Exploring the Acute and Dynamic Relationships Between Movement and Pain in Older Adults With Musculoskeletal Pain

TS will be administered on the back of the left hand. First, a single pinprick stimulus using a von Frey filament of 6.65 Mn or 300 g will be applied to the body site. Participants will rate the perceived pain intensity using a numeric rating scale of 0 (no pain at all) to 100 (worst pain imaginable). Then, a series of 10 pinprick stimuli (6.65 Mn) will be administered at a rate of 1 Hz, applied to the body site within an area of 1 cm2. The temporal summation value will be calculated as the difference between the first and last stimuli.

CPM will be assessed by determining the ability of a cold water bath (conditioning stimulus) to diminish pressure pain thresholds (PPTs) and temporal summation (TS) (test stimuli) applied at a separate body site. For the CPM trials, PPTs and TS will be measured pre and post a conditioning stimulus. Conditioning stimulus: At least 4 minutes will separate the pre pain assessments (i.e., PPT, TS) and the initiation of the conditioning stimulation, during which subjects will sit quietly. Then, participants will immerse their right hand up to the wrist in a cold water bath maintained at 10oC for up to 1 minute or until they report intolerable pain. The dependent variable for the CPM test will be the change in the test stimuli (PPT and TS) following the conditioning stimulus.

This test will be administered using a folding chair without arms, placed against a wall to prevent it from moving during the test. The test begins with the subject seated in the middle of the chair, feet at an angle slightly back from the knees, with one foot slightly in front of the other to help maintain balance when standing. Arms will be crossed at the wrists and held against the chest. At the signal of "go", subjects will rise to a full stand and then return back to the initial position. The subjects will be encouraged to complete as many full stands as possible within a 30-s time limit. Participants will rate their current bodily pain on a 0 to 10 numeric rating scale (NRS), with 0 indicating "No pain" and 10 indicating "Pain as bad as you can imagine". Participants will rate their bodily pain before, during, and after the chair stand test as a measure of movement evoked pain.

The PASB-Q has 7 items to measure reported aerobic PA, muscle strengthening PA, perceived aerobic fitness, and sedentary behavior.

The PASE has a total of 18 items using a 4-point scales and yes/no questions. The items capture seven dimensions of physical activity. People with higher scores are more physically active.

Subjects will be required to walk as far as possible at their usual pace in 6 minutes around a predetermined indoor walking course on a flat surface. The distance subjects cover will be recorded. Participants will rate their current bodily pain on a 0 to 10 numeric rating scale (NRS), with 0 indicating "No pain" and 10 indicating "Pain as bad as you can imagine". Participants will rate their bodily pain before, during, and after the walk as a measure of movement evoked pain.

The GCPS will be used to measure pain-related severity and disability across 7-items

The PCS asks the respondents to reflect upon past painful experiences and to rate the degree to which they experienced negative thoughts or feelings about pain. Catastrophizing is a multidimensional construct composed of rumination, helplessness, and magnification.

The SF-36 is a health survey that yields 8-scale scores (physical functioning, role limitations due to physical problems, bodily pain, vitality, general health perceptions, social functioning, role limitations due to emotional problems, and mental health).

The TSK consists of 11 items and is rated on a 4-point scale. The TSK is used to measure the fear of movement or re-injury. The TSK has been deemed a valid and reliable method for determining fear of movement in both clinical and nonclinical populations.

The PDI is a simple and rapid 7-item instrument for measuring the impact that pain has on the ability of a person to participate in essential life activities.

An anatomical map for locating pain areas that is part of the Pain Assessment Screening Tool and Outcomes Registry (PASTOR) will be used.

The PSQI is a self-report questionnaire used to assess sleep quality and quantity over the last month. The PSQI includes 19 items to measure seven domains of sleep quality: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, daytime dysfunction, sleep disturbance and use of sleeping medications.

AHS is a measure of trait hope in adults formed from agency and pathways thinking. The AHS includes 12 statements that participants rate from 1 (definitely false) to 8 (definitely true) for how the statements describe them. (e.g., "I can think of many ways in life to get the things that are most important to me").

Subjects will rate their perception of exertion while walking using Borg's RPE scale. This rating should reflect how heavy and strenuous the exercise feels, combining all sensations and feeling of physical stress, effort, and fatigue. The scale ranges from 6 to 20, where 6 means "no exertion at all" and 20 means "maximal exertion."