Facilitators and barriers to physical activity in people with chronic low back pain: A qualitative study.
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ABSTRACT: Background
For medical teams, one of the main objectives of rehabilitation for people with chronic low back pain is adherence to physical activity (PA).Objective
The objective of this study was to identify PA barriers and facilitators in this population.Methods
This qualitative study included 4 discussion groups and 16 semi-structured interviews conducted among people with non-specific chronic low back pain who were involved in a specific rehabilitation program or seen in primary care settings.Results
Three main themes were identified: physical factors, psychological factors and socio-environmental factors. The main barrier to PA practice is pain. Psychological barriers were associated with the difficulty in integrating PA in the person's daily life. Environmental barriers were dominated by lack of time. Facilitators identified associated the supervised nature of the physical activity (supervision by professionals) and group practice, which improved people's adherence.Conclusion
The results of this study will allow teams to target relevant educational objectives for these people and develop dedicated self-management programs.
SUBMITTER: Boutevillain L
PROVIDER: S-EPMC5526504 | biostudies-literature | 2017
REPOSITORIES: biostudies-literature
Publications
Facilitators and barriers to physical activity in people with chronic low back pain: A qualitative study.
Boutevillain Laura L Dupeyron Arnaud A Rouch Caroline C Richard Emilie E Coudeyre Emmanuel E
PloS one 20170725 7
<h4>Background</h4>For medical teams, one of the main objectives of rehabilitation for people with chronic low back pain is adherence to physical activity (PA).<h4>Objective</h4>The objective of this study was to identify PA barriers and facilitators in this population.<h4>Methods</h4>This qualitative study included 4 discussion groups and 16 semi-structured interviews conducted among people with non-specific chronic low back pain who were involved in a specific rehabilitation program or seen in ...[more]
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Project description:BackgroundChronic low back pain is a worldwide burden that is not being abated with our current knowledge and treatment of the condition. The fear-avoidance model is used to explain the relationship between pain and disability in patients with chronic low back pain. However there are gaps in empirical support for pathways proposed within this model, and no evidence exists as to whether physical activity moderates these pathways.MethodsThis was a cross-sectional study of 218 people with chronic low back pain. Multiple mediation analyses were conducted to determine the role of fear, catastrophizing, depression, and anxiety in the relationship between pain and disability. Separate analyses were performed with physical activity as the moderator. Individuals were classified as performing regular structured physical activity if they described on average once per week for > 30-minutes an activity classified at least moderate intensity (≥ 4-6 METs), activity prescribed by an allied health professional for their back pain, leisure time sport or recreation, or self-directed physical activity such as resistance exercise.ResultsFear, catastrophizing, and depression significantly mediated the relationship between pain and disability (p<0.001). However the mediating effect of catastrophizing was conditional upon weekly physical activity. That is, the indirect effect for catastrophizing mediating the relationship between pain and disability was only significant for individuals reporting weekly physical activity (B = 1.31, 95% CI 0.44 to 2.23), compared to individuals reporting no weekly physical activity (B = 0.21, 95% CI -0.50 to 0.97). Catastrophizing also mediated the relationship between pain and fear (B = 0.37, 95% CI 0.15 to 0.62), with higher scores explaining 53% of the total effect of pain on fear.ConclusionsThese results support previous findings about the importance of fear and depression as factors that should be targeted in low back pain patients to reduce back pain related disability. We have also extended understanding for the mediating effect of catastrophizing on back pain related disability. Back pain patients engaged with regular physical activity may require counselling with regards to negative pain perceptions.
| S-EPMC5501599 | biostudies-literature
Project description:BackgroundChronic primary low back pain (CPLBP) and other musculoskeletal conditions represent a sizable attribution to the global burden of disability, with rates greatest in older age. There are multiple and varied interventions for CPLBP, delivered by a wide range of health and care workers. However, it is not known if these are acceptable to or align with the values and preferences of care recipients. The objective of this synthesis was to understand the key factors influencing the acceptability of, and values and preferences for, interventions/care for CPLBP from the perspective of people over 60 and their caregivers.MethodsWe searched MEDLINE, CINAHL and OpenAlex, for eligible studies from inception until April 2022. We included studies that used qualitative methods for data collection and analysis; explored the perceptions and experiences of older people and their caregivers about interventions to treat CPLBP; from any setting globally. We conducted a best fit framework synthesis using a framework developed specifically for this review. We assessed our certainty in the findings using GRADE-CERQual.ResultsAll 22 included studies represented older people's experiences and had representation across a range of geographies and economic contexts. No studies were identified on caregivers. Older people living with CPLBP express values and preferences for their care that relate to therapeutic encounters and the importance of therapeutic alliance, irrespective of the type of treatment, choice of intervention, and intervention delivery modalities. Older people with CPLBP value therapeutic encounters that validate, legitimise, and respect their pain experience, consider their context holistically, prioritise their needs and preferences, adopt a person-centred and tailored approach to care, and are supported by interprofessional communication. Older people valued care that provided benefit to them, included interventions beyond analgesic medicines alone and was financially and geographically accessible.ConclusionsThese findings provide critical context to the implementation of clinical guidelines into practice, particularly related to how care providers interact with older people and how components of care are delivered, their location and their cost. Further research is needed focusing on low- and middle-income settings, vulnerable populations, and caregivers.
| S-EPMC10768085 | biostudies-literature
Project description:BackgroundThe aims of this study were (i) to investigate the potential influence of pre-pregnancy regular leisure-time physical activity (PA) on the risk of persistent LBPP half a year after pregnancy, and (ii) to explore the starting time and prevalence of PA among women experiencing LBPP during pregnancy, in relation to remission or persistent LBPP half a year after pregnancy.MethodsThis study is a follow-up study of 639 women who reported LBPP during pregnancy. These women were sent a questionnaire at approximately six months after delivery. The respondents were divided into three groups: 'no pain', 'recurrent pain', and 'continuous pain'. Data were analysed using an independent samples t-test, Pearson's chi-squared test, and univariate and multivariate logistic regression analyses.Results44.5% of subjects reported current PA at six months post partum. The mean starting time of PA was 2.6 months post partum and the mean number of current, weekly events of PA was 3.4; there were no differences between the groups. 82.2% reported previous PA at some period in life. Women with BMI >/= 30 reported current PA to a lesser extent. The number of years of pre-pregnancy PA did not influence the risk of persistent LBPP.ConclusionAlmost half of women who had experienced LBPP during pregnancy reported PA at six months post partum. The number of years of pre-pregnancy PA did not influence the risk of persistent LBPP. Obesity was a risk factor for not practising PA.
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