‘I saw it as a marriage—You can't have one without the other’: A qualitative study of patient and physiotherapist experiences with a therapeutic combined strength and aerobic physical activity exercise programme for hip osteoarthritis

Abstract

AbstractIntroductionTo explore physiotherapist and patient experiences with, and acceptability of, a 12‐week physiotherapist‐guided combined strength and aerobic physical activity exercise programme for hip osteoarthritis (OA).MethodsA qualitative study using semi‐structured interviews with 13 people with hip OA and four physiotherapists. Patients underwent a 12‐week home exercise programme customised by weekly visits with one of the four physiotherapists. The programme aimed for patients to participate in 150 min of moderate‐intensity aerobic physical activity, and 20–30 min of strengthening exercise 2–3 times per week in concordance with American College of Sports Medicine (ACSM) dosage guidelines. Following the programme, patients and physiotherapists participated in individual semi‐structured interviews to explore the acceptability of the exercise programme and barriers and facilitators to participation. Data were audio‐recorded, transcribed and analysed using a thematic approach.ResultsFive over‐arching themes (supporting subthemes) were identified from both patient and physiotherapist interviews: (i) positive outcomes (functional improvements, pain relief, empowerment through experience, commitment to continue); (ii) combined benefits of aerobic and strength exercises (complimentary effects, strengthening exercises key); (iii) valuing support from the physiotherapist (personalised care, skill performance feedback, coach effect, accountability); (iv) motivation and opportunity for exercise (positive symptom loop, integration into daily routine, prior exercise experience, Fitbit motivation); and (v) time‐consuming commitment (physiotherapy visit frequency, travel inconvenience, time for exercise).ConclusionsExperiences of participants in this study indicate that, although time‐consuming, a combined aerobic physical activity and strengthening programme prescribed at ACSM dosage guidelines is acceptable and confers positive outcomes in individuals with hip OA.