Riipinen Perttu, Holmes Michelle, Ogilvie Samantha, Newell Dave, Byfield David, du Rose Alister
Welsh Institute of Chiropractic, University of South Wales, Treforest, UK.
AECC University College, Bournemouth, UK.
Musculoskeletal Care. 2022 Dec;20(4):848-859. doi: 10.1002/msc.1637. Epub 2022 Apr 6.
Pathoanatomical beliefs about the cause of low back pain may negatively influence patients' perceptions of 'best care', such as the inclusion of exercise for low back pain (LBP) management. The aims of this study were to explore what patients receiving manual therapy are told and understand about their LBP diagnosis, and how this affects their perceptions regarding the role of exercise in the management of their LBP.
An interpretative phenomenological analysis (IPA) study design was utilised using semi-structured telephone interviews of patients who experience persistent LBP and seek care at an outpatient clinic at the University of South Wales. Ten participants were interviewed for the study (six male). Interviews were transcribed verbatim and analysed using an IPA approach.
Three main themes were generated: (1) Constructing explanation of pain. (2) Expectations of exercise within care seeking behaviours. (3) Resolving conflict between exercise and back pain narratives. Participants linked their pain to a pathoanatomical cause, impacting their beliefs on exercise as a treatment approach.
Diagnostic models used by clinicians which are grounded within a pathoanatomical framework influence patients' perceptions and rationale for exercise. Exercise prescription using contemporary pain science and biopsychosocial approaches should be emphasised in practice and education.
关于腰痛病因的病理解剖学观念可能会对患者对“最佳治疗”的认知产生负面影响,比如将运动纳入腰痛(LBP)管理。本研究的目的是探究接受手法治疗的患者被告知以及所理解的关于其腰痛诊断的内容,以及这如何影响他们对运动在腰痛管理中作用的认知。
采用解释现象学分析(IPA)研究设计,对患有持续性腰痛并在南威尔士大学门诊寻求治疗的患者进行半结构化电话访谈。本研究共访谈了10名参与者(6名男性)。访谈内容逐字转录,并采用IPA方法进行分析。
产生了三个主要主题:(1)构建疼痛解释。(2)在寻求治疗行为中对运动的期望。(3)解决运动与背痛叙述之间的冲突。参与者将他们的疼痛与病理解剖学原因联系起来,影响了他们对运动作为一种治疗方法的信念。
临床医生使用的基于病理解剖学框架的诊断模型会影响患者对运动的认知和理由。在实践和教育中应强调采用当代疼痛科学和生物心理社会方法进行运动处方。