719: How Patients with Knee Osteoarthritis Regulate Everyday Physical Activity

Topic: Experimental (Non-clinical) Human Studies
Subtopic: Pain Category (ICD-11), Chronic primary musculoskeletal pain, Physiotherapy (e.g. exercise, rehab), Physiotherapy, Digital Health Technologies

Background and Aims: Pain is commonly used in healthcare as a guide for regulating physical activity, despite evidence showing that pain is a poor indicator of tissue load or injury. Clinical recommendations to remain physically active may therefore be interpreted differently by patients living with long-term pain. As digital rehabilitation programmes increasingly support osteoarthritis management, understanding how individuals regulate activity in their everyday contexts becomes clinically important.

Aim: To explore how patients with knee osteoarthritis participating in a digital osteoarthritis rehabilitation programme regulate their everyday physical activity.

Methods: A qualitative study using reflexive thematic analysis was conducted following Braun and Clarke’s methodological framework. Semi-structured interviews with open-ended questions were conducted with 20 participants enrolled in a digital rehabilitation programme for knee osteoarthritis. Participants were purposively sampled to capture variation in symptom severity, sex, body mass index and fear-avoidance. Interviews were transcribed verbatim and analysed iteratively. Data collection is complete, and analysis is ongoing.

Results: Preliminary findings: Early analyses indicate substantial variation in how participants regulate physical activity in daily life. While some describe pain as a primary guide, others report prioritising routines, responsibilities, goals, or external expectations, sometimes deliberately continuing activity despite pain. These differing regulation strategies appear to be associated with patterns of persistence, avoidance, or fluctuating activity over time.

Conclusions: Patients with long term knee osteoarthritis pain do not rely on pain alone when regulating physical activity, even within rehabilitation contexts where pain-based guidance is common. Instead, they balance multiple priorities, and interpretations when making activity related decisions. Understanding how individuals interpret and prioritise different cues when making activity-related decisions may help explain variability in physical activity behaviour and outcomes. This knowledge may inform the development of more person-centred approaches to physiotherapy and digital rehabilitation.

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Wallis, J. A., Taylor, N. F., Bunzli, S., & Shields, N. (2019). Experience of living with knee osteoarthritis: a systematic review of qualitative studies. BMJ open, 9(9), e030060-e030060. https://doi.org/10.1136/bmjopen-2019-030060

Presenting Author: Johan Söderberg
Submitting Author: Johan Söderberg

Senior Author: Petra von Heideken Wågert

IASP 2026 Global Year theme of Neuropathic Pain: No

• Johan Söderberg: PhD student - Department of Health Sciences, Innovation and Design, Mälardalen University
• Petra Heideken Wågert: Professor - Department of Health Sciences, Innovation and Design, Mälardalen University