Chronic pain is a prevalent and complex health issue associated with physical, emotional, and social consequences. Management of pain is multifactorial and challenging; however, physical activity (PA) has consistently been shown to be beneficial. Despite this, PA levels among people with chronic pain are low. This study aimed to identify facilitators and barriers to PA among adults with chronic pain and analyse these using the structure of a validated behaviour change model: the capability, opportunity, and motivation behaviour change model (COM-B). We performed a systematic review of 6 databases and subsequent combined analysis including peer-reviewed primary research published in English up to November 15, 2023. Search terms consisted of 3 components: pain, PA, and facilitators/barriers. Quality appraisal of studies was conducted using appropriate tools. The systematic search yielded 40 eligible studies with a total of 2164 participants. The studies represented various chronic pain conditions, locations, and study designs. The key barriers to engagement in PA were the impact of pain severity, comorbidities, lack of knowledge about PA benefits, and time constraints. Key facilitators were a personalised approach, social support, and awareness of the benefits. The findings were categorised according to the COM-B model, allowing for the identification of modifiable factors. Person-centred approaches, education, and accessible environments were identified as important aspects to consider for successful PA promotion among people with chronic pain. Utilising the factors identified in the COM-B model is crucial for successful future interventions to increasing PA uptake and adherence in this population.

中文翻译：

---

慢性疼痛患者身体活动的障碍和促进因素：系统评价和综合分析。


慢性疼痛是一种普遍且复杂的健康问题，与身体、情感和社会后果有关。疼痛的管理是多因素且具有挑战性的;然而，身体活动 （PA） 一直被证明是有益的。尽管如此，慢性疼痛患者的 PA 水平很低。本研究旨在确定患有慢性疼痛的成年人中 PA 的促进因素和障碍，并使用经过验证的行为改变模型的结构分析这些：能力、机会和动机行为改变模型 （COM-B）。我们对 6 个数据库进行了系统评价，并进行了随后的综合分析，包括截至 2023 年 11 月 15 日以英文发表的同行评审的原始研究。检索词由 3 个组成部分组成：疼痛、PA 和促进因素/障碍。使用适当的工具对研究进行质量评价。系统检索产生了 40 项符合条件的研究，共涉及 2164 名参与者。这些研究代表了各种慢性疼痛状况、地点和研究设计。参与 PA 的主要障碍是疼痛严重程度、合并症、缺乏对 PA 益处的了解和时间限制的影响。关键的促进因素是个性化的方法、社会支持和对好处的认识。根据 COM-B 模型对研究结果进行分类，从而可以识别可改变的因素。以人为本的方法、教育和无障碍环境被确定为在慢性疼痛患者中成功推广 PA 的重要考虑因素。利用 COM-B 模型中确定的因素对于未来成功干预以提高该人群中 PA 的摄取和依从性至关重要。