Are physical activity, sleep, and joint pain associated with physical function and quality of life in individuals with multimorbidity? A cross-sectional analysis of the MOBILIZE trial

Travis Haber; Alessio Bricca; Michelle Hall; Jan Christian Brønd; Lau Thygesen; Søren T. Skou

doi:10.1007/s11136-025-04044-4

Are physical activity, sleep, and joint pain associated with physical function and quality of life in individuals with multimorbidity? A cross-sectional analysis of the MOBILIZE trial

Travis Haber^*
, Alessio Bricca
, Michelle Hall
, Jan Christian Brønd
, Lau Thygesen
, Søren T. Skou

^*Corresponding author for this work

University of Melbourne
Næstved-Slagelse-Ringsted Hospitals
The University of Sydney

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

Purpose: This study investigated the associations between physical activity, sleep, and joint pain intensity with physical function and health-related quality of life (HrQoL) in people with multimorbidity. Methods: A pre-specified cross-sectional study using baseline data from participants with multimorbidity in the MOBILZE trial. Outcomes were physical function (6-minute walk test) and HrQoL (EQ-5D-5 L). Exposures were device-measured physical activity (min/week), joint pain intensity (0-100 visual analogue scale), device-measured sleep efficiency (%), and sleep quality (Modified Karolinska Sleep Questionnaire, 0–5 Likert scale). Separate and combined linear regression models were used to assess associations between exposures and outcomes. Results: We included data from 227 participants. Physical activity was positively associated with physical function (β = 0.56 m, 95% confidence intervals (CI) 0.39 to 0.73) and HrQoL (β = 0.00046, CI 0.000054 to 0.00087). Joint pain intensity was negatively associated with physical function (β = -0.90 m, CI -1.61 to -0.19), but not quality of life. Poorer sleep quality was negatively associated with HrQoL (β = -0.037, CI -0.060 to -0.013), but not physical function. Sleep efficiency was not associated with either outcome. In the combined model, physical activity was not associated with HrQoL, while joint pain was. Conclusions: Our exploratory findings among people with multimorbidity suggest that physical activity and joint pain are potentially clinically meaningful factors relating to physical function, while self-reported sleep quality may meaningfully relate to HrQoL. Clinicians may want to consider supporting patients with multimorbidity in managing their physical activity levels, joint pain, and sleep quality to improve health outcomes. Longitudinal studies and randomised controlled trials are needed to confirm these findings.

Original language	English
Journal	Quality of Life Research
Volume	34
Issue number	12
Pages (from-to)	3575-3586
ISSN	1573-2649
DOIs	https://doi.org/10.1007/s11136-025-04044-4
Publication status	Published - Dec 2025

Funding

Funding Open Access funding enabled and organized by CAUL and its Member Institutions. Travel for TH to perform this research was partly funded by the Osteoarthritis Research Society International Scholarship. This work was supported by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (MOBILIZE; grant agreement No 801790); a research program grant from Region Zealand (Exercise First), Næstved, Slagelse and Ringsted Hospitals’ Research Fund; The Danish Regions and The Danish Health Confederation through the Development and Research Fund (project no. 2703); and The Association of Danish Physiotherapists Research Fund. Furthermore, STS is the recipient of an ongoing, unrelated grant from the European Union’s Horizon 2020 research and innovation programme (ESCAPE; grant agreement No 945377). MH is supported by a National Health Medical Research Council Investigator Emerging Leader 1 (Grant No. 1172928). The funders did not have any role in the study other than to provide funding and they were not involved in the decision to submit the report for publication, nor do they have ultimate authority over any study activities.

Keywords

Exercise
Comorbidities
Sleep
Osteoarthritis
Quality of life
Physical function

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MOBILIZE: Improving health in people with multimorbidity: a paradigm shift in health care from disease-based curative models to personalized exercise therapy and self-management
Skou, S. T. (PI), Bricca, A. (Project participant), Jäger, M. (Project participant), Dideriksen, M. (Project participant) & Pihl, K. (Project participant)
01/08/2019 → 31/07/2024
Project: Research

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@article{9b0a9ab57443429c93bfaaa49da03133,

title = "Are physical activity, sleep, and joint pain associated with physical function and quality of life in individuals with multimorbidity? A cross-sectional analysis of the MOBILIZE trial",

abstract = "Purpose: This study investigated the associations between physical activity, sleep, and joint pain intensity with physical function and health-related quality of life (HrQoL) in people with multimorbidity. Methods: A pre-specified cross-sectional study using baseline data from participants with multimorbidity in the MOBILZE trial. Outcomes were physical function (6-minute walk test) and HrQoL (EQ-5D-5 L). Exposures were device-measured physical activity (min/week), joint pain intensity (0-100 visual analogue scale), device-measured sleep efficiency (\%), and sleep quality (Modified Karolinska Sleep Questionnaire, 0–5 Likert scale). Separate and combined linear regression models were used to assess associations between exposures and outcomes. Results: We included data from 227 participants. Physical activity was positively associated with physical function (β = 0.56 m, 95\% confidence intervals (CI) 0.39 to 0.73) and HrQoL (β = 0.00046, CI 0.000054 to 0.00087). Joint pain intensity was negatively associated with physical function (β = -0.90 m, CI -1.61 to -0.19), but not quality of life. Poorer sleep quality was negatively associated with HrQoL (β = -0.037, CI -0.060 to -0.013), but not physical function. Sleep efficiency was not associated with either outcome. In the combined model, physical activity was not associated with HrQoL, while joint pain was. Conclusions: Our exploratory findings among people with multimorbidity suggest that physical activity and joint pain are potentially clinically meaningful factors relating to physical function, while self-reported sleep quality may meaningfully relate to HrQoL. Clinicians may want to consider supporting patients with multimorbidity in managing their physical activity levels, joint pain, and sleep quality to improve health outcomes. Longitudinal studies and randomised controlled trials are needed to confirm these findings.",

