behaviour that has negative health impacts. This relationship has not been well studied in a chronic pain population. Increasing physical capability is linked with greater quality of life, independence and functioning. Purpose: The primary purpose was to determine a current profile of people attending a multidisciplinary pain clinic and to explore clinical associations between total daytime sedentary behaviour and other measures. The secondary purpose was to explore the associations with different types of sedentary behaviour. Methods: A cross-sectional study was undertaken, utilising a subset of clinical data routinely collected by Hunter Integrated Pain Service (HIPS), Newcastle, Australia on 107 patients. This included Brief Pain Inventory (BPI), Depression Anxiety Stress Scale (DASS), Pain Self-Efficacy Questionnaire (PSEQ), Pain Catastrophisation Scale (PCS), SF-36 Physical Component Subscale (SF36-PCS) and physical and demographic factors. Descriptive data included age, gender, health service use, employment status and selfreported daytime sedentary time to establish a profile of participants. Statistical analysis was conducted between selfreported sitting and lying time, and total self-report sedentary time and BPI, DASS, PSEQ, PCS, SF-36 and other variables. Results: Sitting time was significantly associated with area of main pain (p = 0.04). Participants with head, leg, abdomen, hand or knee pain reported increased sitting time compared to those experiencing pain in other body regions. Significant correlations were found between lying time and BPI-Walking and PSEQ (p < 0.01, p = 0.03), respectively. There was significant correlation between total sedentary time and BPI-Walking, BPI-Work, BPI-Enjoyment and PSEQ (p = 0.03, p = 0.03, p = 0.04, p = 0.03 respectively). Multivariate analysis revealed the only variable significantly associated with lying time was SF36-PCS score (coefficient =-0.192, p < 0.01). DASS-Anxiety and BMI were significantly associated with time spent sitting (coefficient =-0.091, p = 0.04 and coefficient = 0.171, p = 0.01 respectively). Total sedentary time was significantly associated with BPI-Enjoyment, DASS-Stress and BMI (coefficient = 0.680, p < 0.01; coefficient =-0.187, p < 0.01 and coefficient = 0.150, p = 0.03 respectively). The maximum variance of sedentary time explained by these models was 21%. Conclusion(s): This study was not able to find strong associations between self-reported sedentary time and the subset of measures routinely used to assess this patient group (BPI, DASS, PSEQ, PCS, SF-36 and other). The study was limited by the unavailability of medication data during the study period and the poor reliability of self-report sedentary behaviour data. Implications: Given the health impacts of excessive sedentary time, predictors of sedentary behaviour need to be identified. Further studies should include a larger subset of variables, particularly medication plus a more reliable method of measuring sedentary behaviour data.