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| Name | Class |
|---|---|
| St. Ambrose University | OTHER |
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Chronic pain is influenced by biological, psychological, and social factors, including emotions and environmental context. Prior research demonstrates that emotional states and psychosocial processes such as depression, fear-avoidance, and catastrophizing significantly shape the pain experience. Professional sports fandom is known to influence emotional well-being, but its relationship to chronic pain has not yet been examined. This longitudinal observational study aims to evaluate whether weekly performance outcomes of participants' favorite U.S. professional football (NFL) teams are associated with fluctuations in self-reported pain intensity, depression, and pain catastrophization among adults with chronic pain who identify as avid football fans. Participants will complete weekly online surveys throughout the NFL regular season, reporting pain ratings (NPRS) and depressive symptoms (PHQ-2). Team performance (win/loss, played/did not play, rival results) will be recorded by the research team. The study seeks to determine whether sports-related emotional fluctuations correlate with changes in chronic pain experiences.
Chronic pain is now widely recognized as a complex biopsychosocial condition rather than a purely physical phenomenon. The International Association for the Study of Pain (IASP) defines pain as an "unpleasant sensory and emotional experience," and neuroimaging studies reveal that chronic pain involves shifting brain activation from nociceptive to cognitive and emotional circuits over time. This evolving understanding underscores the role of emotions, cognitions, and psychosocial factors in shaping the pain experience and contributes to the clinical difficulty of managing chronic pain.
Psychological factors-including fear-avoidance, catastrophizing, and depression-are known to strongly influence pain severity and disability. While these constructs are often tied to biomedical explanations (e.g., structural imaging findings), such explanations may increase fear or negative expectations and do not fully account for pain severity in many individuals. Social factors also interact with psychological processes to shape pain experiences, yet they remain understudied. One such social factor may be the emotional impact of a chronic pain sufferer's favorite sports team performance.
Sports fandom research demonstrates that strong fan identification provides psychological benefits such as belonging, self-esteem, and life satisfaction. Neuroimaging evidence suggests that sports-related wins activate reward networks, while losses trigger introspective and negative emotional states. Despite these findings, the potential link between weekly sports team performance and symptom fluctuations in people living with chronic pain has not been directly investigated.
This longitudinal observational study will examine whether weekly changes in the performance of participants' preferred NFL football team correlate with changes in self-reported chronic pain intensity (Numeric Pain Rating Scale), depressive symptoms (PHQ-2), and pain catastrophization (Pain Catastrophizing Scale). Participants will be adults aged 18 or older with chronic pain lasting more than one year and who meet predefined criteria for being avid fans of a current NFL team.
Following informed consent, participants will complete baseline demographic and clinical questionnaires. Each week throughout the NFL regular season, participants will receive a brief online survey assessing their pain and depressive symptoms. Independent of participant responses, the research team will document whether the participant's team played, whether they won or lost, and the performance of the team's primary rival.
Data will be analyzed descriptively and through inferential statistics to determine whether emotional changes associated with team performance are associated with clinically meaningful weekly changes in pain, depression, or catastrophizing. This study aims to generate preliminary evidence regarding the interaction between sports-related emotional experiences and chronic pain, potentially identifying a novel social component relevant to understanding pain variability.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1: Avid NFL Fans with Chronic Pain | Participants in this cohort are adults aged 18 or older who have experienced chronic pain for more than one year and meet predefined criteria for being avid fans of an active U.S. professional football (NFL) team. All participants will complete baseline demographic and clinical questionnaires and will provide weekly self-reported measures of pain intensity (NPRS) and depressive symptoms (PHQ-2) throughout the NFL regular season. Team performance variables (game played, win/loss outcome, rival results) will be collected by the research team. Study Activities: Baseline demographic and football-related fan profile questionnaire Baseline Pain Catastrophizing Scale (PCS) Weekly NPRS and PHQ-2 surveys End-of-season PCS Research team documentation of weekly team performance and rival performance Purpose: To evaluate whether weekly NFL team performance is associated with fluctuations in pain intensity, depressive symptoms, and catastrophizing in individuals living with chronic pain |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No Intervention: Observational Cohort | Other | No Intervention: Observational Cohort |
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| Measure | Description | Time Frame |
|---|---|---|
| Pain Intensity (Numeric Pain Rating Scale - NPRS) | Self-reported musculoskeletal pain intensity will be measured using the 0-10 Numeric Pain Rating Scale (NPRS), where 0 indicates "no pain" and 10 indicates "worst pain imaginable." Participants will report their average pain over the past week. | Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026). |
| Depressive Symptoms (Patient Health Questionnaire-2 - PHQ-2) | Depressive symptoms will be measured using the 2-item PHQ-2, assessing anhedonia and depressed mood. Each item is rated 0 (not at all) to 3 (nearly every day), generating a score from 0-6. | Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026). |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Catastrophizing (Pain Catastrophizing Scale - PCS) | The PCS is a 13-item questionnaire assessing rumination, magnification, and helplessness related to pain. Each item is rated 0-4, with total scores ranging from 0-52. Higher scores indicate greater catastrophizing. | Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026). |
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Inclusion Criteria:
Exclusion Criteria:
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The study will include self-identified adults aged 18 and above who have experienced chronic pain (>1 year) and meet the criteria for avid professional football fans.
