“A little bit of a guidance and a little bit of group support”: a qualitative study of preferences, barriers, and facilitators to participating in community-based exercise opportunities among adults living with chronic pain

Abstract

Purpose

To understand preferences, barriers, and facilitators to participating in community-based exercise opportunities among adults living with chronic pain.

Materials and Methods

An interpretive description methodology based on semi-structured interviews was conducted. Adults (age>18 years) living with chronic pain (pain >3 months in duration) were recruited from a multidisciplinary chronic pain clinic in Toronto, Canada. Thematic analysis was used to conceptualize interview data.

Results

Fifteen adults living with chronic pain (11/15 women) were interviewed. Four themes regarding preferences, barriers, and facilitators to participation in community-based exercise are described: (1) accessibility (e.g., cost, location, scheduling, and access to program information from healthcare providers); (2) intrinsic factors (e.g., pain, mental health, and motivation); (3) social factors (e.g., isolation, participation with people with similar capabilities, and safe environment); and (4) program factors (e.g., tailored to adults living with chronic pain, gentle exercise, group-based, and delivered by an instructor knowledgeable about chronic pain).

Conclusions

Participation in community-based exercise opportunities among adults living with chronic pain may be influenced by accessibility, intrinsic factors, social factors, and program factors. Results provide a foundation of understanding to develop person-centered community-based exercise opportunities that are tailored to meet the preferences of this population.

Implications for Rehabilitation

• Although community-based exercise is commonly recommended as part of ongoing self-management of chronic pain, there is limited research exploring perspectives towards community-based exercise opportunities from the perspective of adults living with chronic pain.

• Adults living with chronic pain reported specific preferences, barriers, and facilitators to participating in community-based exercise opportunities, including accessibility, instrinsic factors, social factors, and program factors.

• Most adults living with chronic pain reported a preference for community-based exercise opportunities that: (1) are delivered by an instructor who is knowledgeable about chronic pain; (2) involve gentle exercise; (3) are group-based; and (4) include other individuals with similar physical capabilities.

• Healthcare providers, community-based organizations, and researchers should develop, implement, and evaluate person-centered community-based exercise opportunities for adults living with chronic pain that consider their unique preferences, barriers, and facilitators to participation.

Keywords:

• Exercise
• community-based
• rehabilitation
• chronic pain
• qualitative research

Acknowledgements

This research was completed in partial fulfillment of the requirements for an MScPT degree at the University of Toronto. The authors would like to thank those who volunteered their time to participate in this research as well as staff at Women’s College Hospital who assisted with participant recruitment.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

Kyle Vader was supported by a Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-D) awarded by the Canadian Institutes of Health Research (CIHR) at the time this research was conducted. This work was supported in part by an Innovations Strengthening Primary Health Care through Research (INSPIRE-PHC) Fellowship from the Ontario Strategy for Patient Oriented Research (SPOR) Support Unit, held by Kyle Vader at the time this research was conducted.