Objectively measured activity is not associated with average pain intensity 1 week after surgery: A cross-sectional study

M Komann; J Dreiling; P Baumbach; C Weinmann; E Kalso; U Stamer; T Volk; E Pogatzki-Zahn; H Kehlet; W Meissner

doi:10.1002/ejp.2260

Objectively measured activity is not associated with average pain intensity 1 week after surgery: A cross-sectional study

Eur J Pain. 2024 Mar 7. doi: 10.1002/ejp.2260. Online ahead of print.

Authors

M Komann¹, J Dreiling¹, P Baumbach¹, C Weinmann¹, E Kalso², U Stamer³, T Volk⁴, E Pogatzki-Zahn⁵, H Kehlet⁶, W Meissner¹

Affiliations

¹ Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
² Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Helsinki, Finland.
³ Department of Anaesthesiology and Pain Medicine, InselspitaL, Bern University Hospital, University of Bern, Bern, Switzerland.
⁴ Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland University Faculty of Medicine, Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
⁵ Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Münster, Germany.
⁶ Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark.

PMID: 38450921
DOI: 10.1002/ejp.2260

Abstract

Background: Measures of physical activity and pain-related patient-reported outcomes are important components of patient recovery after surgery. However, little is known about their association in the early post-operative period. This study aims to increase this knowledge. Our primary objective was to determine the association between average pain intensity and activity (in steps) 1 week after surgery. Secondary objectives were the association of activity with other patient-reported outcomes, age, sex, comorbidities and body mass index.

Methods: Data were obtained from the PROMPT sub-project of IMI-PainCare. Patients after breast and endometriosis-related surgery, sternotomy and total knee arthroplasty completed pain-related outcomes questionnaires and wore an ActiGraph activity-tracking device. We correlated steps with average pain intensity on post-operative days 6 and 7. Secondary analyses were done using correlations and t-tests.

Results: In 284 cases, there was no statistically significant correlation between steps and average pain intensity. In addition, none of the 28 secondary analyses showed a statistically significant result.

Conclusions: Pain-related patient-reported outcome measures and physical activity are separate entities. Both should be measured after surgery to assess patient recovery and to identify treatment deficiencies.

Significance statement: Measuring recovery is a multi-dimensional challenge. After surgery, clinicians need to be aware that neither pain intensity nor activity levels tell the whole story. Each can hint to problems and treatment requirements.