The Journal of Pain
Volume 11, Issue 9 , Pages 885-893, September 2010

Actigraphy-Based Physical Activity Monitoring in Adolescents With Juvenile Primary Fibromyalgia Syndrome

  • Susmita Kashikar-Zuck

      Affiliations

    • Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
    • Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
    • Corresponding Author InformationAddress reprint requests to Dr Susmita Kashikar-Zuck, Division of Behavioral Medicine and Clinical Psychology, MLC 3015, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229.
  • ,
  • Stacy R. Flowers

      Affiliations

    • Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
  • ,
  • Emily Verkamp

      Affiliations

    • Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
  • ,
  • Tracy V. Ting

      Affiliations

    • William S. Rowe Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
  • ,
  • Anne M. Lynch-Jordan

      Affiliations

    • Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
    • Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
  • ,
  • T. Brent Graham

      Affiliations

    • Division of Pediatric Rheumatology, Vanderbilt University School of Medicine, Nashville, Tennessee
  • ,
  • Murray Passo

      Affiliations

    • Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, South Carolina
  • ,
  • Kenneth N. Schikler

      Affiliations

    • Division of Pediatric Rheumatology, University of Louisville School of Medicine, Louisville, Kentucky
  • ,
  • Philip J. Hashkes

      Affiliations

    • Department of Rheumatic and Immunologic Diseases, The Cleveland Clinic Foundation, Cleveland, Ohio
  • ,
  • Steven Spalding

      Affiliations

    • Department of Rheumatic and Immunologic Diseases, The Cleveland Clinic Foundation, Cleveland, Ohio
  • ,
  • Gerard Banez

      Affiliations

    • Division of Pediatrics, The Cleveland Clinic Foundation, Cleveland, Ohio
  • ,
  • Margaret M. Richards

      Affiliations

    • Division of Pediatrics, The Cleveland Clinic Foundation, Cleveland, Ohio
  • ,
  • Scott W. Powers

      Affiliations

    • Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
    • Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
  • ,
  • Lesley M. Arnold

      Affiliations

    • Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio
  • ,
  • Daniel Lovell

      Affiliations

    • William S. Rowe Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
    • Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio

Received 17 July 2009; received in revised form 25 November 2009; accepted 13 December 2009. published online 26 April 2010.

Abstract 

Juvenile primary fibromyalgia syndrome (JPFS) is a chronic pain condition associated with significant impairment in physical functioning, but no studies have used newer technologies such as actigraphy to document objective physical activity levels in JPFS. This is the first study to objectively describe physical activity in JPFS patients and examine the relationship of pain, perceived functional impairment, and depressive symptoms on physical activity. One hundred four clinically referred adolescents with JPFS (ages 11 to 18 years) wore a hip-mounted actigraph for 1 week. Data on pain intensity, functional disability, depressive symptoms, and psychiatric diagnoses were obtained using self- and parent-report measures and a standardized psychiatric interview. Results showed that younger patients were more active. Pain intensity was not significantly associated with physical activity levels overall, but the most highly active group of adolescents reported lower levels of pain and disability than the least active. Parent report of adolescents' physical functioning and depressive symptoms were significantly correlated with adolescents' physical activity levels. Actigraphy provides a unique source of information about physical functioning which is distinct from adolescents' self-report of physical functioning in JPFS. Preliminary findings suggest that further study of factors that predict perceived and actual physical functioning in JPFS is warranted.

Perspective

This study presents the results of physical activity monitoring in adolescents with JPFS using actigraphy. Results indicate that actigraphy provides a unique source of objective information that can advance our understanding of physical disability in JPFS and the factors associated with physical impairment.

Key words: Juvenile fibromyalgia, actigraphy, pediatric pain, physical functioning, depression

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 Supported by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS Grant No. R01 AR050028).

PII: S1526-5900(09)00911-0

doi:10.1016/j.jpain.2009.12.009

The Journal of Pain
Volume 11, Issue 9 , Pages 885-893, September 2010