Motivating patients with shoulder and back pain to self-care: can a videotape of exercise support physiotherapy?

ObjectivesThe National Health Service is developing an ethos of self-care. Patients are being encouraged to become proficient in helping themselves. This has long been a philosophy of the physiotherapy profession, where self-care between consultations has been an integral part of the treatment process through encouraging the uptake of self-care skills training. This study explored how patients with shoulder and back pain perceived videotaped exercises and instructions to support their routine physiotherapy, and how the videotape was used.DesignA videotape, developed by physiotherapists for patients with musculoskeletal problems, of exercises to view at home was given to patients by their physiotherapists to support their routine physiotherapy consultations. A qualitative methodology was used to examine how patients responded to being given a videotape of exercises and instructions between consultations. Data were collected through semi-structured interviews.SettingThe study was based in 26 general practices that had access to practice-based physiotherapists in two primary care trusts in the north-west of England.ParticipantsThirty-three patients with shoulder and back pain who received a videotape of exercises and advice were interviewed.ResultsThree themes emerged from the data: finding space for exercise; remembering and doing exercises; and supporting the physiotherapy–patient relationship. Patients discussed aspects of motivation, and described how a videotape of exercises might support or inhibit the performance of exercises prescribed by physiotherapists. Patients identified a range of different ways in which they derived support from the videotape.ConclusionsThe videotape supported patients with a variety of different needs as it enhanced their ability to complete exercises correctly. Videotapes (or DVDs) are useful for patients and could be adopted as a tool to support treatment.