Approach-Avoidance Tendencies Moderate the Relationship Between Fear of Movement and Physical Activity in Osteoarthritis

Research Question: Do psychological processes, such as explicit attitudes and approach-avoidance tendencies toward physical activity, mediate or moderate the relationship between fear of movement and usual physical activity levels among people with osteoarthritis? Method: We conducted an online observational study with 197 participants, including 68 with osteoarthritis. Using questionnaires, we assessed arthritis, fear of movement, usual physical activity level, and explicit attitudes. Approach-avoidance tendencies, an indicator of automatic attitudes, were derived from reaction times in an approach-avoidance task. Results: Results showed that higher fear of movement was associated with lower physical activity levels among participants with osteoarthritis. This association was moderated by approach-avoidance tendencies toward physical activity, with a significant effect only among participants with an automatic tendency to avoid physical activity or a weak tendency to approach it. Conclusions: This study suggests that, among 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. Because 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.