Wong Jessica J, Rinaldi Jen, Pereira Paulo, Mior Silvano, Ead Lauren, Veitch Alanna, Murnaghan Kent, Côté Pierre
School of Physical Therapy, Faculty of Health Sciences, Western University, 1201 Western Road, London, ON, N6G 1H1, Canada.
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 5C1, Canada.
Syst Rev. 2025 Aug 6;14(1):161. doi: 10.1186/s13643-025-02919-8.
Low back pain (LBP) is a major contributor to disability and rehabilitation needs globally. A proportion of patients with LBP undergo surgery and require postsurgical rehabilitation to optimize functioning. However, many encounter barriers to accessing rehabilitation due to structurally generated inequities linked to socioeconomic position. Structural barriers to accessing rehabilitation intersect with diversity-related factors (e.g., gender, ethnicity) to perpetuate stigma and marginalization, leading to tremendous consequences. This literature needs to be reviewed to identify key themes and knowledge gaps focused on structural factors to accessing post-surgical rehabilitation. Our objectives are to conduct a scoping review of the literature to (1) systematically map the literature on the experiences with structural barriers and facilitators to accessing post-surgical rehabilitation of adults who were treated with surgery for LBP (including with or without radiculopathy, symptomatic spinal stenosis); (2) investigate whether these experiences differ when grouped by diversity-related factors (e.g., gender, ethnicity, geographic region).
We will conduct a scoping review of the literature based on Joanna Briggs Institute (JBI) scoping review guidance and report it according to PRISMA-Scoping Reviews. We will search multiple databases from inception to 2025 for qualitative research exploring experiences with structural barriers or facilitators to rehabilitation access after surgery among adults with LBP. Drawing upon the World Health Organization (WHO) Action on Social Determinants of Health framework, structural factors to accessing rehabilitation will include socioeconomic and political contexts; governance; macroeconomic, social and public policies; and cultural and societal values/norms. Paired reviewers will independently screen articles and extract data. Results will be summarized and grouped by type of LBP and rehabilitation, and by intersections with diversity-related factors (e.g., gender, age, ethnicity, disabilities, geographic region). Our interdisciplinary team will engage with an Advisory Committee of knowledge users with lived experience throughout.
Aligned with WHO and EUROSPINE priorities, our scoping review will elucidate the structural barriers and facilitators influencing access to post-surgical rehabilitation for LBP more inclusively. Findings will advance knowledge of structural challenges experienced by adults needing post-surgical rehabilitation, informing rehabilitation and other healthcare strategies to remove barriers and improve functioning globally.
Open Science Framework (OSF) https://osf.io/26h9w.
腰痛（LBP）是全球残疾和康复需求的主要促成因素。一部分腰痛患者接受手术治疗，术后需要康复治疗以优化功能。然而，由于与社会经济地位相关的结构性不平等，许多患者在获得康复治疗方面遇到障碍。获得康复治疗的结构性障碍与性别、种族等与多样性相关的因素相互交织，使耻辱感和边缘化持续存在，导致严重后果。需要对这一文献进行综述，以确定关注获得术后康复治疗的结构性因素的关键主题和知识空白。我们的目标是对文献进行范围综述，以（1）系统梳理关于接受过腰痛手术治疗的成年人（包括有或没有神经根病、症状性椎管狭窄）在获得术后康复治疗时遇到的结构性障碍和促进因素的文献；（2）调查按与多样性相关的因素（如性别、种族、地理区域）分组时，这些经历是否存在差异。
我们将根据乔安娜·布里格斯研究所（JBI）范围综述指南对文献进行范围综述，并按照PRISMA-范围综述报告。我们将检索多个数据库，从建库至2025年，查找探索腰痛成年人术后获得康复治疗的结构性障碍或促进因素经历的定性研究。借鉴世界卫生组织（WHO）健康社会决定因素行动框架，获得康复治疗的结构性因素将包括社会经济和政治背景；治理；宏观经济、社会和公共政策；以及文化和社会价值观/规范。两名评审员将独立筛选文章并提取数据。结果将按腰痛和康复的类型以及与与多样性相关的因素（如性别、年龄、种族、残疾、地理区域）的交叉情况进行总结和分组。我们的跨学科团队将全程与有实际经验的知识用户咨询委员会合作。
与WHO和欧洲脊柱协会的优先事项一致，我们的范围综述将更全面地阐明影响腰痛患者获得术后康复治疗的结构性障碍和促进因素。研究结果将推进对需要术后康复治疗的成年人所经历的结构性挑战的认识，为全球消除障碍和改善功能的康复及其他医疗保健策略提供信息。
开放科学框架（OSF）https://osf.io/26h9w 。
