Daily physical activities of patients with chronic pain or fatigue versus asymptomatic controls. A systematic review

Abstract

Objective: To gain an insight into the daily physical activity levels of patients with chronic pain or fatigue compared with asymptomatic controls. Data sources: MEDLINE, EMBASE, PsycINFO, Picarta, Cochrane Database of Systematic Reviews, reference tracking and a manual search of relevant journals. Review methods: A systematic, computerized database search of the medical databases up to September 2006 was performed. In addition, a hand search of relevant journals was carried out. Appropriate studies reported on the daily physical activities of adult patients with chronic pain or fatigue and included an asymptomatic control group. Two reviewers independently carried out methodological quality assessment and data extraction. A qualitative analysis was performed. Results: Twelve studies were included, involving five different syndromes. Results show large heterogeneity in methods used and syndromes investigated, which limited evidence. Eleven different methods were used to assess daily physical activities resulting in 16 different outcome parameters. There seem to be differences between the different syndromes, but results are not conclusive. Eight studies reported a lower physical activity level in patients compared with controls. There seems to be a difference in results between studies using objective versus those using subjective methods. Conclusions: Results reported in the literature with respect to the activity level of patients with chronic pain or fatigue compared with controls were too heterogeneous to give sufficient evidence and were not conclusive.