Challenges with Daily Activities for patients with Prolapse Lumber Intervertebral Disc: An Explanatory Sequential Mixed Method Study

Abstract

Background: Prolapsed Lumbar Intervertebral Disc (PLID) is a prevalent musculoskeletal condition that significantly affects physical functioning and quality of life. It contributes to pain, disability, kinesiophobia, and impairs activities of daily living. This study aimed to assess the challenges faced by PLID patients in their everyday functioning through a mixed-methods approach. Methods: A mixed-method cross-sectional study was conducted at the Musculoskeletal Unit of CRP, Savar. A total of 68 participants diagnosed with PLID were selected through convenience sampling. Quantitative data were collected using standardized tools: the Visual Analogue Scale (VAS) for pain, the Oswestry Disability Index (ODI) for disability, the Tampa Scale of Kinesiophobia (TSK), and WHOQOL-BREF for quality of life. Qualitative data were obtained through in-depth interviews with 10 participants, focusing on personal care, mobility, lifting, social interaction, and travel difficulties. Data analysis was performed using SPSS v25 and thematic content analysis. Results: The majority of participants reported moderate to severe pain and disability, with 75% indicating high levels of kinesiophobia. Chi-square tests revealed significant associations between pain severity and variables such as age, sex, and marital status (p<0.05). Thematic analysis identified six major challenges: limitations in personal care, weight lifting, standing/sitting/walking/sleeping, traveling, and reduced social participation. Fear of movement and re-injury further aggravated their conditions and restricted rehabilitation participation. Conclusion: PLID has a profound impact on patients’ daily activities, physical mobility, emotional well-being, and social life. The combined quantitative and qualitative findings highlight the necessity of individualized rehabilitation strategies addressing pain, fear-avoidance beliefs, and functional limitations. Physiotherapists should integrate psychosocial support and patient education to enhance treatment adherence and improve overall quality of life. Keywords: Prolapsed Lumbar Intervertebral Disc (PLID), Daily activities, Pain, Disability, Kinesiophobia Quality of life, Mixed-method study, Rehabilitation, Functional limitations, Psychosocial support.