Relationship between physical activity and gait patterns in older adults with chronic pain

Research Objectives: To determine the relationship between physical activity and spatiotemporal gait in older adults with chronic pain.

Design: Ancillary study to the Mobile Intervention to Reduce Pain and Improve Health (MORPH-II) randomized control trial. Participants wore an accelerometer (ActivPAL, Pal Technologies) attached to the anterior thigh for seven consecutive days to measure physical and sedentary activity. Participants walked over a 4-meter instrumented walkway (GAITRite Mat) for five trials at comfortable and fast walking speeds. Outcomes were assessed at baseline and 12-week follow-up.

Setting: Wake Forest University research lab and real-world environment.

Participants: Sixteen participants [age: 64.9 (6.1) years; BMI: 34.7 (4.1) kg/m2] aged 55-85 with chronic pain completed baseline testing, and 10 had usable accelerometer data at follow-up.

Interventions: MORPH-II or control group. Assessors were blinded to groups.

Main Outcome Measures: Total stepping time, step count, and sedentary time were extracted from the accelerometer. Average gait speed, step time, and step length were extracted from the instrumented walkway. Spearman’s correlations were performed.

Results: At baseline, the average step count was 5,581 steps and stepping time was 78.5 minutes. Average gait speed was 1.1 m/s. There was a moderate correlation between average step time at fast speed and sedentary time (rho=0.63; p=0.02). At follow-up, there were moderate to strong correlations between step count and gait speed (rho=0.587; p=0.05), step count and average step length (rho=0.73; p=0.01), and stepping time and average step length (rho=0.67 ; p=0.05) at comfortable walking speed. There were also moderate correlations between stepping time with gait speed (rho=0.51, p=0.02) and average step length (rho=0.63, p=0.01), and step count with gait speed (rho=0.57; p=0.02) and average step length (rho=0.67, p=0.01) at fast walking speed.

Conclusions: Step count and stepping time appear to be related to spatiotemporal gait at comfortable and fast walking speeds. Improving physical activity may help improve gait in older adults with chronic pain.

Author(s) Disclosures: Margaret Welch, MS; Jason Fanning, PhD; Amber Brooks, MD; Katherine Hsieh, PhD

No conflicts of interest.