THE ACCEPTABILITY OF TWO TYPES OF PSYCHOLOGICALLY INFORMED PHYSIOTHERAPY FOR ADULTS WITH CHRONIC NECK PAIN: AN EMBEDDED QUALITATIVE STUDY

Conflicts of interest: No conflicts of interest Sources of funding: This work was supported by a Grant from the Chartered Society of Physiotherapy Charitable Trust (Grant number: PRF-23A-PRE04) Background Conservative strategies for chronic neck pain (CNP) demonstrate modest effects, prompting the adaptation of Cognitive Muscular Therapy (CMT), a novel intervention for CNP. CMT integrates biomechanical retraining to reduce muscle overactivity and improve whole-body postural control, within a framework of psychologically informed physiotherapy. A randomised controlled feasibility trial was undertaken to assess the feasibility of a trial comparing CMT with best practice PIP (psychoeducation, exercise and relaxation). Four patient and public involvement and engagement (PPIE) members with lived experience of CNP, helped shape the trial and its findings. This embedded qualitative study explored the acceptability of CMT and PIP from the perspective of participants with CNP. Methods 19 individual semi-structured interviews were conducted. Firstly, data were inductively coded and secondly, codes relating to acceptability were deductively mapped to Sekhon et al.'s Theoretical Framework of Acceptability. Results Six themes were constructed that align with domains of Sekhon's framework: Perceived effectiveness of the intervention; Perceived coherence of the intervention; Perceived burden associated with the intervention; Self-efficacy; Affective attitude towards the intervention. Both interventions were generally viewed positively with a greater focus on improvements in pain in the CMT group. The time burden associated with both interventions was acknowledged, however time spent with physiotherapists was valued for building rapport. For both interventions, participants highlighted strategies to improve intervention burden and coherence, including providing materials in multiple formats and providing an intervention roadmap. Conclusion Both interventions were acceptable to patients with CNP. For a future randomised trial, PIP is a suitable comparator to CMT.