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Fitbit Activity, Quota-Based Pacing, and Physical and Emotional Functioning Among Adults With Chronic Pain

  • Victoria A. Grunberg
    Affiliations
    Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, Massachusetts

    Harvard Medical School, Boston, Massachusetts

    Division of Newborn Medicine, MassGeneral for Children, Boston, Massachusetts
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  • Jonathan Greenberg
    Affiliations
    Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, Massachusetts

    Harvard Medical School, Boston, Massachusetts
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  • Ryan A. Mace
    Affiliations
    Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, Massachusetts

    Harvard Medical School, Boston, Massachusetts
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  • Jafar Bakhshaie
    Affiliations
    Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, Massachusetts

    Harvard Medical School, Boston, Massachusetts
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  • Karmel W. Choi
    Affiliations
    Psychiatric & Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts

    Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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  • Ana-Maria Vranceanu
    Correspondence
    Address reprint requests to Ana-Maria Vranceanu, PhD, One Bowdoin Square, 1st floor, Suite 100, Boston, Massachusetts 02114.
    Affiliations
    Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, Massachusetts

    Harvard Medical School, Boston, Massachusetts
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      Highlights

      • Fitbits are a promising tool to help promote consistent activity in patients with chronic pain.
      • In our 10-week mind-body program, Fitbit step counts peaked at weeks 6 and 8.
      • Achieving step goals was linked to improved physical function (self-report, 6MWT) and anxiety.
      • Achieving step goals was not associated with ActiGraph performance or depression.
      • Mind-body skills and quota-based pacing using Fitbits may enhance chronic pain outcomes.

      Abstract

      Physical activity can improve function in patients with chronic pain, however, adherence is low, in part due to inconsistent activity patterns. Smart wearable activity trackers, such as Fitbits, may help promote activity. In our program for chronic pain, we examined: 1) Fitbit activity patterns (ie, step count, moderate-to-vigorous physical activity (MVPA), sedentary behavior), and 2) whether achievement of weekly, individualized Fitbit step goals was associated with functional outcomes. We conducted a secondary analysis of Fitbit data from our 10-week mind-body activity program for chronic pain (GetActive-Fitbit arm, N = 41). Participants self-reported emotional and physical function and completed performance-based and accelerometer-based assessments. From week 1 to week 10, 30% of participants increased >800 steps; 32.5% increased MVPA; and 30% decreased sedentary behavior. Only step count significantly changed across time with mean steps peaking at week 8 (M = +1897.60, SD = 467.67). Fitbit step goal achievement was associated with improvements in anxiety (ß = -.35, CI [-2.80, -.43]), self-reported physical function (ß = -.34, CI [-5.17, 8.05]), and performance-based physical function (ß = .29, CI [-71.93, 28.38]), but not accelerometer-based physical function or depression. Adhering to individualized Fitbit step goals in the context of a mind-body activity program may improve anxiety and self-reported and performance-based physical function.

      Perspective

      We examine Fitbit activity patterns and the association between quota-based pacing and functional outcomes within a mind-body activity program for adults with chronic pain. Complementing quota-based pacing and coping skills with Fitbits may be a useful approach to promote activity engagement and behavior change in chronic pain populations.

      Key words

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