Building Workforce Capacity to Deliver Physical and Psychological Rehabilitation for People With Persistent Low Back Pain in Community Settings: A Mixed-Methods Pilot Study

Conflicts of Interest: No conflicts of interest Sources of Funding: Oxford and Thames Valley NIHR ARC Background and purpose We are developing a new workforce model to make high-quality physical and psychological rehabilitation more accessible to people with persistent low back pain (LBP) by training Pilates teachers to deliver rehabilitation in local community venues. We adapted an evidence-based intervention (BeST Programme) into a 9-week programme and investigated its feasibility and acceptability. Methods We recruited adults with LBP for > 6 weeks from two community centres. Researchers observed the programme to assess delivery. Participants rated programme satisfaction and participated in a focus group. Results Thirteen participants were recruited (11 women; median age 41 years (IQR 35–61); median LBP severity (6/10, IQR 4.0–7.3). Most participants described themselves as African or Indian. Group 1 is completed (n=5, findings below) and Group 2 is underway (n=8). In Group 1, participants attended 1–8 sessions (median 5 IQR 2.5–7.5; centre cancelled one session). 4/5 participants attended the focus group. They were highly satisfied with the programme. The content (exercises, discussion, and relaxation) was considered well-balanced. The exercise component was highly valued although some wanted harder exercises. Participants received a printed workbook and usage varied. They suggested the workbook should be more actively integrated into the sessions with clearer guidance on homework tasks and exercises. Overall, the Pilates teacher successfully delivered the programme. At times, they needed to focus the discussion on function rather than pain. Results will inform the next iteration of the programme and teacher training. Conclusion Preliminary findings suggest that the delivery of community-based physical and psychological rehabilitation by a Pilates teacher is feasible and acceptable.