Electronic Thesis and Dissertation Repository


Doctor of Philosophy


Health and Rehabilitation Sciences


Connelly, Denise M.


For older adults, physical exercise is especially important in maintaining functional independence, extending quality of life, and optimizing personal health resources. For patients with chronic pain conditions, exercise participation can significantly improve patient-reported symptoms. Older adults are the most sedentary age group with the majority not meeting the recommended duration and intensity of weekly exercise. Although nonadherence with exercise guidelines may result for a variety of reasons, adverse health conditions including chronic pain are likely of particular concern for older adults. The aim of this research, consisting of two studies employing interpretive phenomenology and constructivist grounded theory, was to understand the meaning of exercise in the lives of ten older adults with chronic back pain and the process by which nine physiotherapists provided exercise programs in caring for older adults with chronic back pain.

The findings of this research overall gave rise to four key insights, which may inform practice for presenting exercise for older adults with chronic back pain. First, is the centrality of a holistic approach to exercise – as involving mind and body, beliefs and behaviours – for management of older adults’ chronic back pain; both older adults and physiotherapists discussed the importance of incorporating older adults’ preferences and values into specific modes of exercise. Second, is the importance of maintaining a focus on function through exercise; with the acceptance of pain as ever-present for older adults living with chronic back pain, both the older adults and physiotherapists in these studies turned their focus toward maximizing functional capacity for maintaining independence, continuing engagement in meaningful activities, and improving quality of life. Third, is the importance of allowing time for older adults to integrate exercise into their lives; the transition to lifelong management of chronic back pain using exercise as a resource requires a lived experience and noticed benefit for older adults to their mind and body as a result of exercising. Finally, experiential learning to understand the meaning of exercise for older adults with chronic back pain may be instructive for physiotherapists and healthcare providers in the assessment and treatment of chronic back pain.

Understanding lived experiences of older adults who continue to exercise with daily pain carries important implications for clinical practice. Healthcare professionals are encouraged to reflexively consider their role in the therapeutic alliance with patients to more tactfully shape the presentation of exercise, supporting older adults to participate in exercise for maintained or improved overall health.