Le 14/10/2021 de 09:00 à 11:00

Retour Session


Beyond activity patterns: the complex process of activity management among patients with chronic musculoskeletal pain

Claude Pichonnaz (Lausanne, Suisse), François Luthi (Sion et Lausanne, Suisse), Céline Ancey (Lausanne, Suisse), Carla Ribeiro (Lausanne, Suisse), Christine Favre (Sion, Suisse, Suisse), Rose-Anna Roley (Lausanne, Suisse), Bertrand Léger (Sion, Suisse), Josiane Mbarga (Lausanne, Suisse)

Objectif : Following an accident, individuals face many limitations and disabilities that confront them with the dilemma of choosing which activities to resume or not. Though useful, the classification according to activity patterns (avoidance, modulation and persistence) neither provides insight into the patients’ strategies for managing activities, nor their underlying factors. The aim of this study was to investigate the relationship to activity of patients hospitalized for vocational rehabilitation after orthopedic trauma.

Matériel/Patients et méthodes : This qualitative research used observation of professional workshops and semi-structured interviews. A content analysis was conducted by an interdisciplinary team (physiotherapists, anthropologists, psychologist). Thirty-three patients were included (6♀/27♂, 44.9±10.6 y.o., 26 unemployed, 7 work at decreased rate, 11+/-2 months since accident).

Résultats : Participants combined various activity management strategies, based on their experience, lay knowledge and education gained during their care. Those who were flexible in their strategies were better able to resume their activities. All patients adjusted to activity limitations by switching between activity patterns according to activity nature, circumstances and context (private or professional). They weighted anticipated consequences and importance given to activity in their decisions.

Discussion - Conclusion : The relationship to activity is a dynamic process of constant negotiation with oneself and others rather than a personal trait. These results suggest that it would be appropriate to train the flexible use of a panel of skills and activity management strategies in rehabilitation, to favor for the achievement of valued activities by minimizing their unwanted consequences. Future research should investigate if this approach could effectively improve the activities’ recovery after orthopedic trauma.

Mots clés : rééducation - traumatisme - activité - recherche qualitative

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