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Patient and physiotherapist perceptions of rehabilitation following primary lumbar discectomy: a qualitative focus group study embedded within an external pilot and feasibility trial
  1. Alison Rushton1,
  2. Nicola R Heneghan1,
  3. Alison Heap2,
  4. Louise White2,
  5. Melanie Calvert3,
  6. Peter C Goodwin4
  1. 1 Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, West Midlands, UK
  2. 2 Physiotherapy, University Hospitals Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK
  3. 3 Institute of Applied Health Research, The University of Birmingham, Birmingham, UK
  4. 4 Health Professions Department (Physiotherapy), Manchester Metropolitan University, Manchester, UK
  1. Correspondence to Dr Alison Rushton; a.b.rushton{at}bham.ac.uk

Abstract

Objective To evaluate patients’ and physiotherapists’ perceptions, preferences and feelings about rehabilitation following lumbar discectomy surgery.

Design A qualitative focus group study, informed from the theoretical perspective of phenomenology, of patients’ and physiotherapists’ experiences of rehabilitation following lumbar discectomy was conducted. The focus groups were used to explore patients’ and physiotherapists’ perceptions and their preferences and feelings about different approaches to rehabilitation. The focus groups were facilitated and observed by experienced researchers and were informed by a topic guide that had been piloted previously.

Setting The study was embedded within an external pilot and feasibility trial that randomised patients across two secondary care spinal surgery sites in the UK to receive either 1:1 physiotherapy and leaflet or leaflet-only interventions.

Participants Five focus groups took place between April and July 2014. A framework analysis of thematic coding (deductive and inductive components) by two researchers captured identified themes common to both patients and physiotherapists. Data from three focus groups with patients and carers (n=11) and two with physiotherapists (n=15) contributed to the analytic framework.

Results Emerging themes included: the value of patient leaflets with or without physiotherapy interventions; the importance of self-motivation in the recovery pathway; benefits of group physiotherapy for some patient groups and patient preference influencing rehabilitation.

Conclusion Patients and physiotherapists perceived the study patient leaflet and 1:1 physiotherapy interventions as high quality and valuable. Patients’ personal priorities, for example, their need to return to work, influenced their preferences for rehabilitation interventions following surgery.

  • Back pain
  • Rehabilitation Medicine
  • Qualitative research
  • Spine

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors Conceived and designed the study: ABR, MC, AH, LW and PCG. Performed the focus groups: ABR and PCG. Analysed the data: ABR and PCG. Overview of analysis and interpretation: ABR, NH, MC, AH, LW and PCG. Wrote the first draft of the paper: ABR and PCG. Contributed to review and subsequent drafts of paper: ABR, NH, MC, AH, LW and PCG.

  • Funding This work was funded by the Queen Elizabeth Hospital Charity, Grant number 17-3-780. Authors receiving funding: AH, ABR, MC, LW and PCG. The funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

  • Competing interests None declared.

  • Ethics approval The UK West Midlands Solihull research ethics committee granted ethical approval (Ref:12/WM/0224).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No further unpublished data are available.

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