Can physiotherapy in an interdisciplinary pain rehabilitation setting improve physical function? A long-term mixed methods follow-up study

ABSTRACT

Purpose

The aim of this study was to describe chronic pain patients’ perception of their physical function and treatment factors for improving or maintaining physical function long-term after the completion of an Interdisciplinary Pain Rehabilitation Program (IPRP) and to compare physical function before, directly after and at long-term follow-up (16–20 months after treatment).

Materials and methods

Patients with severe nonmalignant chronic pain, participating in an IPRP at a specialist clinic, were eligible for inclusion in a convergent mixed methods study. Quantitative data included aerobic capacity, level of physical activity (PA) and self-efficacy for exercise. Qualitative data were collected through semi-structured interviews.

Results

The qualitative analysis resulted in one theme: Orientation change and two categories: Permission to feel self-worth and Reclaiming life, which illuminated factors that enabled a sustained increase in PA. The quantitative data (n = 11) showed a significantly increased maximal oxygen uptake (VO₂max) from 2.46 l/min (SD = 0.9) at baseline to 2.63 l/min (SD = 0.9, p = .03) on completion of the program. VO₂max was sustained at long-term follow-up (2.56 l/min (SD = 1.0, p = .24).

Conclusion

This study indicates that an orientation change process through an IPRP can lead to increased physical function and a sustainable level of PA. Furthermore, it highlights the importance of a person-centered approach to enable sustainable change in patients with chronic pain.

KEYWORDS:

• Chronic pain
• physical activity
• self-efficacy
• body awareness
• physiotherapy
• interdisciplinary rehabilitation

Acknowledgments

This work was supported by the Department of Anaesthesiology and Intensive Care Medicine/Pain Centre, the Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden and the Local Research and Development Council Gothenburg and Södra Bohuslän (VGFOUGSB-964616, VGFOUGSB-977619). We would like to thank physiotherapist Eva-Lotte Karlsson for assisting in data collection. Our thanks also go to the participating patients whose work has made this study possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The work was supported by the Local Research and Development Council Gothenburg and Södra Bohuslän [VGFOUGSB-964616, VGFOUGSB-977619].