Neil Andrews|Jennifer Strong|Pamela Meredith
Activity Pacing, Avoidance, Endurance, and Associations With Patient Functioning in Chronic Pain: A Systematic Review and Meta-Analysis
University of Queensland|Royal Brisbane and Women's Hospital|University of Queensland|University of Queensland
systematically review associations different approaches activity ie activity pacing avoidance endurance indicators patient functioning chronic pain samplesa key word search conducted psycinfo medline via ovid embase pubmed march 2011to included studies 1 written english 2 report adult chronic pain sample 3 report correlation coefficient least 1 measure 1 3 approach activity variables indicator patient functioningtwo reviewers independently screened abstracts fulltext articles eligibility extracted data results correlation analyses grouped basis measure approach activity pacingavoidanceendurance criterion variable measured painphysical functioningpsychological functioning resulting 9 categories randomeffects modeling used pool data across studies categoryfortyone studies eligible inclusion results demonstrated avoidance activity consistently associated pain poorer psychological functioning physical disability enduring activity associated enhanced physical psychological functioning relationships appeared dependent measure used measures reflective persisting activities point severe pain aggravation overactivity linked poorer outcomes pacing generally linked better psychological functioning pain disabilityalthough causation cannot determined results study suggest avoidance activity overactivity associated poorer patient outcomes unexpected results relating pacing may reflect either ineffectiveness pacing used gradually increase individuals activity level notion individuals better psychological functioning pain disability inclined pace activity