This study aimed to describe the experiences and perspectives of older adults with chronic pain concerning community based exercise, to inform the design of a future feasibility study delivering a community-based exercise intervention.
This qualitative study comprised two focus groups(n=8, all female) and an online survey (n=134). Focus group and survey participants were recruited through the membership of a national pain advocacy charity. The focus groups were conducted and recorded online via Microsoft Teams (MS Teams) minutes, with key questions regarding participant's experiences, and concerning community-based exercise. Discussions were transcribed and transcripts were returned to the participants for member checking. The survey included a series of open questions about community-based exercise. Narrative responses to these open questions were included in the analysis. Braun and Clarke’s six-step approach to reflexive thematic analysis was used to analyse the data. A person with lived experience of pain was part of the team involved in data analysis.
There were four main themes identified. In the first theme, "Exercise as a self-management strategy", participants highlighted that negative experiences of community-based exercise led to exercise avoidance. The theme "Programme structure" focused on the need for exercise instructors to be trained in chronic pain and offer a flexible programme in relation to session duration, and level. The theme "Barriers" issues of accessibility, cost, awareness and pain flare-ups were extensive in the data. The final theme highlighted the "Psychosocial characteristics" of community-based exercise such as group dynamics, peer support, and experience of stigma, with a clear preference for exercising with others who have pain.
This study illustrates how a range of factors including past experience with exercise and movement-related fear, can influence the desire of older adults with chronic pain to engage with community-based exercise. Key elements of programme design such as instructor training, a flexible structure and giving attention to accessibility and affordability may enhance engagement. While chronic pain is significantly more common in older females, the lack of female participants in the focus groups is a limitation of the findings and needs to be supplemented with perspectives from males.
The results of this study have been used to inform the design of a feasibility study of community-based exercise for older adults with chronic pain. If the feasibility outcomes are achieved, the intervention will be tested in a full powered trial.
exercise
qualitative
