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Physical activity barriers and facilitators in patients awaiting spine surgery: A qualitative study
Journal article   Open access   Peer reviewed

Physical activity barriers and facilitators in patients awaiting spine surgery: A qualitative study

José Manuel García-Moreno, Stephan U Dombrowski, Dresden Forshner, Alex Lui, Erin Bigney, Jillian Kearney, Neil Manson, Christopher Small, Niels Wedderkopp and Jeffrey J Hébert
PloS one, Vol.21(8), e0355173
2026
DOI: https://doi.org/10.1371/journal.pone.0355173
PMID: 42550839
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Open Access CC BY V4.0

Abstract

Adult Aged Exercise - psychology Female Humans Intervertebral Disc Displacement - psychology Intervertebral Disc Displacement - surgery Lumbar Vertebrae - surgery Male Middle Aged Qualitative Research Spinal Stenosis - physiopathology Spinal Stenosis - psychology Spinal Stenosis - surgery Waiting Lists
Background Degenerative spine conditions and physical inactivity are major public health concerns. Engaging in physical activity before spine surgery may improve postoperative outcomes experienced by patients with lumbar stenosis or lumbar disc herniation. This study aims to identify barriers and facilitators to physical activity among patients with degenerative lumbar spine conditions awaiting surgery. Methods In this qualitative patient-oriented study, guided by a patient partner who contributed to the development of the interview guide and interpretation of findings, we conducted data-prompted semi-structured interviews (a method in which personalised physical activity information is used to stimulate reflection and discussion), with patients diagnosed with lumbar spinal stenosis or lumbar disc herniation on a surgical waiting list. Interviews were structured around the Theoretical Domains Framework (TDF). Patient responses were deductively coded to TDF domains and inductively analyzed to identify subthemes. Key domains were determined through researcher consensus based on the frequency and clarity of specific beliefs within each domain. Results We interviewed 18 patients (8 female), 11 with lumbar spinal stenosis and 7 with lumbar disc herniation, with a mean (SD) age of 54.7 (17.3) years. Five key TDF domains were identified: skills, beliefs about capabilities, beliefs about consequences, environmental context and resources, and emotion. Barriers to physical activity included a lack of physical capacity, pain and other adverse symptoms, potential for negative consequences, inappropriate environment, and negative emotions. Facilitators to physical activity were motivation, appropriate environment, supportive social influences, positive emotions, alternate strategies, and daily physical activity habits. Conclusions Physical activity behaviour in patients awaiting spine surgery is shaped by an interplay of physical, emotional and contextual factors. These findings can inform the design of tailored, theory-driven preoperative physical activity interventions, targeting key barriers such as pain, fear of harm, and limited access to resources, while leveraging factors including motivation, professional guidance, social support, and habit formation.

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UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

Source: SDGs in the Output

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