Painful Choices: A Qualitative Exploration of Facilitators and Barriers to Active Lifestyles Among Adults With Osteoarthritis

Abstract

Research has indicated physical activity and exercise can effectively attenuate biopsychosocial osteoarthritis-related symptoms in adults, more so than other management strategies; however, both leisure and structured physical activity are scarcely recommended by health care providers, and remain rarely adopted and adhered to in this patient population. Using qualitative interviews, the present study investigated potential facilitators and barriers to physical activity for adults with osteoarthritis. Fifteen participants (30-85 years of age) with osteoarthritis engaged in semi-structured interviews, which focused on experiences with physical activity/exercise, daily osteoarthritis management, and experiences with health professionals' recommendations. Analysis of the interview transcripts revealed that pain relief, clear health-related communication, and social support facilitated physical activity. Physical pain, psychological distress, and inadequate medical support were the most frequently expressed barriers. The present study supports the biopsychosocial nature of osteoarthritis, which may have important implications for advancing exercise as an effective and long-term intervention strategy in aging adults with osteoarthritis.

Provider–Patient Communication and Involvement in Physical Activity Programs Among Patients Receiving Physical Therapy Services: A Qualitative Study

“…However, it is important to consider factors that prevent PA in older adults. A common barrier to PA cited in previous studies (Bethancourt et al, 2014;Gillette, Petrescu-Prahova, Herting, & Belza, 2015;Stone & Baker, 2017) and also found here is that patients face physical limitations that prevent them from engaging in PA. Cost and lack of transportation are tangible barriers to PA program participation described by interviewed PTs and in previous studies (Bethancourt et al, 2014;Schutzer & Graves, 2004).…”

Leisure Time Physical Activity Among U.S. Adults With Arthritis, 2008−2015

“…Adults with arthritis report both generic and arthritis-specific barriers to physical activity (e.g., functional limitations, fear that physical activity will worsen pain). [19][20][21] Multiple evidence-based strategies for promoting and supporting physical activity among adults with arthritis exist, but the minimal increase in this study suggests that these approaches are underused. Although there is currently no evidence that specific medical interventions increase physical activity (e.g., a recent meta-analysis of people with osteoarthritis found no increase in physical activity after total knee or hip arthroplasty 22 ), healthcare providers may increase physical activity among adults with arthritis through medical management of physical activity barriers (e.g., pain), counseling all patients with arthritis to engage in physical activity to manage their arthritis symptoms, 23 and referring patients to community, evidence-based physical activity programs.…”

Barriers and facilitators to recommended physical activity in lower-limb osteoarthritis: protocol for a qualitative study exploring patients and physiotherapist perspectives using the theoretical domains framework and behaviour change taxonomy

“…Semi-structured interviews were chosen for the phase I data collection to enable patients with lower-limb OA to go into great depth when discussing their perceptions of PA,42 to provide a rich account of their perspectives, while allowing for flexibility with-in the session 43. Questions will initially be asked in an open manner with prompts given or clarification sought if key points are identified with participants encouraged to identify new ideas during the interview.…”

“…Questions will initially be asked in an open manner with prompts given or clarification sought if key points are identified with participants encouraged to identify new ideas during the interview. The topic guide (please see online supplementary appendices for the phase I topic guide) has been developed by including perspectives of patients with lower-limb OA (through patient and public involvement), and incorporating systematic review data, contemporary interview research,31 43–45 and surveys exploring perspectives46 of patients with lower-limb OA. The guide includes questions regarding a participant’s current PA, their perspectives of physiotherapy interventions including barriers and facilitators to (objective 1), and BCTs they believe would optimise (objective 2), adherence to physiotherapist PA prescription during the treatment and post-treatment time periods.…”