Greater recalled pain and movement-evoked pain are associated with longer 400-meter walk and repeat stair climb time: the Study of Muscle, Mobility and Aging

Theresa Mau; Haley N Barnes; Corey B Simon; Megan Hetherington-Rauth; Scott R Bauer; Elsa S Strotmeyer; Nancy E Lane; Michael C Rowbotham; Ashley A Weaver; Terri L Blackwell; Yurun Cai; Nancy W Glynn; Bret H Goodpaster; Steven R Cummings; Anne B Newman; Peggy M Cawthon; Stephen B Kritchevsky

doi:10.1101/2024.10.19.24315822

Greater recalled pain and movement-evoked pain are associated with longer 400-meter walk and repeat stair climb time: the Study of Muscle, Mobility and Aging

medRxiv [Preprint]. 2024 Oct 21:2024.10.19.24315822. doi: 10.1101/2024.10.19.24315822.

Authors

Theresa Mau^{1

2}, Haley N Barnes¹, Corey B Simon^{3

4}, Megan Hetherington-Rauth^{1

2}, Scott R Bauer^{2

5

6}, Elsa S Strotmeyer⁷, Nancy E Lane⁸, Michael C Rowbotham⁹, Ashley A Weaver¹⁰, Terri L Blackwell¹, Yurun Cai¹¹, Nancy W Glynn⁷, Bret H Goodpaster¹², Steven R Cummings^{1

2}, Anne B Newman⁷, Peggy M Cawthon^{1

2}, Stephen B Kritchevsky¹³

Affiliations

¹ San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA.
² Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
³ Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
⁴ Duke Clinical Research Institute, Durham, NC, USA.
⁵ Department of Medicine and Urology, University of California San Francisco, San Francisco, California, USA.
⁶ San Francisco VA Healthcare System, San Francisco, California, USA.
⁷ Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
⁸ Department of Medicine and Rheumatology, University of California Davis, Sacramento, California, USA.
⁹ Department of Anesthesia, University of California San Francisco School of Medicine, San Francisco, California, USA.
¹⁰ Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
¹¹ Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pennsylvania, USA.
¹² AdventHealth, Translational Research Institute, Orlando, Florida, USA.
¹³ Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

Abstract

Background: Musculoskeletal pain frequently accompanies the development of mobility disability and falls in old age. To better understand this, we aimed to quantify the impact of different pain measures-recalled pain and movement-evoked pain-on 400-meter walk and stair climb time in older adults participating in the Study of Muscle, Mobility and Aging (SOMMA).

Methods: In SOMMA (N=879, age=76.3 ± 5.0 years, 59% women, 84% Non-Hispanic White), participants completed usual pace 400m walk (avg=6.6 ± 1.2 min.) and repeat stair climb tests (avg=26.6 ± 7.2 sec.). Assessments of recalled pain included the Brief Pain Inventory short form (BPI-sf), total lower body pain (lower back, hips, knees, feet/ankles), stiffness (hip or knee), and Neuropathy Total Symptom Score (NTSS-6). Movement-evoked pain was assessed separately before and after the 400m walk and repeat stair climb tasks. Multivariable linear regression modeled the associations of pain with time to complete the tasks, reported as β[95%CI] expressed per SD increment of pain measure or β[95%CI] per pain categories, adjusted for age, sex, race, ethnicity, body mass index, prescription medications, and depressive symptoms.

Results: Greater degree of any pain measure was associated with longer physical performance time, though intercorrelations between recalled pain measures varied (r=0.13-0.57, p<0.05 for all). For each SD increment in lower body pain, participants had longer walk time (by 10.5 sec [6.1, 14.8]) and stair climb (by 0.6 sec [0.1, 1.1]). Compared to participants with no change in pain upon movement, walk time was longer in those with more pain upon movement (19.5 sec [10.3, 28.7]) (p<0.001) but not those with less pain upon movement; stair climb showed similar patterns.

Conclusions: Recalled and movement-evoked pain measures were weakly correlated with one another but similarly associated with time to complete 400m walk and stair climb tests. Different pain assessments capture different functional domains of pain but have similar associations with physical performance in these older adults.

Keywords: 400m walk speed; movement-evoked pain; recalled pain; repeat stair climb.

Publication types

Preprint

Grants and funding

The National Institute on Aging (NIA) funded the Study of Muscle, Mobility and Aging (SOMMA; R01AG059416). Infrastructure support was partially funded by the NIA Claude D. Pepper Older American Independence Centers at the University of Pittsburgh and Wake Forest University School of Medicine, P30AG024827 and P30AG021332. Additional infrastructure support came from the Clinical and Translational Science Institutes funded by the National Center for Advancing Translational Science at Wake (UL1TR001420). NEL was supported by the R01AG070647. CBS was supported by a K-award (K76AG074943). SRB was supported by a K-award (1K76AG074903).