Consideration of chronic pain in trials to promote physical activity for diabetes: a systematic review of randomized controlled trials

• Published in: PloS one 2013-08, Vol.8 (8), p.e71021-e71021
• Main Authors: Riva, John J, Wong, Jessica J, Brunarski, David J, Chan, Alice H Y, Lobo, Rebecca A, Aptekman, Marina, Alabousi, Mostafa, Imam, Maha, Gupta, Anita, Busse, Jason W
• Format: Article
• Language: English
• Subjects: Arthritis; Back pain; Chronic illnesses; Chronic pain; Chronic Pain - therapy; Clinical medicine; Clinical trials; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 1 - pathology; Diabetes Mellitus, Type 1 - therapy; Diabetes Mellitus, Type 2 - pathology; Diabetes Mellitus, Type 2 - therapy; Diabetes therapy; Diabetic neuropathy; Diabetics; Epidemiology; Exercise; Exercise Therapy; Health sciences; Humans; Intervention; Medical research; Medicine; Motor Activity; Pain; Pain management; Patients; Physical activity; Physical fitness; Physicians; Quality of life; Randomization; Randomized Controlled Trials as Topic; Studies; Systematic review; Type 2 diabetes
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0071021

Chronic pain has been estimated to affect 60% of patients with diabetes and is strongly associated with reduced activity tolerance. We systematically reviewed randomized controlled trials (RCTs) that explored interventions to improve physical activity among patients with diabetes to establish whether co-morbid chronic pain was captured at baseline or explored as an effect modifier and if trials reported a component designed to target chronic pain. We searched CINAHL, Cochrane Central Registry of Controlled Trials, EMBASE, ERIC, MEDLINE, SPORTDiscus and PsycInfo from inception of each database to March 2012 for RCTs that enrolled patients with diabetes and randomly assigned them to an intervention designed to promote physical activity. Two reviewers independently selected trials and abstracted data. We identified 136 trials meeting our inclusion criteria, only one of which that reported capturing chronic pain measures at baseline. No trial reported on specific interventions to address chronic pain as a competing demand, or as an effect modifier. Only 1 trial identified that aimed to promote physical activity among patients with diabetes reported that co-morbid chronic pain was captured at baseline. No trials reported exploring chronic pain as an effect modifier or targeting it as part of its intervention.