liu.seSearch for publications in DiVA
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Patients' experiences of how symptoms are explained and influences on back-related health after pre-surgery physiotherapy: A qualitative study
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0003-3707-5869
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
2019 (English)In: Musculoskeletal science & practice, ISSN 2468-7812, Vol. 40, p. 34-39Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Since the pre-surgery phase is a new setting for physiotherapy, exploring patients' experiences might contribute to new insights for future development of care in patients with degenerative lumbar spine disorders.

OBJECTIVES: To describe patients' experiences of how symptoms are explained, and their experiences of the influences on back-related health after pre-surgery physiotherapy.

DESIGN: Explorative qualitative design using semi-structured interviews analysed with content analysis.

PARTICIPANTS: Eighteen patients with degenerative lumbar spine disorder scheduled for surgery, participated in pre-surgery physiotherapy.

FINDINGS: Five categories were identified: Influences on symptoms, physical function and sleep; Influences on coping and well-being; Explanations of back-related symptoms and wanting to be well-informed; Influence on social functioning; The ability of the model of care to influence reassurance and prevention.

CONCLUSION: Improvements in back-related health in all the biopsychosocial dimensions emerged. Even those who expressed no symptom improvements, felt better performing exercises than being inactive, and exercises improved their frame of mind, a useful experience in possible low back pain recurrences. Pre-surgery physiotherapy provided reassurance and gave time to reflect on treatments and lifestyle. Despite pre-surgery physiotherapy, back-related symptoms were mainly described in line with a biomedical explanatory model. Those using broader explanations were confident that physiotherapy and self-management could influence their symptoms. Suggesting more emphasis on explanatory models suitable for surgery, pre- and post-surgery physiotherapy and self-management in the professionals' dialogue with patients.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 40, p. 34-39
Keywords [en]
Content analysis, Exercise therapy, Patients' experience, Physiotherapy, Qualitative study, Spinal surgery
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:liu:diva-154072DOI: 10.1016/j.msksp.2019.01.003ISI: 000460108500005PubMedID: 30665046Scopus ID: 2-s2.0-85060104361OAI: oai:DiVA.org:liu-154072DiVA, id: diva2:1282992
Funder
Region Östergötland
Note

This article had the status submitted when included in the thesis with the title "Pre-surgery physiotherapy and pain thresholds in patients with degenerative lumbar spine disorders" and the permanent link http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-150553.

Funding agencies: County Council of Ostergotland, Linkoping, Sweden

Available from: 2019-01-28 Created: 2019-01-28 Last updated: 2019-03-20Bibliographically approved
In thesis
1. Pre-surgery physiotherapy and pain thresholds in patients with degenerative lumbar spine disorders
Open this publication in new window or tab >>Pre-surgery physiotherapy and pain thresholds in patients with degenerative lumbar spine disorders
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Patients scheduled for spinal surgery often experience long duration of pain, which may influence the pain-regulation system, function and health and have an impact on post-surgery outcome. Prehabilitation potentially augments functional capacity before surgery, which may have beneficial effects after surgery.

Aim: The overall aim of the thesis is to study pre-surgery physiotherapy and somatosensory function in patients with degenerative lumbar spine disorders and to explore the patients’ experiences of pre-surgery physiotherapy.

Methods: Somatosensory function was measured with quantitative sensory testing (QST). Pre-surgery physiotherapy was evaluated with patient-reported outcome measures (n = 197). Patients’ experiences of how symptoms are explained and their experiences of the influences on back-related health after pre-surgery physiotherapy were explored.

Results: Half of the patients reported back or leg pain for more than 2 years. On a group level, the somatosensory profiles were within the reference range. On an individual level, an altered somatosensory profile was found in 23/105 patients, these were older, more often women, and reported higher pain, larger pain distribution and worse SF-36 MCS (mental health component summary). Patients with disc herniation, more sensitive to pressure pain in the hand presurgery, was associated with poorer function, self-efficacy, anxiety and depression score pre-surgery, worse function, self-efficacy and leg pain 3 months post-surgery and worse health related quality of life, self-efficacy, depression score 1 year postsurgery. The results for sensitivity for cold pain were similar, except that it even was associated with poorer function and pain 1 year post-surgery. The pre-surgery physiotherapy group had less back pain, better function, health, self-efficacy, fear avoidance score, depression score and physical activity level than the waiting-list group after the pre-surgery intervention. The effects were small. Both groups improved significantly after surgery, with no differences between groups, except that the higher physical activity level in the physiotherapy group remained at the 1-year follow-up. Only 58% of the patients reported a minimum of one visit for rehabilitation during the 1 year preceding the decision to undergo surgery. Patients experienced that pre-surgery physiotherapy had influenced symptoms, physical function, coping, well-being and social functioning to various degrees. Pre-surgery physiotherapy was experienced as a tool for reassurance and an opportunity to reflect about treatment and lifestyle. The patients mainly used biomedical explanatory models based on image reports to explain their backrelated symptoms. Both broader and more narrow, as well as lack of explanations of symptoms emerged. Further, wanting and sometimes struggling to be wellinformed about symptoms and interventions were described.

Conclusions: Being more sensitive to pressure- and cold pain in the hand, as a sign of widespread pain pre-surgery, was associated with poorer function, pain and health at post-surgery in patients with disc herniation. Pre-surgery physiotherapy decreased pain, fear avoidance, improved health related quality of life; and it decreased the risk of a worsening in psychological well-being before surgery. The improvements were small, and improvements after surgery were similar for both groups. At the 1-year follow-up, the physiotherapy group still had a higher activity level than the waiting list group. The pre-surgery physiotherapy was well tolerated. Patients’ reported experiences also illustrates the influence on function, pain and health. Patients experienced that pre-surgery physiotherapy provided reassurance and gave time to reflect on treatments and lifestyle. Symptoms were mainly described in line with a biomedical explanatory model. Those using a broader explanation were confident that physiotherapy and self-management could influence their back-related symptoms.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2018. p. 86
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1629
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-150553 (URN)10.3384/diss.diva-150553 (DOI)9789176852767 (ISBN)
Public defence
2018-09-21, Berzeliussalen, Campus US, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2018-08-27 Created: 2018-08-27 Last updated: 2019-09-30Bibliographically approved

Open Access in DiVA

fulltext(528 kB)107 downloads
File information
File name FULLTEXT01.pdfFile size 528 kBChecksum SHA-512
a2940ebd213efed6f0e881bbaf5f643a2cdf2730be685c4ba7a9f9e676fb0dc0b970dbc4d39898b8f54bcf145df87ab3cbea171202dfe7dcf998bac8b20b565d
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records BETA

Lindbäck, YvonneEnthoven, PaulÖberg, Birgitta

Search in DiVA

By author/editor
Lindbäck, YvonneEnthoven, PaulÖberg, Birgitta
By organisation
Division of PhysiotherapyFaculty of Medicine and Health Sciences
Physiotherapy

Search outside of DiVA

GoogleGoogle Scholar
Total: 107 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 97 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf