Article

OBJECTIVE: To assess views of patients with chronic low back pain (cLBP)
concerning barriers to home-based exercise program adherence and to record
expectations regarding new technologies. DESIGN: Qualitative study based on
semi-structured interviews. PARTICIPANTS: A heterogeneous sample of 29 patients who performed a home-based exercise program for cLBP learned during supervised
physiotherapy sessions in a tertiary care hospital. INTERVENTIONS: Patients were
interviewed at home by the same trained interviewer. Interviews combined a
funnel-shaped structure and an itinerary method. RESULTS: Barriers to adherence
related to the exercise program (number, effectiveness, complexity and burden of
exercises), the healthcare journey (breakdown between supervised sessions and
home exercise, lack of follow-up and difficulties in contacting care providers),
patient representations (illness and exercise perception, despondency, depression
and lack of motivation), and the environment (attitudes of others, difficulties
in planning exercise practice). Adherence could be enhanced by increasing the
attractiveness of exercise programs, improving patient performance (following a
model or providing feedback), and the feeling of being supported by care
providers and other patients. Regarding new technologies, relatively younger
patients favored visual and dynamic support that provided an enjoyable and
challenging environment and feedback on their performance. Relatively older
patients favored the possibility of being guided when doing exercises. Whatever
the tool proposed, patients expected its use to be learned during a supervised
session and performance regularly checked by care providers; they expected
adherence to be discussed with care providers. CONCLUSIONS: For patients with cLBP, adherence to home-based exercise programs could be facilitated by
increasing the attractiveness of the programs, improving patient performance and
favoring a feeling of being supported. New technologies meet these challenges and
seem attractive to patients but are not a substitute for the human relationship
between patients and care providers.
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Langue : ANGLAIS