Survey of the Barriers, Enablers, and Preferences to Swimming for People With Chronic Low Back Pain

Background and Purpose: It is common practice for health professionals to recommend swimming to people with chronic low back pain (CLBP) for rehabilitation and pain management and to improve levels of physical activity. Uptake and engagement in swimming involve a change in behavior, influenced by various factors including barriers, enablers, and preferences. The aim of this study was to identify the most common barriers, enablers, and preferences to swimming for people with CLBP and map them onto the Capability Opportunity Motivation-Behavior (COM-B) model. Methods: People with CLBP were invited to complete a survey collecting data regarding the barriers, enablers, and preferences in relation to swimming. The questions were scored on a 5-point Likert scale and mapped onto the COM-B model. Results: Eighty-two people completed the survey. More than 50% of participants agreed with the following barriers: I am not sure which swimming stroke is best for my back pain and I lack motivation to go swimming. These barriers mapped to the psychological capability and reflective motivation dimensions on the COM-B model. At least 50% of participants agreed with the following enablers: I would like to use swimming to improve my strength, flexibility, weight, fitness, health, mood, and well-being; setting goals and making an action plan could help me swim regularly, I am more likely to go swimming if a health professional advised me and I believe that swimming is good for my back. These enablers were also mapped to the reflective motivation and physical and social opportunity dimensions on the COM-B model. Discussion and Conclusions: The findings from this survey suggest that when recommending swimming, health professionals should discuss the wider health benefits of swimming, discuss specific swimming strokes and why swimming could be beneficial for back pain, and consider using motivational tools to encourage reflective motivation such as goal setting and action planning.