USERS’ EXPERIENCE OF BACK-TO-FIT<SUP>TM</SUP>– A NOVEL DIGITAL INTERVENTION TO PROMOTE EXERCISE SELF-MANAGEMENT IN LOW BACK PAIN: A QUALITATIVE EVALUATION

A. Senarath Rathnayake^1,2, V. Sparkes¹, L. Sheeran¹

¹Cardiff University, School of Healthcare Sciences, Cardiff, United Kingdom, ²University of Hertfordshire, School of Health and Social Work, Department of Physiotherapy, Hatfeild, United Kingdom

Background: Low back pain (LBP) is globally the number one cause of disability where the majority of patients have that is non-specific (NSLBP). Exercise and self-management are highly recommended for people with NSLBP in best practice guidelines. Despite the well-established recommendations and guidelines, people with NSLBP find it difficult to engage in physical activity (PA) and exercise for various reasons and the complex nature of their pain. Digital interventions (DIs) show promise in helping people with NSLBP to self-manage and be active. However, most existing DIs are not scientifically evaluated, do not meet consumer needs, and report poor user experience. BACK-to-FIT^TMis evidence, theory, and practice-based DI developed to promote PA and exercise self-management in people with NSLBP, using stakeholder input across three developmental phases as recommended by Medical Research Guidelines-UK.

Purpose: To explore the user experience and feedback of BACK-to-FIT^TMafter a 4-week follow-up period.

Methods: This study enrolled 16 participants who experienced recurrent NSLBP and had pain in the past 4 weeks. Participants used BACK-to-FIT^TM for 4-weeks, which provided 4 distinct modules of exercise and LBP education to improve self-management and exercise/PA engagement. Online semi-structured interviews were conducted at the end of the 4 weeks to explore the user experience of BACK-to-FIT^TM and gather feedback on what did and did not work when using the intervention and suggestions to improve it. Recordings from individual interviews were transcribed verbatim, and the transcripts were analysed using inductive thematic analysis.

Results: Analysis of the interview transcripts of 11 users who completed the 4-week follow-up yielded four overarching themes (subthemes in parentheses):
1) Intervention engagement (niche for an LBP resource, everyone used differently according to preferences, shared experience,
2) Facilitators (quality of the content and the design, felt safe and reassured convenience),
3) Benefits of BACK-to-FIT^TM (regained control of pain and readiness, improvements in physical health and mental health, a better understanding of LBP), and
4) Recommendations for improvement (technical problems, developing to a mobile app, scope for a more tailored and improved version). Overall analysis revealed a positive user experience, and they found BACK-to-FIT^TM a beneficial, convenient and informative intervention.

Conclusions: The novel intervention BACK-to-FIT^TM appeared to support exercise self-management of the users and had positive feedback. Furthermore, it has the potential to improve further to deliver a more bespoke and improved version.

Implications: It is anticipated that BACK-to-FIT^TM can aid in enhancing LBP exercise self-management and be an excellent resource to reduce the massive burden of LBP. Moreover, it merits further development and subsequent evaluation in larger-scale studies to affirm its feasibility.

Funding acknowledgements: This study was funded by Biomechanics and Bioengineering Research Centre Versus Arthritis, Cardiff University, UK(Grant number -20781).

Keywords:
Low back pain
Exercise and Physical activity
Digital interventions

Topics:
Musculoskeletal: spine
Health promotion & wellbeing/healthy ageing/physical activity
Innovative technology: information management, big data and artificial intelligence

Did this work require ethics approval? Yes

Institution: Cardiff University

Committee: School of Healthcare Sciences Ethics Committee

Ethics number: REC745