Evidence map›Paper›PMID 42286624›Full record

ArticleBMC health services research2026

Structural barriers and facilitators of accessing rehabilitation among adults aged 50 years and older with low back pain: a scoping review of the literature.

Jessica J Wong, Lauren Ead, Alanna Veitch, Nora Bakaa, Kennedy Latour, Jen Rinaldi, Ginny Brunton, Heather Shearer, Michelle Hewitt, Kent Murnaghan and 1 more

Abstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jessica J WongSchool of Physical Therapy, Faculty of Health Sciences, Western University, 1201 Western Road, London, ON, N6G 1H1, Canada. jessica.wong@uwo.ca.
Lauren EadInstitute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, Canada.
Alanna VeitchInstitute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, Canada.
Nora BakaaSchool of Physical Therapy, Faculty of Health Sciences, Western University, 1201 Western Road, London, ON, N6G 1H1, Canada.
Kennedy LatourUndergraduate Education, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
Jen RinaldiInstitute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, Canada.
Ginny BruntonInstitute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, Canada.
Heather ShearerInstitute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, Canada.
Michelle HewittDisability Without Poverty, Kelowna, BC, Canada.
Kent MurnaghanLibrary Services, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
Pierre CôtéInstitute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOlder adults with low back pain (LBP) experience challenges when seeking rehabilitation; a comprehensive view of structural factors to access is needed to inform rehabilitation delivery. We aimed to systematically map the experiences regarding structural barriers and facilitators to accessing rehabilitation among adults aged 50 years and older with LBP; and explore whether experiences vary by social factors.

methodsWe conducted a scoping review based on Joanna Briggs Institute methodology. Eligible studies were qualitative and mixed-method studies (qualitative component) on structural barriers or facilitators to rehabilitation access among adults ≥ 50 years with LBP. Structural factors included socioeconomic and political contexts, governance, policies, and cultural/societal values. We searched databases from inception to February 2025. Paired reviewers independently screened citations and extracted data. We conducted a descriptive synthesis to map the structural barriers/facilitators and identify knowledge gaps. An Advisory Committee including people with lived experience, family members, and healthcare practitioners provided critical input across stages.

resultsOf the 8550 citations screened, 16 studies were relevant (3 from middle-income countries, 12 from high-income countries, 1 covering both; 12 studies on LBP, 4 studies on lumbar spinal stenosis). Common domains of structural barriers/facilitators to access were mapped for LBP and lumbar spinal stenosis in middle- or high-income countries: (1) finances (e.g., costs, insurance coverage, financial support from family); (2) location, transportation, inaccessibility or service unavailability (e.g., inadequate public transportation, wait-times, close proximity to services and resources); (3) lack of knowledge, perceptions, or stigma with certain rehabilitation approaches (e.g., limited education of treatment options provided to patients). Some older adults described ageism from providers (e.g., advised to accept back pain as part of aging) or stigma with certain rehabilitation approaches (e.g., mobility aids) as barriers. Studies in high-income countries also explored healthcare-related factors (e.g., referrals, collaboration across providers) as structural barriers/facilitators to access. Findings varied by rurality, socioeconomic strata, and disabilities.

conclusionsIn middle- and high-income countries, older adults with LBP or lumbar spinal stenosis experience many structural barriers to rehabilitation access that vary across social factors. Structural factors relate to finances, location/transportation, availability of services, healthcare provider-related factors, ageism, and stigma. Findings inform future work towards strategies for equitable rehabilitation delivery in middle- and high-income countries. Research is needed in low-income countries.

Indexed as

Health Services AccessibilityLow Back PainAgedHumansMiddle AgedSocioeconomic FactorsAgingBarriersFacilitatorsLow back painMusculoskeletalOlder adultsRehabilitationScoping reviewSocial factorsStructural factors

Identifiers

PMID42286624
PMCPMC13491603

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.