Therapeutics
Shinya Ogaya, PhD
Associate Professor
Saitama Prefectural University
Koshigaya, Saitama, Japan
Shimamura Masahiko, PhD
Postdoctoral Researcher
Saitama Prefectural University
Koshigaya, Saitama, Japan
Kenta Horiuchi, MS
PhD student
Saitama Prefectural University
Koshigaya, Saitama, Japan
Satoshi Kido, PhD
Associate Professor
Saitama Prefectural Univerisity
Koshigaya, Saitama, Japan
Recording daily logbooks is an effective self-monitoring strategy to enhance awareness of pain and physical activity. The therapists often focus on asking about pain, which may lead patients’ attention toward negative symptoms rather than encouraging physical activity. It is uncertain whether focusing on pain or activity during a physical activity program is more beneficial for knee pain treatment. Therefore, this study aims to compare the effects of pain-focused and activity-focused self-monitoring among participants in a community-based exercise program.
Design:
Participants aged ≥50 with knee pain were recruited. They were randomly assigned to either a pain-monitoring (PM) or activity-monitoring (AM) group. Both groups attended the same six-week exercise sessions. Each participant kept a daily logbook: the PM group recorded pain activities, intensity, and location; the AM group recorded performed exercises, confidence level and duration. Outcome measures included KOOS, NRS, ICOAP, HADS, PCS, knee extension strength, TUG, and physical activity. Data were analyzed using ANCOVA with adjusting by age, sex, and baseline BMI.
Results:
After excluding dropouts, 28 and 30 participants were assigned to the PM and AM groups, respectively. ANOVA revealed significant main effects of time: KOOS pain increased, while ICOAP constant, PCS, and TUG decreased. Significant interaction effects were observed in physical activity; averaged sedentary time changed from 323 to 336 min in the PM group and from 334 to 309 min in the AM group; low physical activity changed from 358 to 348 min in the PM group and from 344 to 351 min in the AM group; moderate-to-vigorous activity changed from 52 to 44 min in the PM group and from 53 to 55 min in the AM group.
Conclusion:
The AM group demonstrated increased physical activity. These findings suggest that focusing on physical activity rather than pain may better support behavioral change.
