Putting physical activity whilst experiencing low back pain in context: balancing the risks and benefits

Publication date: Available online 22 October 2015
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Ben Darlow, Meredith Perry, Sarah Dean, Fiona Mathieson, G David Baxter, Anthony Dowell
ObjectiveTo analyse attitudes and beliefs about movement and physical activity in people with low back pain (LBP) and compare these beliefs between people with acute and chronic LBP.DesignQualitative inductive analysis of data collected via face-to-face semi-structured interviews.SettingTwelve participants with acute LBP (<6 weeks) and eleven participants with chronic LBP (>3 months) were purposively recruited from one region of New Zealand. Interviews were audio-recorded and transcribed verbatim.InterventionsNot-applicable.Main Outcome MeasureThemes which emerged from participant interview transcripts using analysis based on Interpretative Description.ResultsParticipants with acute and chronic LBP made judgements about physical activity and rest using the same conceptual model. Concerns about creating more pain, tissue damage, or impairment influenced the physical activity judgements of most participants with acute and chronic LBP. These perceived risks were balanced against the perceived benefits, the most important of which were psychological or social rather than physical. Judgements made by those with acute and chronic LBP were context dependent and influenced by the nature and duration of pain, the type of physical activity, the importance of the activity, and the participant's previous experience. Participants with acute pain who had not experienced back pain previously often expressed more uncertainty whereas those with chronic LBP appeared to have developed cognitive rules which determined physical activity decisions.ConclusionsExploring the perceived risks, benefits, and contextual factors which influence decisions about physical activity and rest may help clinicians to understand the behaviour of patients with acute and chronic LBP. Clinicians may best support their patients to engage in physical activity by providing an informed assessment of risks and explanation about the range of potential benefits.



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