Approach-Avoidance Tendencies Influence the Relationship Between Fear of Movement and Physical Activity in Osteoarthritis
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Purpose
Almost twice as many people with arthritis report being physically inactive compared to people without arthritis. The objective of this study was to examine whether psychological processes including fear of movement, explicit attitudes, and approach-avoidance tendencies toward physical activity, are associated with lower physical activity levels in people with arthritis.
Methods
An online observational study was conducted in 197 participants, including 68 with osteoarthritis and 13 with rheumatoid arthritis. Arthritis, fear of movement, usual level of physical activity, and explicit attitudes were assessed using questionnaires. Approach-avoidance tendencies, an indicator of implicit attitudes, was derived from reaction times in an approach-avoidance task.
Results
Results showed that higher fear of movement was associated with lower physical activity levels in participants with osteoarthritis than in those without osteoarthritis. This association was moderated by approach-avoidance tendencies toward physical activity, with a significant effect only in participants with an automatic tendency to avoid physical activity or a weak tendency to approach it. In addition, contrary to our hypothesis, higher fear of movement was associated with a stronger tendency to approach physical activity and avoid sedentary behaviors, suggesting that people who were most fearful of movement may also be those who unconsciously internalized the importance of physical activity the most.
Conclusion
This study suggests that in adults with osteoarthritis, the detrimental effect of fear of movement on usual physical activity levels may be mitigated by strong automatic tendencies to approach physical activity. Since these tendencies result from the automatic activation of affective memories, health professionals should consider not only promoting physical activity but also ensuring its association with positive emotional experiences.
