title: Perceived barriers and facilitators to increasing physical activity among people with musculoskeletal disorders: a qualitative investigation to inform intervention development.
abstract: OBJECTIVE
  Musculoskeletal conditions can impair people's ability to undertake physical activity as they age. The purpose of this qualitative study was to investigate perceived barriers and facilitators to undertaking physical activity reported by patients accessing ambulatory hospital clinics for musculoskeletal disorders.
  
  
  METHODS
  A questionnaire with open-ended items was administered to patients (n=217, 73.3% of 296 eligible) from three clinics providing ambulatory services for nonsurgical treatment of musculoskeletal disorders. The survey included questions to capture the clinical and demographic characteristics of the sample. It also comprised two open-ended questions requiring qualitative responses. The first asked the participant to describe factors that made physical activity more difficult, and the second asked which factors made it easier for them to be physically active. Participants' responses to the two open-ended questions were read, coded, and thematically analyzed independently by two researchers, with a third researcher available to arbitrate any unresolved disagreement.
  
  
  RESULTS
  The mean (standard deviation) age of participants was 53 (15) years; n=113 (52.1%) were male. A total of 112 (51.6%) participants reported having three or more health conditions; n=140 (64.5%) were classified as overweight or obese. Five overarching themes describing perceived barriers for undertaking physical activity were "health conditions", "time restrictions", "poor physical condition", "emotional, social, and psychological barriers", and "access to exercise opportunities". Perceived physical activity facilitators were also aligned under five themes, namely "improved health state", "social, emotional, and behavioral supports", "access to exercise environment", "opportunities for physical activities", and "time availability".
  
  
  CONCLUSIONS
  It was clear from the breadth of the data that meaningful supports and interventions must be multidimensional. They should have the capacity to address a variety of physical, functional, social, psychological, motivational, environmental, lifestyle, and other perceived barriers. It would appear that for such interventions to be effective, they should be flexible enough to address a variety of specific concerns.
authors.affiliation: Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia ; Centre for Functioning and Health Research, Metro South Health, Griffith University, Brisbane, QLD, Australia.
authors.forename: Steven M
authors.initials: SM
authors.lastname: McPhail
authors.affiliation: Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia ; Centre for Functioning and Health Research, Metro South Health, Griffith University, Brisbane, QLD, Australia.
authors.forename: Mandy
authors.initials: M
authors.lastname: Schippers
authors.affiliation: Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Marshall
authors.affiliation: Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia ; Centre for Functioning and Health Research, Metro South Health, Griffith University, Brisbane, QLD, Australia.
authors.forename: Monique
authors.initials: M
authors.lastname: Waite
authors.affiliation: Centre for Functioning and Health Research, Metro South Health, Griffith University, Brisbane, QLD, Australia ; Griffith Health Institute and School of Human Services and Social Work, Griffith University, Brisbane, QLD, Australia.
authors.forename: Pim
authors.initials: P
authors.lastname: Kuipers
mesh_terms: D000328:Adult; D001294:Attitude to Health; D015992:Body Mass Index; D003144:Communication Barriers; D015444:Exercise / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009140:Musculoskeletal Diseases / Q000517:prevention & control / Q000523:psychology* / Q000628:therapy*; D036301:Qualitative Research; D012649:Self Concept
keywords: behavior; comorbidity; exercise; lifestyle; pain; sedentary