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| Name | Affiliation | Role |
|---|---|---|
| Adriaan Louw, PT, PhD | Evidence In Motion | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Evidence in Motion | Story City | Iowa | 50248 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20357418 | Background | George SZ, Valencia C, Beneciuk JM. A psychometric investigation of fear-avoidance model measures in patients with chronic low back pain. J Orthop Sports Phys Ther. 2010 Apr;40(4):197-205. doi: 10.2519/jospt.2010.3298. | |
| 14690673 | Background | Moseley GL. Evidence for a direct relationship between cognitive and physical change during an education intervention in people with chronic low back pain. Eur J Pain. 2004 Feb;8(1):39-45. doi: 10.1016/S1090-3801(03)00063-6. |
| Label | URL |
|---|---|
| News N. Emotions in Soccer Fans' Brains: Exploring the Thrills and Agony. Neuroscience News | View source |
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| ID | Term |
|---|---|
| D059350 | Chronic Pain |
| D003863 | Depression |
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001526 | Behavioral Symptoms |
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| Correlation Between Weekly Team Performance and Symptom Changes | Team performance will be operationalized as: Win, Loss, or Did Not Play, Rival team win/loss, Margin of victory/defeat. These variables will be analyzed against weekly NPRS and PHQ-2 scores to determine associations between sports-related emotional events and chronic pain symptoms. | Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026). |
| Weekly Response Rate / Completion Rate | Proportion of participants completing each weekly survey. | Weekly assessments from study enrollment through the end of the NFL regular season (approximately September 2025 to January 2026). |
| 15322439 | Background | Moseley GL, Nicholas MK, Hodges PW. A randomized controlled trial of intensive neurophysiology education in chronic low back pain. Clin J Pain. 2004 Sep-Oct;20(5):324-30. doi: 10.1097/00002508-200409000-00007. |
| 11556941 | Background | Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x. |
| 14583691 | Background | Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003 Nov;41(11):1284-92. doi: 10.1097/01.MLR.0000093487.78664.3C. |
| 11690728 | Background | Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole MR. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001 Nov;94(2):149-158. doi: 10.1016/S0304-3959(01)00349-9. |
| 15207508 | Background | Salaffi F, Stancati A, Silvestri CA, Ciapetti A, Grassi W. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain. 2004 Aug;8(4):283-91. doi: 10.1016/j.ejpain.2003.09.004. |
| 8084705 | Background | Wann DL. The "noble" sports fan: the relationships between team identification, self-esteem, and aggression. Percept Mot Skills. 1994 Jun;78(3 Pt 1):864-6. doi: 10.1177/003151259407800337. |
| 19218070 | Background | Jull G, Sterling M. Bring back the biopsychosocial model for neck pain disorders. Man Ther. 2009 Apr;14(2):117-8. doi: 10.1016/j.math.2009.01.004. No abstract available. |
| 30067920 | Background | Stewart M, Loftus S. Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation. J Orthop Sports Phys Ther. 2018 Jul;48(7):519-522. doi: 10.2519/jospt.2018.0610. |
| 20838269 | Background | Sloan TJ, Walsh DA. Explanatory and diagnostic labels and perceived prognosis in chronic low back pain. Spine (Phila Pa 1976). 2010 Oct 1;35(21):E1120-5. doi: 10.1097/BRS.0b013e3181e089a9. |
| 25430861 | Background | Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner JA, Avins AL, James K, Wald JT, Kallmes DF, Jarvik JG. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 27. |
| 23273516 | Background | Nijs J, Roussel N, Paul van Wilgen C, Koke A, Smeets R. Thinking beyond muscles and joints: therapists' and patients' attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment. Man Ther. 2013 Apr;18(2):96-102. doi: 10.1016/j.math.2012.11.001. Epub 2012 Dec 28. |
| 32862151 | Background | van Meulenbroek T, Huijnen IPJ, Simons LE, Conijn AEA, Engelbert RHH, Verbunt JA. Exploring the underlying mechanism of pain-related disability in hypermobile adolescents with chronic musculoskeletal pain. Scand J Pain. 2020 Aug 31;21(1):22-31. doi: 10.1515/sjpain-2020-0023. Print 2021 Jan 27. |
| 27428892 | Background | Vlaeyen JWS, Crombez G, Linton SJ. The fear-avoidance model of pain. Pain. 2016 Aug;157(8):1588-1589. doi: 10.1097/j.pain.0000000000000574. No abstract available. |
| 36420950 | Background | Yang H, Lu ML, Haldeman S, Swanson N. Psychosocial risk factors for low back pain in US workers: Data from the 2002-2018 quality of work life survey. Am J Ind Med. 2023 Jan;66(1):41-53. doi: 10.1002/ajim.23444. Epub 2022 Nov 23. |
| 37445234 | Background | Zimney K, Van Bogaert W, Louw A. The Biology of Chronic Pain and Its Implications for Pain Neuroscience Education: State of the Art. J Clin Med. 2023 Jun 21;12(13):4199. doi: 10.3390/jcm12134199. |
| 23983029 | Background | Hashmi JA, Baliki MN, Huang L, Baria AT, Torbey S, Hermann KM, Schnitzer TJ, Apkarian AV. Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain. 2013 Sep;136(Pt 9):2751-68. doi: 10.1093/brain/awt211. |
| 34456418 | Background | Vader K, Bostick GP, Carlesso LC, Hunter J, Mesaroli G, Perreault K, Tousignant-Laflamme Y, Tupper S, Walton DM, Wideman TH, Miller J. The Revised IASP Definition of Pain and Accompanying Notes: Considerations for the Physiotherapy Profession. Physiother Can. 2021 Spring;73(2):103-106. doi: 10.3138/ptc-2020-0124-gee. No abstract available. |
| 30791696 | Background | De Baets L, Matheve T, Meeus M, Struyf F, Timmermans A. The influence of cognitions, emotions and behavioral factors on treatment outcomes in musculoskeletal shoulder pain: a systematic review. Clin Rehabil. 2019 Jun;33(6):980-991. doi: 10.1177/0269215519831056. Epub 2019 Feb 22. |
| D001519 | Behavior |