Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
Pain. 2022 Aug 1;163(8):e953-e962. doi: 10.1097/j.pain.0000000000002540. Epub 2021 Nov 15.
There is moderate quality evidence that exercise can help to prevent future low back pain (LBP). This study aimed to explore patient needs and preferences for exercise programs to prevent LBP and the outcomes of these programs that would be most important to a patient. Researchers conducted 26 semistructured interviews with people with LBP. Interviews were audio-recorded, transcribed, and analysed using framework thematic analysis. Three themes were developed. Theme 1 emphasised that everyone's LBP was different, translating to preferences for tailored prevention programs with a high level of initial supervision and individualised biomedical explanations for the program. Theme 2 highlighted important outcomes. Pain was considered not only for intensity but also for the duration, frequency, and severity of flare-ups or episodes. Other important outcomes were general fitness and capacity to engage in everyday activities, social interactions, and work. Theme 3 outlined aspects of exercise programs that were considered important for people with fluctuating pain, including how to foster a sense of "progress," set realistic expectations, and support patients to establish exercise routines that can adapt to fluctuating pain. Theme 4 discussed participants' desire for social connection. Patients want exercise programs for LBP prevention, which are highly individualised, provide meaningful explanations of exercises, and help them maintain exercise in the long-term. Clinicians should discuss with patients the transition from a focus on treatment to the prevention of LBP. This provides greater opportunity to adjust goals and expectations and provide relevant education. Balancing the need for individualised care against affordability presents an ongoing challenge.
有中等质量的证据表明，运动有助于预防未来的下背痛（LBP）。本研究旨在探讨患者对预防 LBP 的运动方案的需求和偏好，以及对患者最重要的这些方案的结果。研究人员对 26 名患有 LBP 的人进行了半结构化访谈。采访进行了录音、转录，并使用框架主题分析进行了分析。确定了三个主题。主题 1 强调每个人的 LBP 都不同，这转化为对量身定制的预防计划的偏好，这些计划需要高水平的初始监督和针对该计划的个性化生物医学解释。主题 2 强调了重要的结果。疼痛不仅被认为是强度，还被认为是发作或发作的持续时间、频率和严重程度。其他重要的结果是一般的健康和从事日常活动、社交互动和工作的能力。主题 3 概述了对患有波动性疼痛的人来说，运动计划的重要方面，包括如何培养“进步”感、设定现实的期望以及支持患者建立可以适应波动性疼痛的锻炼习惯。主题 4 讨论了参与者对社会联系的渴望。患者希望预防 LBP 的运动方案具有高度个性化，对运动进行有意义的解释，并帮助他们长期保持运动。临床医生应该与患者讨论从关注治疗到预防 LBP 的转变。这为调整目标和期望以及提供相关教育提供了更大的机会。平衡个性化护理的需求与可负担性是一个持续存在的挑战。
