title: Management of pain induced by exercise and mobilization during physical therapy programs: views of patients and care providers.
abstract: BACKGROUND
  The expectations of patients for managing pain induced by exercise and mobilization (PIEM) have seldom been investigated. We identified the views of patients and care providers regarding pain management induced by exercise and mobilization during physical therapy programs.
  
  
  METHODS
  We performed a qualitative study based on semi-structured interviews with a stratified sample of 12 patients (7 women) and 14 care providers (6 women): 4 general practitioners [GPs], 1 rheumatologist, 1 physical medicine physician, 1 geriatrician, 2 orthopedic surgeons, and 5 physical therapists.
  
  
  RESULTS
  Patients and care providers have differing views on PIEM in the overall management of the state of disease. Patients' descriptions of PIEM were polymorphic, and they experienced it as decreased health-related quality of life. The impact of PIEM was complex, and patient views were sometimes ambivalent, ranging from denial of symptoms to discontinuation of therapy. Care providers agreed that PIEM is generally not integrated in management strategies. Care providers more often emphasized the positive and less often the negative dimensions of PIEM than did patients. However, the consequences of PIEM cited included worsened patient clinical condition, fears about physical therapy, rejection of the physical therapist and refusal of care. PIEM follow-up is not optimal and is characterized by poor transmission of information. Patients expected education on how better to prevent stress and anxiety generated by pain, education on mobilization, and adaptations of physical therapy programs according to pain intensity.
  
  
  CONCLUSIONS
  PIEM management could be optimized by alerting care providers to the situation, improving communication among care providers, and providing education to patients and care providers.
authors.affiliation: Department of Social Sciences, Université Paris Descartes, Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Alami
authors.forename: Dominique
authors.initials: D
authors.lastname: Desjeux
authors.forename: Marie Martine
authors.initials: MM
authors.lastname: Lefèvre-Colau
authors.forename: Anne Sophie
authors.initials: AS
authors.lastname: Boisgard
authors.forename: Eric
authors.initials: E
authors.lastname: Boccard
authors.forename: François
authors.initials: F
authors.lastname: Rannou
authors.forename: Serge
authors.initials: S
authors.lastname: Poiraudeau
mesh_terms: D000328:Adult; D004434:Early Ambulation / Q000379:methods* / Q000523:psychology; D005081:Exercise Therapy / Q000379:methods* / Q000523:psychology*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation*; D010147:Pain Measurement / Q000379:methods / Q000523:psychology*; D017060:Patient Satisfaction; D036301:Qualitative Research