Learning elements in rehabilitation among the working population with low back pain (LBP).

Background:
Persons with LBP are challenged in reorganizing life in a new context, and learning processes seem to be a keypoint. Research shows disease-, realization process and relational context are important for the outcome of rehabilitation. The purpose of this study is to identify learning elements in different positions to the working population with LBP undergoing rehabilitation.
Methods:
Mixed methods were used to answer the research question. Based on Wenger´s theory of learning an interview guide was developed. 7 participants were interviewed. The qualitative findings were quantified in a survey (N = 40). To the analysis of learning elements Wenger´s theoretical context was used.
Results:
In the qualitative study 3 different positions of learning were identified: 1: minimum commitment with marginal participation. 2: minimum of engagement in learning with peripheral participation. 3: going from peripheral to central participation. To verify the identified 3 different positions of learning a quantitative questionnaire was conducted and the participants were asked to answer questions about learning elements based on Wenger´s theory. The results indicate most agreement to position 2 & 3.
Conclusion:
In this study 3 different positions of learning are identified. In the 3 learning positions the participants used different learning elements to develop meaningful negotiation in practice, create their own style and method to cope in rehabilitation. We suggest that future rehabilitation program include focus on the three positions of learning and that professionals are aware of the consequences of the three different positions in rehabilitation to persons with LBP. It is appropriated that guidelines and training programs for rehabilitation to persons with LBP include the 3 different positions of learning based on Wenger´s theory of learning. This can contribute to the fact that persons with LBP are less challenged in reorganizing life in a new context.Main messagesBased on Wenger´s theory of learning the study identified 3 positions of learning among the working population with LBP in rehabilitation. Future rehabilitation should focus on the 3 positions.