Project Details
Projekt
SP5 BACKtivity: Dynamic assessments of psychosocial processes and physical activity in individuals with low back pain in daily life and health care
Subject Area
Orthopaedics, Traumatology, Reconstructive Surgery
Term
since 2021
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 439742772
During the first funding period, SP5 established the PRIA Dynamic Daily Life Sample (n=222 ) to investigate theory-based psychosocial and behavioral dynamics in low back pain (LBP) using smartphone-based experience sampling and accelerometry (i.e., ambulatory assessment, AA). AA was feasible and acceptable for both asymptomatic individuals and those with prolonged LBP (≥12 weeks). Unexpectedly, many with LBP reported low pain-related disability and above-average physical activity (PA). Within-person analyses revealed that in moments of lower-than-usual fear of movement and higher-than-usual pain self-efficacy, participants reported lower pain intensity and better back health. Preliminary evidence from an interdisciplinary multimodal pain treatment (IMPT) at a collaborating clinic also supports the relevance of psychosocial resources for recovery, suggesting that improvements in pain intensity are more closely related to mental health than to physical functioning. Associations between pain intensity and PA varied by PA domain and time scale of assessment. While momentary associations for leisure-time PA and pain intensity were positive (within-person), average leisure-time PA was not associated with pain intensity (between-person). These findings highlight the importance of assessing both within-person processes and between-person factors. During the second funding period, we will extend our AA to individuals with more severe psychosocial and functional impairments to examine how psychosocial processes a) manifest in daily life, b) unfold during IMPT, c) change in response to a Just-in-Time Adaptive Intervention (JITAI), and d) relate to social contexts (e.g., health care providers). We will combine our AA with 24-hour functional measurements and compare findings with AA data from animal experiments. We expect within-person associations between psychosocial factors and pain to differ across time scales and from associations at the between-person level. During and after IMPT, we expect steeper change trajectories for psychosocial variables and PA than for pain perception. We will conduct three intensive longitudinal observational studies in daily life and two IMPT settings (outpatient, inpatient). Finally, we will translate findings into a feasibility study examining JITAI acceptability for promoting PA habits. By capturing dynamic theory-based psychosocial processes as experienced in daily life, SP5 adds a distinctive psychological and methodological perspective to the research unit and informs future diagnostics and individualized prevention and treatment.
DFG Programme
Research Units
