Avoidance or Incapacitation

Key Push and Pull Factors Affecting Return to Work Identified by Patients With Long-Term Pain and General Practitioners in Sweden

“…Rather, patients in this study described the pushing of themselves to work as a form of overactivity (Andrews, Strong, Meredith, Gordon, & Bagraith, 2015). In contrast to the results by Andrews, Strong, Meredith et al (2015), patients in this study did not describe overactivity as resulting in an exacerbation of pain, but more often in loss of energy and fatigue. Participants in this study described their overactivity as a consequence of their personal characteristics.…”

Overactivity in chronic pain

“…There were no significant associations found between either overactivity or avoidance and mean objective activity levels. Andrews et al 6 have previously suggested that mean objective activity levels may not be a good indicator of activity avoidance or overactivity in cross-sectional comparisons due to the large variation in this variable in healthy populations. This study did, however, link overactivity to predictable patterns of activity and pain as per our third hypothesis.…”

“…Although age and gender were controlled for, a number of additional variables are known to impact on physical activity levels in healthy populations. 6 Additional studies may consider using a larger sample size and controlling for additional variables to increase confidence in the effect sizes observed.…”

“…Recently, Andrews et al 6 outlined a way to incorporate objective measures of physical activity to measure overactivity behaviour in observational studies. They suggested that, as overactivity (operationalised by Fordyce's operant model of chronic pain) implies engagement in “excessive” amounts of physical activity that significantly exacerbates pain, 16 , 37 this could be determined by observing physical activity levels that are a “certain level” above a person's average activity level, which is then followed by an increase in pain that escalates to “a point” that is above an individual's average pain intensity.…”

Durchhalten um jeden Preis?

“…2 Anfangs zeigen sich die Folgen des aufgabenkontingenten Durchhalteverhaltens zumeist im Freizeitbereich, später leidet auch das berufliche Umfeld. Quelle: Janni/stock.adobe.com (Symbolbild) wie ein Jo-Jo auf und ab, und auf eine Phase der Überaktivität folgt eine Phase des Vermeidens von Aktivität [19] (▶ Abb. 3).…”