Hope as a predictor of physical activity behavior in middle-aged and older adults with musculoskeletal pain

Abstract

Background: Musculoskeletal pain is a barrier to physical activity, enhancing functional decline in older adults. Thus, identifying psychological factors that promote physical activity in older adults with musculoskeletal pain is warranted. Prior research shows that the psychological construct of hope predicts the frequency of exercise in healthy younger adults. However, the impact of hope on physical activity behavior in an older population with clinical pain is unknown. This observational study was designed to determine whether hope predicted self-reported and objective physical activity levels in older adults with musculoskeletal pain. Methods: Fifty-two middle-aged to older adults (age range 55-85 years; 67% female) completed all assessments. Participants completed questionnaires to assess hope (Adult Hope Scale), self-reported physical activity (Physical Activity Scale for the Elderly), bodily pain (SF-36), kinesiophobia (Tampa Scale of Kinesiophobia), and pain catastrophizing (Pain Catastrophizing Scale). Participants also wore accelerometers on the hip for one week to objectively measure physical activity levels. Correlations were conducted to determine relationships between variables. Hierarchical regressions were conducted to determine whether hope predicted self-reported and objective physical activity levels after controlling for relevant demographics, pain, and other psychological variables. Results: After controlling for bodily pain, hope significantly predicted self-reported physical activity and was associated with greater physical activity levels. Bodily pain, but not hope, significantly predicted average daily steps derived from the accelerometer. Decreased bodily pain was associated with more daily steps. Conclusion: These findings suggest that trait hope could be a key psychological predictor of self-reported physical activity in older adults with musculoskeletal pain. Clarifying the role of hope in the physical activity behavior of older adults could present a novel target for intervention.