Occupational Therapy - Activity Diary guidance

Your Occupational Therapist has suggested that you keep an activity diary for one week. It will be used in your next review appointment to look at how pain can vary according to activities, mood, time of day and pain relief measures.

Why keep an activity diary?

• To help understand how you spend your day
• To see patterns in your daily activities
• To notice how activity, rest, and routine affect you, in terms of your pain experience.

How to fill in your diary

1. Add the date - Write the day and date at the top of each page.
2. Record your day (hour by hour)
   For each hour you are awake, write:

• Your main activity (e.g. walking, cooking, resting, reading, TV, Personal care etc)
• Whether you were sitting or standing (if relevant)
• Note your mood or thoughts (optional)
• Note your pain – (Low, moderate, severe)
• Note amount and name of medication taken
• Note other relief measures (Heat/ Cold pack, T.E.N.S, relaxation, stetches/movement, distraction or anything else.

Example of diary entries:

Please include the time you went to bed, your waking time, the number of times you woke during the night and how rested you felt in the morning (0-5: 0 = not rested, 5 = fully rested).

1. Activity diary

Date and day of the week: ___________________________

Please include the time you went to bed, your waking time, the number of times you woke during the night and how rested you felt in the morning (0-5: 0 = not rested, 5 = fully rested).

2. Activity diary

Date and day of the week: ___________________________

Please include the time you went to bed, your waking time, the number of times you woke during the night and how rested you felt in the morning (0-5: 0 = not rested, 5 = fully rested).

3. Activity diary

Date and day of the week: ___________________________

Please include the time you went to bed, your waking time, the number of times you woke during the night and how rested you felt in the morning (0-5: 0 = not rested, 5 = fully rested).

4. Activity diary

Date and day of the week: ___________________________

Please include the time you went to bed, your waking time, the number of times you woke during the night and how rested you felt in the morning (0-5: 0 = not rested, 5 = fully rested).

Activity diary

Occupational Therapy - Activity Diary guidance

Why keep an activity diary?

• To understand how you spend your day
• See patterns in your daily activities
• Notice how activity, rest, and routine affect you, in terms of your pain experience.

How to fill in your diary

1. Add the date
   Write the day and date at the top of each page.

• Record your day (hour by hour)
  For each hour you are awake, write:
• Your main activity (e.g. walking, cooking, resting, reading, TV, Personal care etc)

Whether you were sitting or standing (if relevant)

• Note your mood or thoughts (optional)
• Note your pain – (Low, moderate, severe).
• Note amount and name of medication taken
• Note other relief measures (Heat/ Cold pack, T.E.N.S, relaxation, stetches/movement, distraction or anything else)

Please include the time you went to bed, your waking time, the number of times you woke during the night and how rested you felt in the morning (0-5: 0 = not rested, 5 = fully rested).

Please bring the completed diary with you to your next review with your treating Occupational Therapist.