Poster Presentation Sydney Spinal Symposium 2024

"I could 100% see myself getting hurt if I did it wrong": a qualitative exploration of exercise perceptions in people with chronic low back pain (#32)

Andrew R Natoli 1 2 , Matt D Jones 1 2 , Emily D Walker 1 2 , Mitchell T Gibbs 1 2
  1. School of Health Science, Faculty of Medicine , UNSW, Sydney, NSW, Australia
  2. Centre for Pain IMPACT, Neuroscience Research Australia , Sydney, NSW, Australia

Aims: Exercise is a first line treatment for chronic low back pain (CLBP)1. Traditionally, exercise interventions have focused on the ‘core’ musculature, informed by the reductionistic biomedical model, however studies suggest there is no superior exercise modality for CLBP management2,3. A contemporary approach to CLBP management informed by the holistic biopsychosocial model has shifted exercise prescription paradigms to focus on client education and beliefs4. This study therefore explores the perceptions of exercise in people with CLBP and their implications, aiming to guide more holistically tailored interventions.

Methods: Adults aged ≥18 years with low back pain lasting >3 months were included in this study. Participants were recruited through both social media (i.e., Facebook, Instagram, Twitter) and poster advertisements on community notice boards around Sydney. 16 participants (4 female) partook in one 45-minute, semi-structured interview each over Zoom with author AN. A 6-stage reflexive thematic analysis was carried out using NVivo12, as outlined by Braun and Clarke5.

Results. Exercise was perceived as beneficial for both health and CLBP relief, but perceptions around efficacy varied depending on modality. Participants distinguished 'gym' exercises such as deadlifts to facilitate feelings of empowerment and enjoyment, while traditional rehabilitation exercises like the bird dog were believed to directly address CLBP. Most participants held an overarching belief that exercises targeting the 'core' are crucial for CLBP relief. Exercises involving spinal bending and external load were mostly seen as potential injury sources. A phenomenon of implicit exercise messaging, highlighted useful educational topics for healthcare practitioners. Overall, participants emphasised the importance of guidance from trustworthy healthcare practitioners.

Conclusions: This study revealed participants perceptions of the effects of different exercises on health and pain relief when experiencing CLBP. This study confirms previous findings showing how healthcare practitioners can play an influential role in shaping these exercise beliefs7. These findings highlight the importance of using holistic exercise in research and the implications for clinical practice.

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