Consideration of chronic pain in trials to promote physical activity for diabetes: a systematic review of randomized controlled trials.
BACKGROUND
Chronic pain has been estimated to affect 60% of patients with diabetes and is strongly associated with reduced activity tolerance. We systematically reviewed randomized controlled trials (RCTs) that explored interventions to improve physical activity among patients with diabetes to establish whether co-morbid chronic pain was captured at baseline or explored as an effect modifier and if trials reported a component designed to target chronic pain.


RESULTS
We searched CINAHL, Cochrane Central Registry of Controlled Trials, EMBASE, ERIC, MEDLINE, SPORTDiscus and PsycInfo from inception of each database to March 2012 for RCTs that enrolled patients with diabetes and randomly assigned them to an intervention designed to promote physical activity. Two reviewers independently selected trials and abstracted data. We identified 136 trials meeting our inclusion criteria, only one of which that reported capturing chronic pain measures at baseline. No trial reported on specific interventions to address chronic pain as a competing demand, or as an effect modifier.


CONCLUSIONS
Only 1 trial identified that aimed to promote physical activity among patients with diabetes reported that co-morbid chronic pain was captured at baseline. No trials reported exploring chronic pain as an effect modifier or targeting it as part of its intervention.
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada. rivaj@mcmaster.ca
John J
JJ
Riva
Jessica J
JJ
Wong
David J
DJ
Brunarski
Alice H Y
AH
Chan
Rebecca A
RA
Lobo
Marina
M
Aptekman
Mostafa
M
Alabousi
Maha
M
Imam
Anita
A
Gupta
Jason W
JW
Busse
D059350:Chronic Pain / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology / Q000628:therapy*; D015444:Exercise; D005081:Exercise Therapy; D006801:Humans; D009043:Motor Activity; D016032:Randomized Controlled Trials as Topic