BACKGROUND: Exercising for ≥150 min/week is a recommended strategy for self-managing arthritis. However, exercise nonadherence is a problem. Arthritis pain anxiety may interfere with regular exercise. According to the fear-avoidance model, individuals may confront their pain anxiety by using adaptive self-regulatory responses (eg, changing exercise type or duration). Furthermore, the anxiety-self-regulatory responses relationship may vary as a function of individuals’ pain acceptance levels.OBJECTIVES: To investigate pain acceptance as a moderator of the pain anxiety-adaptive self-regulatory responses relationship. The secondary objective was to examine whether groups of patients who differed in meeting exercise recommendations also differed in pain-related and self-regulatory responses.METHODS: Adults (mean [± SD] age 49.75±13.88 years) with medically diagnosed arthritis completed online measures of arthritis pain-related variables and self-regulatory responses at baseline, and exercise participation two weeks later. Individuals meeting (n=87) and not meeting (n=49) exercise recommendations were identified.RESULTS: Hierarchical multiple regression analysis revealed that pain acceptance moderated the anxiety-adaptive self-regulatory responses relationship. When pain anxiety was lower, greater pain acceptance was associated with less frequent use of adaptive responses. When anxiety was higher, adaptive responses were used regardless of pain acceptance level. MANOVA findings revealed that participants meeting the recommended exercise dose reported significantly lower pain and pain anxiety, and greater pain acceptance (P<0.05) than those not meeting the dose.CONCLUSIONS: Greater pain acceptance may help individuals to focus their efforts to adapt to their pain anxiety only when it is higher, leaving self-regulatory capacity to cope with additional challenges to exercise adherence (eg, busy schedule).

中文翻译：

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成年人对关节炎疼痛焦虑的适应性自我调节反应的预测：疼痛接受是否重​​要？

背景：每周进行≥150分钟的锻炼是自我管理关节炎的推荐策略。但是，运动不坚持是一个问题。关节炎疼痛焦虑症可能会干扰日常运动。根据避免恐惧模型，个体可以通过使用自适应自我调节反应（例如，改变运动类型或持续时间）来面对自己的疼痛焦虑。此外，焦虑-自我调节反应关系可能会因个人的疼痛接受水平而异。目的：研究疼痛接受作为调节疼痛-焦虑-自我调节反应关系的调节剂。次要目标是检查在满足运动建议方面有所不同的患者组在疼痛相关和自我调节反应方面是否也有所不同。方法：成人（平均[±SD]年龄49.75±13岁）。88岁）（具有医学诊断的关节炎）在基线完成了关节炎疼痛相关变量和自我调节反应的在线测量，并在两周后参加了运动。结果：确定了满足锻炼建议（n = 87）和不满足锻炼建议（n = 49）的个人。结果：分层多​​元回归分析显示，疼痛接受减轻了焦虑适应性自我调节反应的关系。当疼痛焦虑较低时，疼痛接受程度越高，适应性反应的使用频率就越低。当焦虑程度较高时，无论疼痛接受程度如何，均采用适应性反应。MANOVA研究结果表明，达到建议运动剂量的参与者与未达到建议剂量的参与者相比，疼痛和疼痛焦虑显着降低，并且对疼痛的接受程度更高（P <0.05）。