Chang Alison H, Hertel Emma, Bruun Malene Kjær, Kristensen Erika Maria, Petersen Kristian Kjær-Staal, Rathleff Michael Skovdal
Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Eur J Pain. 2025 Jul;29(6):e70026. doi: 10.1002/ejp.70026.
Physical activity (PA) is a first-line treatment for knee osteoarthritis and provides benefits for functional improvement and pain relief. However, movement-evoked pain often hinders PA participation and long-term adherence. The relationship between PA and pain is not fully understood and may vary across individuals. We examined the temporal associations between PA and subsequent knee pain in individuals with knee osteoarthritis.
In a 10-day ecological momentary assessment (EMA) cohort study, PA was recorded using an Actigraph accelerometer; momentary knee pain intensity was rated on a numeric rating scale in responses to four daily text prompts. Linear mixed-effects models examined within-day and between-day associations between PA and knee pain, adjusting for age, sex and BMI.
The sample included up to 454 observations across 10 days from 17 participants (age = 64 ± 7 years, BMI = 27 ± 4 kg/m, 61% women), each consisting of a temporal pair of PA minutes and subsequent momentary pain. Within-day, greater moderate-to-vigorous PA (MVPA) minutes were associated with a subsequent increase in knee pain (adjusted β = 0.112, 95% CI: 0.023, 0.201, p = 0.014); while light-intensity PA showed no association with subsequent pain (adjusted β = -0.003, 95% CI: -0.011, 0.005, p = 0.461). Current-day MVPA and light-intensity PA minutes were not associated with next-day knee pain.
While MVPA may temporarily increase knee pain, its impact was transient. Light-intensity PA showed no association with pain, suggesting it may be a suitable alternative for those with movement-evoked pain. Understanding these temporal patterns can help guide tailored pain management and PA adherence strategies. Further research is needed to confirm these preliminary findings.
Understanding the dynamic relationship between PA and knee pain is crucial for optimising the management of knee OA. This exploratory study offers new insights by leveraging high-frequency data to examine the intra- and inter-day associations of MVPA and light-intensity PA with subsequent knee pain. The preliminary findings demonstrate that MVPA may lead to transient pain increases, while light-intensity PA is not associated with pain intensity. Identifying these PA-pain temporal patterns can inform personalised strategies for pain management and improving long-term activity adherence.
身体活动（PA）是膝关节骨关节炎的一线治疗方法，对功能改善和疼痛缓解有益。然而，运动诱发的疼痛常常阻碍PA的参与和长期坚持。PA与疼痛之间的关系尚未完全了解，且可能因人而异。我们研究了膝关节骨关节炎患者PA与随后膝关节疼痛之间的时间关联。
在一项为期10天的生态瞬时评估（EMA）队列研究中，使用Actigraph加速度计记录PA；通过对四条每日文本提示的回复，用数字评分量表对瞬时膝关节疼痛强度进行评分。线性混合效应模型研究了PA与膝关节疼痛之间的日内和日间关联，并对年龄、性别和BMI进行了调整。
该样本包括来自17名参与者（年龄 = 64 ± 7岁，BMI = 27 ± 4 kg/m²，61%为女性）在10天内的多达454次观察，每次观察都由一对PA分钟数和随后的瞬时疼痛组成。在日内，更高的中度至剧烈PA（MVPA）分钟数与随后膝关节疼痛的增加相关（调整后的β = 0.112，95%置信区间：0.023，0.201，p = 0.014）；而轻度PA与随后的疼痛无关（调整后的β = -0.003，95%置信区间：-0.011，0.005，p = 0.461）。当日的MVPA和轻度PA分钟数与次日膝关节疼痛无关。
虽然MVPA可能会暂时增加膝关节疼痛，但其影响是短暂的。轻度PA与疼痛无关，这表明它可能是运动诱发疼痛患者的合适替代选择。了解这些时间模式有助于指导定制的疼痛管理和PA坚持策略。需要进一步研究来证实这些初步发现。
了解PA与膝关节疼痛之间的动态关系对于优化膝关节OA的管理至关重要。这项探索性研究通过利用高频数据来检查MVPA和轻度PA与随后膝关节疼痛的日内和日间关联，提供了新的见解。初步研究结果表明，MVPA可能导致疼痛短暂增加，而轻度PA与疼痛强度无关。识别这些PA - 疼痛时间模式可以为个性化的疼痛管理策略和提高长期活动坚持性提供信息。
