Abstract
Purpose
This research project explored the experiences, attitudes, beliefs, and perceptions of healthcare professionals (physiotherapists and orthopaedic surgeons) and people with chronic low back pain (CLBP) regarding the barriers and facilitators to activity normalisation following physiotherapy.
Methods
A qualitative study of the perspectives of patients, physiotherapists and orthopaedic surgeons on CLBP was undertaken in Saudi Arabia. One focus group discussion was conducted with seven patients who had received physiotherapy for CLBP, along with one focus group discussion with eight physiotherapists and seven individual interviews with orthopaedic surgeons. The focus group discussions and interviews were transcribed and analysed using framework analysis.
Results
We identified seven factors facilitating or hindering activity normalisation following physiotherapy: symptom control, patient education and awareness, adherence to treatment plan, psychosocial factors, role of the clinician, social support, and issues relating to the healthcare system.
Conclusion
Clinicians stressed the importance of exercise and regular activity in spite of pain as an important factor hindering activity normalisation. Patients appreciated reassurance and advice from clinicians but also noted that conflicting and ambiguous advice and diagnosis was common. This may contribute to poor adherence with advice and exercise. Fear of pain and recurrence of injury were highlighted as important factors hindering activity normalisation, particularly since some patients did not take active steps to control pain. Finally, whilst multidisciplinary teams may support patient recovery and activity normalisation, this is often expensive and intensive and may be beyond the reach of a healthcare system without a properly functioning referral system and insufficient specialised clinics and physicians.
Conflicts of interest: None
Sources of funding: This research was supported through a PhD scholarship from Prince Sattam bin Abdulaziz University, Saudi Arabia, at the University of Nottingham, United Kingdom.
