Article

OBJECTIVE: To systematically review the associations between different approaches
to activity (ie, activity pacing, avoidance, or endurance) and indicators of
patient functioning in chronic pain samples. DATA SOURCES: A key word search was
conducted in PsycINFO, MEDLINE via Ovid, EMBASE,
and PubMed up to March 2011.
STUDY SELECTION: To be included, studies had to (1) be written in English, (2)
report on an adult chronic pain sample, and (3) report a correlation coefficient
between at least 1 measure of 1 of the 3 "approach to activity" variables and an
indicator of patient functioning. DATA EXTRACTION: Two reviewers independently
screened abstracts and full-text articles for eligibility and extracted the data.
Results of correlation analyses were grouped on the basis of measure of approach
to activity (pacing/avoidance/endurance) and the criterion variable measured
(pain/physical functioning/psychological functioning), resulting in 9 categories.
Random-effects modeling was then used to pool data across studies in each
category. DATA SYNTHESIS: Forty-one studies were eligible for inclusion. Results
demonstrated that avoidance of activity was consistently associated with more
pain, poorer psychological functioning, and more physical disability. While
enduring with activity was associated with enhanced physical and psychological
functioning, these relationships appeared to be dependent on the measure used,
with measures more reflective of persisting with activities to the point of
severe pain aggravation (overactivity) linked to poorer outcomes. Pacing was
generally linked to better psychological functioning but more pain and
disability. CONCLUSIONS: Although causation cannot be determined, results of this
study suggest that both avoidance of activity and overactivity are associated
with poorer patient outcomes. Unexpected results relating to pacing may reflect
either the ineffectiveness of pacing if not used to gradually increase an
individual's activity level or the notion that individuals with better
psychological functioning but more pain and disability are more inclined to pace activity.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS