What you think matters

"Self-efficacy" is key for osteoarthritis sufferers.

happy people
Confidence can compel people to stay active.

Osteoarthritis patients who are more confident in their abilities in the morning go on to be more physically active throughout the day, according to new research by Penn State.

In the study published in the journal Health Psychology, the participants each wore a device throughout the day which measured the intensity of their physical activity and how many steps they took.

The findings?

What you think you can do matters.

“If you feel more confident, you’re more likely to be physically active that day,” said Ruixue Zhaoyang, the lead author of the study. “And if you feel more confident than yesterday, you are more likely to be more active than yesterday.”

Overcoming pain 

Self-efficacy — a person’s confidence in his or her ability to do something — influences physical activity independent from other factors such as pain, mood and even support from a spouse.

Researchers said the study could give insight into how to better design physical-activity interventions.

Zhaoyang, a postdoctoral fellow in Penn State’s Center for Healthy Aging, said that although earlier research has found physical activity to be one of the best ways to reduce and manage symptoms of osteoarthritis, pain often prevents patients from being as physically active as they should be.

As a result, stiffness tends to worsen and muscle strength can continue to deteriorate.

While previous studies have examined physical activity among people with other chronic conditions, researchers have yet to explore the psychological aspect of activity in people with osteoarthritis.

“Osteoarthritis is a common condition, and we wanted to look at how we can help people who suffer from it improve their activity levels,” Zhaoyang said. “Self-efficacy is a very strong predictor of people’s physical activity, and we wanted to see how it specifically affects this population.”

Over the 22 days of the study, 135 participants recorded their self-efficacy each morning by answering such questions such as, “How confident are you that you can be physically active today despite pain?”

They also answered questions about their mood and how much pain they were feeling.

Participants then wore accelerometers throughout the day, which measured the intensity of their physical activity and how many steps they took.

It’s personal, but fleeting, too

Zhaoyang said one of the interesting aspects of the study was that it compared not only self-efficacy from person to person, but also day to day within the same person. This gave the researchers a better idea about how daily fluctuations in self-efficacy influence a person’s activity.

Researchers determined that even if a person’s self-efficacy was lower than another participant’s, it still resulted in more physical activity as long as it was higher for them personally.

“It’s not about your confidence compared to other people, it’s about comparing it within yourself. If you feel more confident than yesterday, you are more likely to be more active than yesterday,” Zhaoyang said.

They also found the effect to be ephemeral: A bump in self-efficacy failed to carry over to the following day.

“So for someone who’s trying to help someone become more active, if you boost their confidence today but don’t
do it tomorrow, the effect will disappear,” she said.

Lynn Martire, a professor in the Department of Human Development and Family Studies who also worked on the study, said mobile technologies such as smartphones and FitBit devices might help with interventions, thanks to the many comparisons they provide over time.

“With the effect of self-efficacy only lasting a single day,” she said, “the timing of motivational messaging is key.”

Joslyn Neiderer is a writer and editor with Penn State’s strategic communications department.