title: Impact of pain characteristics and fear-avoidance beliefs on physical activity levels among older adults with chronic pain: a population-based, longitudinal study.
abstract: BACKGROUND
  To explore the level of physical activity in a population based sample of older adults; to analyze the influence of pain characteristics and fear-avoidance beliefs as predictors of physical activity among older adults reporting chronic pain.
  
  
  METHODS
  Demographics, pain characteristics (duration, intensity), physical activity, kinesiophobia (excessive fear of movement/(re) injury), self-efficacy and self-rated health were measured with questionnaires at baseline and 12-months later. Logistic regression analyses were done to identify associations at baseline and predictors of physical activity 12-months later during follow-up.
  
  
  RESULTS
  Of the 1141 older adults (mean age 74.4 range 65-103 years, 53.5% women) included in the study, 31.1% of those with chronic pain were sufficiently active (scoring ≥ 4 on Grimby's physical activity scale) compared to 56.9% of those without chronic pain. Lower age (OR = 0.93, 95% CI = 0.88-0.99), low kinesiophobia OR = 0.95, 95% CI = 0.91-0.99), and higher activity level at baseline (OR = 10.0, 95% CI = 4.98-20.67) significantly predicted higher levels of physical activity in individuals with chronic pain.
  
  
  CONCLUSIONS
  The level of physical activity was significantly lower among those with chronic pain and was significantly associated with kinesiophobia. Our findings suggest that fear- avoidance believes plays a more important role in predicting future physical activity levels than pain characteristics. Thus our findings are important to consider when aiming to increase physical activity in older adults that have chronic pain.
authors.affiliation: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden. Caroline.Larsson@med.lu.se.
authors.forename: Caroline
authors.initials: C
authors.lastname: Larsson
authors.affiliation: Department of health Science, Lund University, Lund, Sweden. Eva.Ekvall-Hansson@med.lu.se.
authors.forename: Eva
authors.initials: E
authors.lastname: Ekvall Hansson
authors.affiliation: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden. Kristina.Sundquist@med.lu.se.|Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA. Kristina.Sundquist@med.lu.se.
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
authors.affiliation: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden. Ulf.Jakobsson@med.lu.se.
authors.forename: Ulf
authors.initials: U
authors.lastname: Jakobsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001362:Avoidance Learning / Q000502:physiology; D002908:Chronic Disease; D059350:Chronic Pain / Q000175:diagnosis / Q000523:psychology*; D005239:Fear / Q000502:physiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity / Q000502:physiology; D010147:Pain Measurement / Q000379:methods / Q000523:psychology*; D011159:Population Surveillance / Q000379:methods; D011795:Surveys and Questionnaires