Background/Purpose: Chronic peripheral joint pain is extremely prevalent and a major cause of physical and psychosocial dysfunction. Exercise improves pain and physical function, but the effect of exercise on psychosocial function (health beliefs, depression, anxiety and quality of life) is unknown. To improve our understanding of the inter-relationship between pain, physical and psychosocial function and exercise we conducted a Cochrane Review of qualitative studies that reported people’s views, beliefs, feelings and experiences of exercise.

Methods: Twenty three clinical, public health, psychology, social care databases and 25 other relevant resources were searched for relevant studies. Two reviewers independently read and extracted data and used a thematic analysis to match the data against a conceptual framework and identify broad themes and sub-themes. Reviewers compared their individual coding, considered the extent to which each sub-theme was mutually exclusive and how they understood the data in relation to their individual coding. They reached a consensus on which a priorithemes were supported by the data, and whether new themes identified by the reviewers did actually map to the pre-existing broad theme. This approach has provided a clear path from the original research data, to individual study author’s descriptions and analyses to the findings of the qualitative review synthesis.

Results: Nine studies met the inclusion criteria. Their design, methodological rigor and reporting was good. Most of the studies gave clear descriptions of their methodology, clearly reported their findings, and took steps to ensure transparency and minimise the bias arising from researcher’s values and opinions in their reporting, interpretation and conclusions.

Chronic hip and knee pain affects all domains of people’s lives. Beliefs about chronic pain shaped people’s attitudes and behaviors about how to manage their pain. With little information or advice from healthcare professionals people attributed joint pain to “wear and tear”, ageing processes and/or familial disposition. Physical activity was often associated with onset or increase in pain and interpreted as causing additional joint damage, so people avoided activity for fear of causing additional harm.

People’s views about their symptoms, health beliefs and psychosocial experiences revealed implications for practice which included: providing people with more and better information and advice about the safety and benefits of exercise; tailoring exercise to ensure they are enjoyable and seen by people as being relevant; challenging unhelpful health beliefs; providing practical support.

Conclusion: The uptake and effectiveness of exercise might be improved by challenging inappropriate health beliefs, providing better information and advice about the safety and value of exercise, tailoring exercise programmes to individual’s preferences, abilities and needs and provide better support.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/peoples-views-beliefs-and-experiences-of-exercise-for-chronic-hip-and-knee-pain-cochrane-review-with-qualitative-synthesis/