Advertisement

Defining Activity Pacing: Is It Time to Jump Off the Merry-Go-Round?

  • Nicole Andrews
    Correspondence
    Address reprint requests to Nicole Andrews, PhD, Department of Occupational Therapy, The Royal Brisbane and Women's Hospital, Level 2 James Mayne Building, Herston, Queensland, Australia 4029.
    Affiliations
    Department of Occupational Therapy and the Professor Tess Cramond Multidisciplinary Pain Centre, The Royal Brisbane and Women's Hospital, Brisbane, Australia
    School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
    Search for articles by this author
  • Michael Deen
    Affiliations
    Metro South Health Persistent Pain Management Service, Division of Rehabilitation, The Princess Alexandra Hospital, Brisbane, Australia
    Menzies Health Institute of Queensland, Griffith University, Brisbane, Australia
    Search for articles by this author
      Many researchers have acknowledged that activity pacing is a poorly defined construct and the various sources of conceptual confusion relating to the term activity pacing have been documented.
      • Andrews N.E.
      • Strong J.
      • Meredith P.J.
      Activity pacing, avoidance, endurance, and associations with patient functioning in chronic pain: a systematic review and meta-analysis.
      • Gill J.R.
      • Brown C.A.
      A structured review of the evidence for pacing as a chronic pain intervention.
      • Murphy S.L.
      • Clauw D.J.
      Activity pacing: what are we measuring and how does that relate to intervention?.
      • Gill J.R.
      • Brown C.A.
      A structured review of the evidence for pacing as a chronic pain intervention.
      • Nielson W.R.
      • Jensen M.P.
      • Karsdorp P.A.
      • Vlaeyen J.W.
      Activity pacing in chronic pain: concepts, evidence, and future directions.
      This has cast doubt about the validity of current activity pacing self-report measures.
      • Andrews N.E.
      • Strong J.
      • Meredith P.J.
      • Fleming J.A.
      The relationship between overactivity and opioid use in chronic pain: a 5-day observational study.
      • Antcliff D.
      • Keeley P.
      • Campbell M.
      • Oldham J.
      • Woby S.
      The development of an activity pacing questionnaire for chronic pain and/or fatigue: a Delphi technique.
      In response to this, a number of research groups have recently attempted to define activity pacing through varying methodologies and have worked toward developing tools to assess activity pacing.
      • Antcliff D.
      • Keeley P.
      • Campbell M.
      • Oldham J.
      • Woby S.
      The development of an activity pacing questionnaire for chronic pain and/or fatigue: a Delphi technique.
      • Cuperus N.
      • Vliet Vlieland T.
      • Brodin N.
      • Hammond A.
      • Kjeken I.
      • Lund H.
      • Murphy S.
      • Neijland Y.
      • Opava C.H.
      • Roskar S.
      • Sargautyte R.
      • Stamm T.
      • Mata X.T.
      • Uhlig T.
      • Zangi H.
      van den Ende CH: Characterizing the concept of activity pacing as a non-pharmacological intervention in rheumatology care: results of an international Delphi survey.
      • Jamieson-Lega K.
      • Berry R.
      • Brown C.A.
      Pacing: a concept analysis of the chronic pain intervention.
      • Nielson W.R.
      • Jensen M.P.
      • Karsdorp P.A.
      • Vlaeyen J.W.
      Activity pacing in chronic pain: concepts, evidence, and future directions.
      Although this may seem like a positive step toward advancement in the field, each research group has arrived at different conclusions adding to the level of uncertainty about the meaning of the term activity pacing.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Pain
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Andrews N.E.
        • Strong J.
        • Meredith P.J.
        Activity pacing, avoidance, endurance, and associations with patient functioning in chronic pain: a systematic review and meta-analysis.
        Arch Phys Med Rehabil. 2012; 93: 2109-2121.e7
        • Andrews N.E.
        • Strong J.
        • Meredith P.J.
        • Fleming J.A.
        The relationship between overactivity and opioid use in chronic pain: a 5-day observational study.
        Pain. 2016; 157: 466-474
        • Andrews N.E.
        • Strong J.
        • Meredith P.J.
        • Gordon K.
        • Bagraith K.S.
        “It’s very hard to change yourself”: an exploration of overactivity in people with chronic pain using interpretative phenomenological analysis.
        Pain. 2015; 156: 1215-1231
        • Antcliff D.
        • Campbell M.
        • Woby S.
        • Keeley P.
        Assessing the psychometric properties of an activity pacing questionnaire for chronic pain and fatigue.
        Phys Ther. 2015; 95: 1274-1286
        • Antcliff D.
        • Keeley P.
        • Campbell M.
        • Oldham J.
        • Woby S.
        The development of an activity pacing questionnaire for chronic pain and/or fatigue: a Delphi technique.
        Physiotherapy. 2013; 99: 241-246
        • Cuperus N.
        • Vliet Vlieland T.
        • Brodin N.
        • Hammond A.
        • Kjeken I.
        • Lund H.
        • Murphy S.
        • Neijland Y.
        • Opava C.H.
        • Roskar S.
        • Sargautyte R.
        • Stamm T.
        • Mata X.T.
        • Uhlig T.
        • Zangi H.
        van den Ende CH: Characterizing the concept of activity pacing as a non-pharmacological intervention in rheumatology care: results of an international Delphi survey.
        Scand J Rheumatol. 2015; 4: 1-9
        • Esteve R.
        • Ramirez-Maestre C.
        • Peters M.L.
        • Serrano-Ibanez E.R.
        • Ruiz-Parraga G.T.
        • Lopez-Martinez A.E.
        Development and initial validation of the activity patterns scale in patients with chronic pain.
        J Pain. 2016; 17: 451-461
      1. Fordyce WE: Behavioral methods for chronic pain and illness. Saint Louis, The C.V. Mosby Company, 1976

        • Gatzounis R.
        • Schrooten M.G.
        • Crombez G.
        • Vlaeyen J.W.
        Operant learning theory in pain and chronic pain rehabilitation.
        Curr Pain Headache Rep. 2012; 16: 117-126
        • Gil K.M.
        • Ross S.L.
        • Keefe F.J.
        Behavioral treatment of chronic pain: four pain management protocols.
        in: France R.D. Krishnan K.R.R. Chronic Pain. Washington, DC, American Psychiatric Asscoiation Press, 1988: 277-413
        • Gill J.R.
        • Brown C.A.
        A structured review of the evidence for pacing as a chronic pain intervention.
        Eur J Pain. 2009; 13: 214-216
        • Jamieson-Lega K.
        • Berry R.
        • Brown C.A.
        Pacing: a concept analysis of the chronic pain intervention.
        Pain Res Manag. 2013; 18: 207-213
        • Murphy S.L.
        • Clauw D.J.
        Activity pacing: what are we measuring and how does that relate to intervention?.
        Pain. 2010; 149: 582-583
        • Murphy S.L.
        • Kratz A.L.
        Activity pacing in daily life: a within-day analysis.
        Pain. 2014; 155: 2630-2637
        • Nielson W.R.
        • Jensen M.P.
        • Karsdorp P.A.
        • Vlaeyen J.W.
        Activity pacing in chronic pain: concepts, evidence, and future directions.
        Clin J Pain. 2013; 29: 461-468
        • Sternbach R.A.
        Treatment of the chronic pain patient.
        J Human Stress. 1978; 4: 11-15

      Linked Article