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Vader K1, Doulas T1, Patel R2, Miller J1
1Queen's University, School of Rehabilitation Therapy, Kingston, Canada, 2Queen's University, School of Medicine, Kingston, Canada
Background: Chronic pain affects an estimated 1 in 5 adults and contributes to disability, poor quality of life, and high healthcare costs. Participation in physical activity and exercise can help to decrease pain severity, improve physical function, and enhance quality of life for adults living with chronic pain. Despite the benefits, participation in physical activity and exercise among this patient population is low. A better understanding of the experience and perceived barriers/facilitators to participation in physical activity and exercise may help to better inform physical activity interventions for adults with chronic pain.
Purpose: To explore in-depth perspectives on physical activity and exercise and perceived barriers/facilitators to participation among adults living with chronic pain.
Methods: We conducted an interpretive descriptive qualitative study to explore in-depth perspectives on physical activity and exercise among adults with chronic pain. We conducted a combination of in-person and telephone semi-structured interviews with participations. We recruited adults who self-identified as living with chronic pain (pain that has lasted for at least 3 months) from primary care teams and an academic hospital-based chronic pain clinic in Kingston, Canada. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Pairs of researchers independently coded and then jointly reviewed each transcript to ensure agreement of the coding scheme. Detailed coding of the first three transcripts was used to create a preliminary coding scheme which was used to analyze the remaining transcripts. Qualitative data management software (MAXQDA) was used to assist with data storage. Analysis and data collection were considered complete saturation was reached (when no new themes were emerging from the transcripts). An audit trail, reflexive dialogue, and multiple team meetings were used to establish analytical rigour and maintain trustworthiness.
Results: 16 participants took part in an interview between October 2017 and January 2018. The majority of participants identified as female (11/16) and had a median age of 53 years. Three themes (and subsequent sub-themes) emerged through data analysis: (1) the reality of physical activity and exercise when living with chronic pain (physical activity through daily tasks, low intensity physical activity is best, ´flaring-up´ after physical activity, and feeling discouraged), (2) factors influencing participation in physical activity and exercise (access to fitness equipment/facilities, motivation, uncertainty/fluctuating responses, social supports, perceived benefits, competing demands for time, knowledge, fears, physical abilities, environment, pain/fatigue, and confidence), and (3) potential outcomes of participation in physical activity and exercise (improved pain management, mental/emotional changes, social connections, functional improvements, and improved overall health).
Conclusion(s): Physical activity and exercise through daily tasks is common for many adults with chronic pain. A combination of factors are perceived as barriers/facilitators to participation in physical activity and exercise. Potential outcomes of participating in physical activity and exercise included physical, psychological, and social outcomes among adults with chronic pain.
Implications: Healthcare providers may benefit from individually exploring perceived barriers and facilitators to physical activity and exercise among adults with chronic pain with the goal of increasing participation among this patient population. Findings may have implications for tailoring physical activity and exercise interventions for adults living with chronic pain.
Keywords: physical activity, exercise, chronic pain
Funding acknowledgements: KV is supported by a Frederick Banting and Charles Best Canada Graduate Scholarship from the Canadian Institutes of Health Research.
Purpose: To explore in-depth perspectives on physical activity and exercise and perceived barriers/facilitators to participation among adults living with chronic pain.
Methods: We conducted an interpretive descriptive qualitative study to explore in-depth perspectives on physical activity and exercise among adults with chronic pain. We conducted a combination of in-person and telephone semi-structured interviews with participations. We recruited adults who self-identified as living with chronic pain (pain that has lasted for at least 3 months) from primary care teams and an academic hospital-based chronic pain clinic in Kingston, Canada. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Pairs of researchers independently coded and then jointly reviewed each transcript to ensure agreement of the coding scheme. Detailed coding of the first three transcripts was used to create a preliminary coding scheme which was used to analyze the remaining transcripts. Qualitative data management software (MAXQDA) was used to assist with data storage. Analysis and data collection were considered complete saturation was reached (when no new themes were emerging from the transcripts). An audit trail, reflexive dialogue, and multiple team meetings were used to establish analytical rigour and maintain trustworthiness.
Results: 16 participants took part in an interview between October 2017 and January 2018. The majority of participants identified as female (11/16) and had a median age of 53 years. Three themes (and subsequent sub-themes) emerged through data analysis: (1) the reality of physical activity and exercise when living with chronic pain (physical activity through daily tasks, low intensity physical activity is best, ´flaring-up´ after physical activity, and feeling discouraged), (2) factors influencing participation in physical activity and exercise (access to fitness equipment/facilities, motivation, uncertainty/fluctuating responses, social supports, perceived benefits, competing demands for time, knowledge, fears, physical abilities, environment, pain/fatigue, and confidence), and (3) potential outcomes of participation in physical activity and exercise (improved pain management, mental/emotional changes, social connections, functional improvements, and improved overall health).
Conclusion(s): Physical activity and exercise through daily tasks is common for many adults with chronic pain. A combination of factors are perceived as barriers/facilitators to participation in physical activity and exercise. Potential outcomes of participating in physical activity and exercise included physical, psychological, and social outcomes among adults with chronic pain.
Implications: Healthcare providers may benefit from individually exploring perceived barriers and facilitators to physical activity and exercise among adults with chronic pain with the goal of increasing participation among this patient population. Findings may have implications for tailoring physical activity and exercise interventions for adults living with chronic pain.
Keywords: physical activity, exercise, chronic pain
Funding acknowledgements: KV is supported by a Frederick Banting and Charles Best Canada Graduate Scholarship from the Canadian Institutes of Health Research.
Topic: Pain & pain management
Ethics approval required: Yes
Institution: Queen's University
Ethics committee: Health Sciences and Affiliated Teaching Hospitals Research Ethics Board
Ethics number: 6021163
All authors, affiliations and abstracts have been published as submitted.
