• Francesc Medina-Mirapeix, Pilar Escolar-Reina, Juan J Gascón-Cánovas, Joaquina Montilla-Herrador, and Sean M Collins.
• Departamento de Fisioterapia, Facultad de Medicina, Universidad de Murcia, Campus de Espinardo, ES-30100, Murcia, Spain. mirapeix@um.es
• J Rehabil Med. 2009 Apr 1;41(5):347-52.

ObjectiveTo identify the beliefs and perceptions of patients with chronic neck and low back pain that influence adherence to home exercise during exacerbation and/or remission of pain.DesignQualitative study using a focus group technique.SubjectsThirty-four patients (23 women, age range 26-70 years) with chronic neck or low back pain who had participated in a home exercise programme.MethodsSeven focus groups were formed. Participants were sampled purposefully from all patients with chronic neck or low back pain who attended for physiotherapy at 4 primary healthcare centres. Patients were interviewed about how they perceived their adherence to a home exercise programme during chronic pain. Data were analysed using a phenomenographic method.ResultsSeveral themes about patients' beliefs and perceptions were identified as factors related to adherence. These factors change when pain or disabilities appear, decrease or disappear for an extended period. Beliefs about illness and treatment are more likely when pain is present and when pain disappears for an extended period. However, patients consider perceptions about barriers, social support and physical environment when pain decreases.ConclusionThese findings may represent an important potential for improving the adherence of patients with chronic pain to home exercise programmes.

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