Exploring barriers and facilitators to the adoption of regular exercise practice in patients at risk of a recurrence of low back pain (MyBack project): a qualitative study

Abstract

Purpose

This study aimed to explore potential barriers and facilitators to the adoption of regular exercise practice in patients at risk of a recurrence of low back pain (LBP).

Materials and Methods

Eleven patients, who recovered from a previous episode of LBP, participated in two focus groups. The semi-structured interview schedule was informed by the Behaviour Change Wheel and the Theoretical Domains Framework. Focus groups were held through videoconference, audio and video recorded and transcribed verbatim. A deductive content analysis was performed by two researchers independently.

Results

Eighteen barriers and 19 facilitators were identified. The most common barriers included “lack of knowledge on how to manage a recurrence of LBP,” “lack of behavioural regulation strategies and having other priorities” and “lack of self-efficacy/confidence to practice exercise autonomously and deal with a new episode of LBP.” “Knowledge on exercise and recurrences,” “regular exercise habits,” “having specific behavioural regulation strategies,” “exercise practice with others,” “willingness to practice exercise and considering it a priority,” and “presence of positive emotions related with exercise practice” were the most common facilitators.

Conclusions

These findings will inform the development of a behaviour change-informed exercise intervention to promote regular exercise practice among patients at risk of a recurrence of LBP.

IMPLICATIONS FOR REHABILITATION

• Exercise interventions are the most effective strategies to reduce the risk of a recurrence of LBP, but patients do not exercise regularly.

• Exercise interventions targeting specific determinants of behaviour change are needed to support the adoption of this practice.

• The findings of this study will allow the design of a health intervention to promote the adoption of regular exercise practice for people at risk of having a recurrence of LBP.

• Researchers, health professionals and policymakers should promote the implementation of evidence- based and theory-driven interventions for the secondary prevention of LBP to reduce its burden on health systems.

Keywords:

• Low back pain
• recurrences
• exercise
• behaviour change
• primary healthcare
• qualitative research

Acknowledgements

We would like to acknowledge all participants who contributed to this study for their willingness and openness to be interviewed.

Disclosure statement

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

Data availability statement

De-identified data from this study may be made available by emailing the corresponding author. The data are not publicly available because their containing information that could compromise the privacy of research participants and due to language restrictions (in portuguese). Analytic code used to conduct the analyses presented in this study are available in Supplementary Data 3. All materials used to conduct the study are available in Supplementary Data 2 and 3.

Additional information

Funding

This work was funded by the FCT-Fundação para a Ciência e a Tecnologia, I. P., under the PhD grant awarded to STD (UI/BD/150882/2021) and the grant awarded to the MyBack project (PTDC/SAU-SER/7406/2020).