What do patients value about spinal manipulation and home exercise for back-related leg pain? A qualitative study within a controlled clinical trial.

Abstract:

BACKGROUND:Patient perceptions may influence the effectiveness and utilization of healthcare interventions, particularly for complex health conditions such as sciatica or back-related leg pain (BRLP). OBJECTIVES:To explore BRLP patients' perceptions of spinal manipulative therapy (SMT) and home exercise with advice (HEA). DESIGN:Qualitative study in a controlled clinical trial. METHOD:Semi-structured interviews conducted after 12 weeks of treatment asked participants about satisfaction with care and whether treatment was worthwhile. An interdisciplinary research team conducted content analysis using qualitative data analysis software to identify and summarize themes. RESULTS:Of 192 trial participants, 174 (91%) completed interviews (66% female, age 57.0 ± 11.5 years). Participants identified interactions with providers and staff, perceived treatment effects, and information as key contributors to both their satisfaction and the worthwhile nature of treatment. HEA was liked for its convenience and ability to foster an exercise habit. SMT was liked for specific aspects of the modality (e.g. manipulation, stretching) and provider competency. Most participants reported no dislikes for SMT or HEA, but some noted the dose/time commitment for SMT and discipline of HEA as least liked aspects of the interventions. CONCLUSIONS:The quality of patient-provider interactions, perceived treatment effects, and information sharing influenced BRLP patients' satisfaction with care. Qualitative research describing patients' preferences can facilitate translation of study findings into practice and allow clinicians to tailor treatments to facilitate compliance and satisfaction with care.

journal_name

Man Ther

journal_title

Manual therapy

authors

Maiers M,Hondras MA,Salsbury SA,Bronfort G,Evans R

doi

10.1016/j.math.2016.09.008

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

183-191

eissn

1356-689X

issn

1532-2769

pii

S1356-689X(16)30719-6

journal_volume

26

pub_type

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