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Pain and Physical Activity Association in Critically Ill Patients

Critical care patients experience varying levels of pain during their stay in the intensive care unit, often requiring administration of analgesics and sedation. Such medications generally exacerbate the already sedentary physical activity profiles of critical care patients, contributing to delayed recovery. Thus, it is important not only to minimize pain levels, but also to optimize analgesic strategies in order to maximize mobility and activity of ICU patients. Currently, we lack an understanding of the relation between pain and physical activity on a granular level. In this study, we examined the relationship between nurse assessed pain scores and physical activity as measured using a wearable accelerometer device. We found that average, standard deviation, and maximum physical activity counts are significantly higher before high pain reports compared to before low pain reports during both daytime and nighttime, while percentage of time spent immobile was not significantly different between the two pain report groups. Clusters detected among patients using extracted physical activity features were significant in adjusted logistic regression analysis for prediction of pain report group.