Physiotherapist and Patient Perspectives on a Snack-based Physical Activity Application and Tracking Device for People with Chronic Non-specific Low Back Pain: A Qualitative Study

ABSTRACT Objectives: To explore patients' and physiotherapists' perspectives on a snack-based physical activity (PA) approach and mobile health technologies (mHealth) for non-specific chronic low back pain (NSCLBP). Snack-based PA refers to short, frequent bouts of activity (2-5 minutes) integrated into daily routines. Design: Qualitative study using Interpretative Phenomenological Analysis (IPA) of semi-structured online interviews. Setting: Community-based recruitment in the United Kingdom. Interviews were conducted online via Microsoft Teams between May and November 2024. Participants: Sixteen participants were purposively sampled: eight adults with NSCLBP (lasting >=3 months in the previous year) and eight physiotherapists with >=2 years' experience managing people with NSCLBP. Results: Three shared themes were identified across both groups: (1) understanding the needs and requirements of PA; (2) perceptions of snack-based activity; and (3) factors influencing mobile health application use. Five subthemes were identified within themes one and three, together with two additional subthemes reported only by patients, relating to data sharing and technical issues. Both groups valued the time-efficiency and practical integration of snack-based activity, while highlighting the need for personalisation, age-appropriate content, accessibility and affordability. Conclusions: Physiotherapists and patients emphasised the potential value of the snack-based PA approach in terms of adherence. However, both groups agreed that future intervention development should prioritise personalisation, user-friendly design, and equitable digital access. Keywords: Low Back Pain; Chronic Pain; Exercise; Physical Activity; Qualitative Research; Mobile Applications; Telemedicine; Patient Compliance; Physical Therapists; Snack-based Physical Activity.