Restricted accessResearch articleFirst published online 2024-11
The Relationships Among Chronic Pain Subtypes,Motor Function,and Physical Activity in Community-Dwelling Japanese Older Adults: A Cross-Sectional Study
We investigated the relationships among motor function, physical activity, and the characteristics of chronic pain (the number of pain sites, pain intensity, and pain-type).
Design
Cross-sectional study.
Setting
An ongoing community-based prospective study conducted in Itoshima, Japan.
Subjects
Community-dwelling Japanese aged 65-75 years (n = 805; 401 men, 404 women).
Measures
Chronic pain subtypes were examined in terms of the number of pain sites, pain intensity, and pain type. Motor function was evaluated by handgrip strength, walking speed, and the 5 Times Stand-up and Sit Test (FTSST). Locomotive activity, non-locomotive activity, and sedentary time were evaluated by a tri-axial accelerometer as physical-activity parameters.
Analysis
Multiple regression model adjusting for age, sex, education level, employment status, subjective economic status, body mass index, cognitive function, comorbidity, current tobacco use, current alcohol consumption, and regular exercise.
Results
In a multivariate analysis, the subjects’ walking speed was negatively associated with multisite, moderate-to-severe, and neuropathic-like pain. The FTSST was positively associated with single-site, moderate-to-severe, and neuropathic-like pain. There was no significant association between handgrip strength and any chronic pain subtypes. Locomotive activity was negatively related to multisite, moderate-to-severe, and neuropathic-like pain, but there was no clear association between the amount of non-locomotive activity, sedentary time, and chronic pain subtypes.
Conclusion
Severe chronic pain was associated with decreased locomotion-related motor function and physical activity.
InoueSKobayashiFNishiharaM, et al.Chronic pain in the Japanese Community--Prevalence, characteristics and impact on quality of life. PLoS One. 2015;10(6):e0129262. doi: 10.1371/journal.pone.0129262
2.
CohenSPVaseLHootenWM. Chronic pain: An update on burden, best practices, and new advances. Lancet. 2021;397(10289):2082-2097. doi: 10.1016/S0140-6736(21)00393-7
3.
SchwanJSclafaniJTawfikVL. Chronic pain management in the elderly. Anesthesiol Clin. 2019;37(3):547-560. doi: 10.1016/j.anclin.2019.04.012
4.
TakuraTUshidaTKanchikuT, et al.The societal burden of chronic pain in Japan: An internet survey. J Orthop Sci. 2015;20(4):750-760. doi: 10.1007/s00776-015-0730-8
5.
ZapparoliLMarianoMPaulesuE. How the motor system copes with aging: A quantitative meta-analysis of the effect of aging on motor function control. Commun Biol. 2022;5(1):79. doi: 10.1038/s42003-022-03027-2
6.
ButeraKARoffSRBufordTWCruz-AlmeidaY. The impact of multisite pain on functional outcomes in older adults: biopsychosocial considerations. J Pain Res. 2019;12:1115-1125. doi: 10.2147/JPR.S192755
7.
MäntyMThinggaardMChristensenKAvlundK. Musculoskeletal pain and physical functioning in the oldest old. Eur J Pain. 2014;18(4):522-529. doi: 10.1002/j.1532-2149.2013.00386.x
8.
VaderKDoulasTPatelRMillerJ. Experiences, barriers, and facilitators to participating in physical activity and exercise in adults living with chronic pain: A qualitative study. Disabil Rehabil. 2021;43(13):1829-1837. doi: 10.1080/09638288.2019.1676834
9.
GyasiRMPhillipsDRBoampongMS, et al.Bodily pain in physical function and the role of physical activity among community-dwelling adults aged 50-69 years in Ghana. J Gerontol A Biol Sci Med Sci. 2023;78(9):1604-1611. doi: 10.1093/gerona/glad156
10.
PanFByrneKSRamakrishnanRFerreiraMDwyerTJonesG. Association between musculoskeletal pain at multiple sites and objectively measured physical activity and work capacity: Results from UK Biobank study. J Sci Med Sport. 2019;22(4):444-449. doi: 10.1016/j.jsams.2018.10.008
11.
MurataSDoiTSawaR, et al.Association between objectively measured physical activity and the number of chronic musculoskeletal pain sites in community-dwelling older adults. Pain Med. 2019;20(4):717-723. doi: 10.1093/pm/pny112
12.
AebischerOSuterMRVollenweiderPMarques-VidalP. Association between chronic pain and physical activity in a Swiss population-based cohort: A cross-sectional study. BMJ Open. 2022;12(7):e057288. doi: 10.1136/bmjopen-2021-057288
TreedeRDRiefWBarkeA, et al.Chronic pain as a symptom or a disease: The IASP classification of chronic pain for the international classification of diseases (ICD-11). Pain. 2019;160(1):19-27. doi: 10.1097/j.pain.0000000000001384
15.
BreivikHCollettBVentafriddaVCohenRGallacherD. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287-333. doi: 10.1016/j.ejpain.2005.06.009
16.
FreynhagenRBaronRGockelUTölleTR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 2006;22(10):1911-1920. doi: 10.1185/030079906X132488
17.
MatsubayashiYTakeshitaKSumitaniM, et al.Validity and reliability of the Japanese version of the painDETECT questionnaire: A multicenter observational study. PLoS One. 2013;8(9):e68013. doi: 10.1371/journal.pone.0068013
18.
FernandesGSValdesAMWalshDAZhangWDohertyM. Neuropathic-like knee pain and associated risk factors: A cross-sectional study in a UK community sample. Arthritis Res Ther. 2018;20:215. doi: 10.1186/s13075-018-1717-6
19.
