{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T08:43:54Z","timestamp":1776156234508,"version":"3.50.1"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Persistent musculoskeletal (MSK) disorders are one of the leading reasons for years lived with disability within the UK. Guidelines encourage integrating self\u2010management support. Hydrotherapy supports patients with persistent MSK conditions; however, self\u2010management following NHS\u2010led hydrotherapy has been inconsistent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To identify outcomes of hydrotherapy alongside the barriers, facilitators, and contributory factors affecting self\u2010management in the local persistent MSK pain population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between April 2023 and May 2023, a service evaluation was undertaken exploring factors affecting self\u2010management in the local persistent MSK pain population following NHS\u2010led hydrotherapy. Demographics, clinical factors, functional status (MSK\u2010HQ) and patient\u2010reported experiences, including barriers and facilitators to self\u2010management, were recorded. Data was analysed using descriptive statistics alongside exploration of themes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety patients completed hydrotherapy. White British (<jats:italic>n<\/jats:italic>\u00a0=\u00a024) and Indian British (<jats:italic>n<\/jats:italic>\u00a0=\u00a023) were the most common groups to attend. Multiple joint (<jats:italic>n<\/jats:italic>\u00a0=\u00a027) and spinal conditions (<jats:italic>n<\/jats:italic>\u00a0=\u00a026) were the most common MSK conditions. Mean pre\u2010 and post\u2010MSK\u2010HQ scores were 20.8 and 26.1, respectively. Among the contactable patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a069), 49 patients did not maintain independent water\u2010based self\u2010management reporting barriers such as ongoing support, access and financial concerns. Patients supported the establishment of a support group (<jats:italic>n<\/jats:italic>\u00a0=\u00a056) to help maintain water\u2010based exercises.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The local persistent MSK pain population lacks self\u2010efficacy for independent water\u2010based self\u2010management. A supportive and collaborative approach is proposed to address this via a patient\u2010led hydrotherapy support group.<\/jats:p><\/jats:sec>","DOI":"10.1002\/msc.70075","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T09:47:22Z","timestamp":1741772842000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring Barriers and Facilitators to Self\u2010Management for Patients With Persistent Musculoskeletal Conditions Following NHS\u2010Led Hydrotherapy: A Service Evaluation"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3886-1451","authenticated-orcid":false,"given":"Natasha","family":"Pathak","sequence":"first","affiliation":[{"name":"Musculoskeletal Physiotherapy Department Sandwell and West Birmingham NHS Trust  West Bromwich 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