The Lived Experiences of Patients Exercising with the Paula Method for Low Anterior Resection Syndrome: A Qualitative Study

Purpose Curative treatment for rectal cancer includes removal of part or all of the rectum. As a result, patients may experience Low Anterior Resection Syndrome (LARS), characterized by bowel dysfunction that negatively affects quality of life. Nurses assist patients in the self-management of LARS, yet there is a need to develop more self-care modalities. Therefore, this study aimed to describe the experience using the Paula method of exercise in patients with LARS. Methods A qualitative study of semi-structured interviews of 17 patients who completed a 12-week exercise intervention as part of a larger multicenter randomized controlled trial. Interviews were recorded, transcribed, and analyzed thematically. Results Three main themes were identified: (1) The Paula Method Exercises with subthemes, Preferred/Nonpreferred Exercises and Frequency, Feeling in the Body, and The Paula Method Instructor; (2) Change in Bowel Function with subthemes, urgency, frequency/fragmentation, and incontinence/unpredictable stools; (3) Additional Self-Care Modalities to Manage LARS, with subthemes dietary/over-the-counter medications and schedule bowel movements/self-navigate. Conclusions Participants perceived the Paula method exercises to be acceptable and reported that they helped alleviate symptoms, particularly bowel frequency and urgency. The exercises provided confidence and a feeling of reducing uncertainty. The Paula method may be added to complement existing self-care modalities. Key words : bowel dysfunction; exercise; Low anterior resection syndrome; Paula method, rectal cancer; self-care