Patient and physiotherapist perceptions of rehabilitation following primary lumbar discectomy: a qualitative focus group study embedded within an external pilot and feasibility trial

Objective: To evaluate patients’ and physiotherapists’ perceptions, preferences and feelings about rehabilitation following lumbar discectomy surgery.

Design: A qualitative focus group study, informed from the theoretical perspective of phenomenology, of patients’ and physiotherapists’ experiences of rehabilitation following lumbar discectomy was conducted. The focus groups were used to explore patients’ and physiotherapists’ perceptions, and their preferences and feelings about different approaches to rehabilitation. The focus groups were facilitated and observed by experienced researchers
and were informed by a topic guide that had been piloted previously.

Setting: The study was embedded within an external pilot and feasibility trial that randomised patients across two secondary care spinal surgery sites in the UK to receive either 1:1 physiotherapy and leaflet or leaflet only interventions.
Participants: Five focus groups took place between April and July 2014. A framework analysis of thematic coding (deductive and inductive components) by two researchers captured identified themes common to both patients and physiotherapists. Data from 3 focus groups with patients and carers (n=11) and 2 with physiotherapists (n=15) contributed to the analytic framework.

Results: Emerging themes included: the value of patient leaflets with or without
physiotherapy interventions; the importance of self-motivation in the recovery pathway, benefits of group physiotherapy for some patient groups; and patient preference influencing rehabilitation.