Facilitators and barriers to physical activity in people with chronic low back pain: A qualitative study

Abstract

BackgroundFor medical teams, one of the main objectives of rehabilitation for people with chronic low back pain is adherence to physical activity (PA).ObjectiveThe objective of this study was to identify PA barriers and facilitators in this population.MethodsThis 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.ResultsThree 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.ConclusionThe results of this study will allow teams to target relevant educational objectives for these people and develop dedicated self-management programs.

Predictive variables of motivation and barriers for the practice of physical exercise in adolescence

“…These results are similar to those reported in previous studies finding environmental and psychological barriers, knowledge, lack of medical support and energy or age (Blake, Stanulewicz, & McGill, 2017;Casper, Bocarro, Kanters, & Floyd, 2011;Maxwell-Smith, Zeps, Hagger, Platell, & Hardcastle, 2017). Likewise, the study by Boutevillain, Dupeyron, Rouch, Richard & Coudeyre (2017) also supports these results, emphasizing that group practice increases people's adherence to the practice of physical exercise.…”

Fear-avoidance beliefs are associated with exercise adherence: secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low back pain

“…In previous studies, LBP intensity [55] and older age [58] compromised adherence to exercise or exercise progression. Contradictory to earlier studies, they had no effect in the present study, perhaps because in most participants the intensity of LBP was mild to moderate, they were still working, and the age range was set to 30-55 years.…”

“…In 2012- 2014, when the study interventions were conducted, Pilates was quite a popular exercise type in Finland, and for that reason it was expected to be more attractive than a typically conventional/traditional neuromuscular exercise form. It has been suggested that factors associated with exercise adherence among LBP patients can be divided into three categories [55]: 1) physical factors like pain [55] and perceived health status [56]; 2) psychological factors such as the fear of pain [23], diagnostic uncertainty [22], low self-efficacy [21], and depression and anxiety [21]; and 3) environmental factors, such as difficulty in integrating exercise into daily life [22,55], lack of time [22,23,55], and intervention-related variables [33]. This classification is partly insufficient: it is difficult to place education level, which is a socio-demographic background factor, into any of those categories.…”

Serious Gaming to Support Exercise Therapy for Patients with Chronic Nonspecific Low Back Pain: A Feasibility Study

“…12,39 By integrating SGs into a tailored exercise program, we tried to overcome some important barriers to exercise therapy, such as insufficient support during home exercises, 14,15 low confidence in a correct exercise performance 12,15 and poor motivation. 14,15,40 The participants in our study indicated that they felt supported and more confident about their exercise performance due to the feedback from the SGs at home. With respect to motivation, patients often need extra support (e.g.…”