SoniAWanigasekeraVMezueM, et al.Central sensitization in knee osteoarthritis: Relating presurgical brainstem neuroimaging and PainDETECT-based patient stratification to arthroplasty outcome. Arthritis Rheumatol. 2019;71:550–560 doi: 10.1002/art.40749
20.
SaitoTLiuXYatsugiHChuTYokoteTKishimotoH. Relationship between chronic pain types (nociceptive and neuropathic-like symptoms) and frailty in community-dwelling Japanese older adults: A cross-sectional study. J Pain Res. 2023;16:2675-2684. doi: 10.2147/JPR.S402002
21.
ShinkaiSWatanabeSKumagaiS, et al.Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age Ageing. 2000;29(5):441-446. doi: 10.1093/ageing/29.5.441
22.
Muñoz-BermejoLAdsuarJCMendoza-MuñozM, et al.Test-retest reliability of five times sit to stand test (FTSST) in adults: A systematic review and meta-analysis. Biology2021;10(6):510. doi: 10.3390/biology10060510
23.
OshimaYKawaguchiKTanakaS, et al.Classifying household and locomotive activities using a triaxial accelerometer. Gait Posture. 2010;31(3):370-374. doi: 10.1016/j.gaitpost.2010.01.005
24.
OhkawaraKOshimaYHikiharaYIshikawa-TakataKTabataITanakaS. Real-time estimation of daily physical activity intensity by a triaxial accelerometer and a gravity-removal classification algorithm. Br J Nutr.2011;105(11):1681-1691. doi: 10.1017/S0007114510005441
25.
CassidySFullerHChauJCattMBaumanATrenellMI. Accelerometer-derived physical activity in those with cardio-metabolic disease compared to healthy adults: A UK Biobank study of 52,556 participants. Acta Diabetol. 2018;55(9):975-979. doi: 10.1007/s00592-018-1161-8
26.
OwenNBaumanABrownW. Too much sitting: A novel and important predictor of chronic disease risk?Br J Sports Med. 2009;43(2):81-83. doi: 10.1136/bjsm.2008.055269
27.
FujiwaraYSuzukiHYasunagaM, et al.Brief screening tool for mild cognitive impairment in older Japanese: validation of the Japanese version of the Montreal Cognitive Assessment. Geriatr Gerontol Int. 2010;10(3):225-232. doi: 10.1111/j.1447-0594.2010.00585.x
28.
YatsugiHChenTChenS, et al.Normative data of objectively measured physical activity and sedentary time in community-dwelling older Japanese. Int J Environ Res Publ Health. 2021;18(7):3577. doi: 10.3390/ijerph18073577
29.
HendersonJVHarrisonCMBrittHCBayramCFMillerGC. Prevalence, causes, severity, impact, and management of chronic pain in Australian general practice patients. Pain Med. 2013;14(9):1346-1361. doi: 10.1111/pme.12195
30.
JacksonTChenHIezziTYeeMChenF. Prevalence and correlates of chronic pain in a random population study of adults in Chongqing, China. Clin J Pain. 2014;30(4):346-352. doi: 10.1097/AJP.0b013e31829ea1e3
31.
PatelKVGuralnikJMDansieEJTurkDC. Prevalence and impact of pain among older adults in the United States: Findings from the 2011 national health and aging trends study. Pain. 2013;154(12):2649-2657. doi: 10.1016/j.pain.2013.07.029
32.
González-RoldánAMTerrasaJLSitgesCvan der MeulenMAntonFMontoyaP. Age-related changes in pain perception are associated with altered functional connectivity during resting state. Front Aging Neurosci. 2020;12:116. doi: 10.3389/fnagi.2020.00116
33.
GoodpasterBHParkSWHarrisTB, et al.The loss of skeletal muscle strength, mass, and quality in older adults: The Health, Aging and Body Composition Study. J Gerontol A Biol Sci Med Sci. 2006;61(10):1059-1064. doi: 10.1093/gerona/61.10.1059
34.
ParkSMKimHJJeongH, et al.Longer sitting time and low physical activity are closely associated with chronic low back pain in population over 50 years of age: A cross-sectional study using the sixth Korea National Health and Nutrition Examination Survey. Spine J. 2018;18(11):2051-2058. doi: 10.1016/j.spinee.2018.04.003
35.
ParkHParkWLeeM, et al.The association of locomotive and non-locomotive physical activity measured by an accelerometer with functional fitness in healthy elderly men: A pilot study. J Exerc Nutrition Biochem2018;22(1):41-48. doi: 10.20463/jenb.2018.0007
36.
MerkleSLSlukaKAFrey-LawLA. The interaction between pain and movement. J Hand Ther. 2020;33(1):60-66. doi: 10.1016/j.jht.2018.05.001
37.
NelsonNChurillaJR. Physical activity, fear avoidance, and chronic non-specific pain: A narrative review. J Bodyw Mov Ther. 2015;19(3):494-499. doi: 10.1016/j.jbmt.2015.02.001
38.
WoolfCJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(3 Suppl):S2-S15. doi: 10.1016/j.pain.2010.09.030
39.
FjeldMKÅrnesAPEngdahlB, et al.Consistent pattern between physical activity measures and chronic pain levels: The Tromsø Study 2015 to 2016. Pain. 2023;164(4):838-847. doi: 10.1097/j.pain.0000000000002773
40.
PrinceSAAdamoKBHamelMEHardtJConnor GorberSTremblayM. A comparison of direct versus self-report measures for assessing physical activity in adults: A systematic review. Int J Behav Nutr Phys Activ. 2008;5:56. doi: 10.1186/1479-5868-5-56
41.
RikliRE. Reliability, validity, and methodological issues in assessing physical activity in older adults. Res Q Exerc Sport. 2000;71Suppl 2:89-96. doi: 10.1080/02701367.2000.11082791
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