keywords = "Exercise, Comorbidities, Sleep, Osteoarthritis, Quality of life, Physical function",

author = "Travis Haber and Alessio Bricca and Michelle Hall and Br{\o}nd, \{Jan Christian\} and Lau Thygesen and Skou, \{S{\o}ren T.\}",

year = "2025",

month = dec,

doi = "10.1007/s11136-025-04044-4",

language = "English",

volume = "34",

pages = "3575--3586",

journal = "Quality of Life Research",

issn = "1573-2649",

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Are physical activity, sleep, and joint pain associated with physical function and quality of life in individuals with multimorbidity? A cross-sectional analysis of the MOBILIZE trial. / Haber, Travis; Bricca, Alessio; Hall, Michelle et al.
In: Quality of Life Research, Vol. 34, No. 12, 12.2025, p. 3575-3586.

Research output: Contribution to journal › Journal article › Research › peer-review

TY - JOUR

T1 - Are physical activity, sleep, and joint pain associated with physical function and quality of life in individuals with multimorbidity? A cross-sectional analysis of the MOBILIZE trial

AU - Haber, Travis

AU - Bricca, Alessio

AU - Hall, Michelle

AU - Brønd, Jan Christian

AU - Thygesen, Lau

AU - Skou, Søren T.

PY - 2025/12

Y1 - 2025/12

N2 - Purpose: This study investigated the associations between physical activity, sleep, and joint pain intensity with physical function and health-related quality of life (HrQoL) in people with multimorbidity. Methods: A pre-specified cross-sectional study using baseline data from participants with multimorbidity in the MOBILZE trial. Outcomes were physical function (6-minute walk test) and HrQoL (EQ-5D-5 L). Exposures were device-measured physical activity (min/week), joint pain intensity (0-100 visual analogue scale), device-measured sleep efficiency (%), and sleep quality (Modified Karolinska Sleep Questionnaire, 0–5 Likert scale). Separate and combined linear regression models were used to assess associations between exposures and outcomes. Results: We included data from 227 participants. Physical activity was positively associated with physical function (β = 0.56 m, 95% confidence intervals (CI) 0.39 to 0.73) and HrQoL (β = 0.00046, CI 0.000054 to 0.00087). Joint pain intensity was negatively associated with physical function (β = -0.90 m, CI -1.61 to -0.19), but not quality of life. Poorer sleep quality was negatively associated with HrQoL (β = -0.037, CI -0.060 to -0.013), but not physical function. Sleep efficiency was not associated with either outcome. In the combined model, physical activity was not associated with HrQoL, while joint pain was. Conclusions: Our exploratory findings among people with multimorbidity suggest that physical activity and joint pain are potentially clinically meaningful factors relating to physical function, while self-reported sleep quality may meaningfully relate to HrQoL. Clinicians may want to consider supporting patients with multimorbidity in managing their physical activity levels, joint pain, and sleep quality to improve health outcomes. Longitudinal studies and randomised controlled trials are needed to confirm these findings.

AB - Purpose: This study investigated the associations between physical activity, sleep, and joint pain intensity with physical function and health-related quality of life (HrQoL) in people with multimorbidity. Methods: A pre-specified cross-sectional study using baseline data from participants with multimorbidity in the MOBILZE trial. Outcomes were physical function (6-minute walk test) and HrQoL (EQ-5D-5 L). Exposures were device-measured physical activity (min/week), joint pain intensity (0-100 visual analogue scale), device-measured sleep efficiency (%), and sleep quality (Modified Karolinska Sleep Questionnaire, 0–5 Likert scale). Separate and combined linear regression models were used to assess associations between exposures and outcomes. Results: We included data from 227 participants. Physical activity was positively associated with physical function (β = 0.56 m, 95% confidence intervals (CI) 0.39 to 0.73) and HrQoL (β = 0.00046, CI 0.000054 to 0.00087). Joint pain intensity was negatively associated with physical function (β = -0.90 m, CI -1.61 to -0.19), but not quality of life. Poorer sleep quality was negatively associated with HrQoL (β = -0.037, CI -0.060 to -0.013), but not physical function. Sleep efficiency was not associated with either outcome. In the combined model, physical activity was not associated with HrQoL, while joint pain was. Conclusions: Our exploratory findings among people with multimorbidity suggest that physical activity and joint pain are potentially clinically meaningful factors relating to physical function, while self-reported sleep quality may meaningfully relate to HrQoL. Clinicians may want to consider supporting patients with multimorbidity in managing their physical activity levels, joint pain, and sleep quality to improve health outcomes. Longitudinal studies and randomised controlled trials are needed to confirm these findings.

KW - Exercise

KW - Comorbidities

KW - Sleep

KW - Osteoarthritis

KW - Quality of life

KW - Physical function

U2 - 10.1007/s11136-025-04044-4

DO - 10.1007/s11136-025-04044-4

M3 - Journal article

C2 - 40782142

SN - 1573-2649

VL - 34

SP - 3575

EP - 3586

JO - Quality of Life Research

JF - Quality of Life Research

IS - 12

ER -

Are physical activity, sleep, and joint pain associated with physical function and quality of life in individuals with multimorbidity? A cross-sectional analysis of the MOBILIZE trial

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MOBILIZE: Improving health in people with multimorbidity: a paradigm shift in health care from disease-based curative models to personalized exercise therapy and self-management

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