Physical Therapists' Clinical Knowledge of Multidisciplinary Low Back Pain Treatment Guidelines

Learman, Kenneth; Ellis, Alyson; Goode, Adam P.; Showalter, Christopher; Cook, Chad

doi:10.2522/ptj.20130567

Cited by 22 publications

(26 citation statements)

References 30 publications

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“…Although the sample size in the present study is similar to that in previous studies [6,30], larger multi-center cohorts will be required to increase generalizability. Third, we did not investigate PT's knowledge about pain neuroscience [31], their attitude toward biopsychosocial perspectives for LBP management [24,32,33], and their adherence to clinical practice guidelines for LBP management [34]. These potential confounders should be considered in future studies with larger samples of PTs to help identify the contributing factors for increasing the ability of PTs to understand a patient's psychological status through physical therapy evaluation.…”

Section: Limitationsmentioning

confidence: 99%

Difference between physical therapist estimation and psychological patient-reported outcome measures in patients with low back pain

Miki¹,

Kondo²,

Takebayashi³

et al. 2020

PLoS ONE

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Minimizing the number of patient-reported outcome measures (PROMs) can reduce patient burden. The primary aim of the present study was to investigate whether physical therapists (PTs) can estimate psychological PROM scores in patients with low back pain (LBP) through physical therapy evaluation. The secondary aims were; 1) to investigate whether the clinical experiences of PTs influence correlations between PT estimates and psychological PROM scores, and 2) to investigate the sensitivity and specificity of PT estimates for the psychological features detected by the PROMs. We recruited hospitalized patients owing to LBP, who underwent evaluation by PTs on the initial day of hospitalization. Patients completed PROMs, including the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia, and Hospital Anxiety and Depression Scale immediately before the initial physical therapy session. PTs rated the magnitude of patient kinesiophobia, pain catastrophizing, anxiety, and depression using an 11-point numerical rating scale (NRS; 0 = not detected at all, 10 = very highly detected) through physical therapy evaluation immediately after the initial session. The PTs were blinded to the PROM results. We categorized PTs into two subgroups (PTs with �4 years and those with <4 years of clinical experience). Data from 78 patients (mean [SD] age = 60.5 [16.3] years) and 21 PTs were analyzed. A statistically significant but weak correlation (P = .04, Spearman's ρ = .24) was detected only in the total PCS scores and PT NRS scores in a dataset of all patients and PTs. Further, there were no statistically significant differences in correlations (all P >.05) between the two subgroups of PTs in all measures. Low sensitivity and high specificity of PT estimates for psychological features through physical therapy evaluation were identified in all PROMs when PT NRS scores were categorized into the binary score by 5 (negative: <5; positive: �5).

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Section: Limitationsmentioning

confidence: 99%

Difference between physical therapist estimation and psychological patient-reported outcome measures in patients with low back pain

Miki¹,

Kondo²,

Takebayashi³

et al. 2020

PLoS ONE

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“…Hendrick et al [5] found that less biomedical oriented approach was associated with adherence to LBP practice guidelines. Therefore, we contend that the management of LBP from both biomedical and behavioral perspectives and other potential factors may be associated with adherence to guidelines [5] [6], for example, demographic factors, the highest education level attained, the attitude of therapists towards self-directed learning to facilitate evidence-based clinical practice (e.g. participation in workshops and conferences, and engaging in literature review).…”

Section: Introductionmentioning

confidence: 99%

McKenzie Therapists Adhere More to Evidence-Based Guidelines and Have a More Biopsychosocial Perspective on the Management of Patients with Low Back Pain than General Physical Therapists in Japan

Takasaki¹,

Saiki²,

Iwasada³

2014

OJTR

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Design: Cross-sectional. Objective: Aim 1 was to preliminarily explore the contributions of the following factors to adherence to LBP practice guidelines using regression modeling: 1) the credential qualification of Mechanical Diagnosis and Therapy (MDT); 2) balance of biomedical and behavioral (i.e. biopsychosocial) oriented approach for low back pain (LBP); 3) demographics; 4) academic degree and 5) the attitude towards updating information for evidence-based clinical practice. Aim 2 was to investigate whether therapists credentialed in MDT (Cred.MDT) were more behavioral oriented and less biomedical oriented than general physical therapists. Summary of Background Data: LBP practice guidelines are not adhered to by every physical therapist. MDT is a behavioral modification approach. Thus, it was hypothesized that the Cred.MDT therapist was more behavioral oriented and more adherent to LBP practice guidelines compared with general physical therapists. Methods: One-hundred-twenty Cred.MDT therapists and 2000 general physical therapists in Japan were contacted. For regression modeling, the dependent variable was adherent to guidelines using a questionnaire with a vignette. Independent variables included balance of biomedical and behavioral perspectives for LBP using the Pain Attitudes and Beliefs Scale for Physiotherapist (PABS-PT), demographics, academic degree and the attitude towards updating * Corresponding author. H. Takasaki et al. 174 information for evidence-based clinical practice. The ratio of the two mean scores of the biomedical and behavioral subscales in the PABS-PT was compared between the Cred.MDT therapist group and the general physical therapists group. Results: Data of 46 general physical therapists and 44 Cred.MDT therapists were available. The Cred.MDT therapist group was significantly (P < 0.05) more behavioral oriented and more adherent to LBP practice guidelines compared with the general physical therapist group. The regression indicated significance of the two predictors of adherence to guidelines, Cred.MDT (β = 0.58, P < 0.001) and academic degree (β = 0.19, P = 0.03). Conclusions: Cred.MDT therapists are more guideline-consistent and have a more biopsychosocial treatment orientation than general physical therapists in Japan.

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“…Such deficiencies in patient knowledge and practice may be attributed to related deficiencies in knowledge or educational role among their caregivers. In agreement with this explanation, Learman et al (2014) in a study in the United States and Canada found that only 16.6% of the participating physiotherapists correctly answered questions regarding LBP imaging, appropriate medication, and advice to stay active. The application of the present study instruction protocol had a positive impact on participants' knowledge and reported practice.…”

Section: Discussionmentioning

confidence: 84%

Nursing intervention protocol for adult patients experiencing chronic low back pain

Taha¹,

Mohamed²,

Elaziz³

2015

Cent Eur J Nurs Midw

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Aim: The aim of this study was to evaluate the effectiveness of a nursing intervention protocol targeting the knowledge and practice of adult patients experiencing low back pain. Design: A quasi-experimental research design. Methods: Pre-post assessment of outcome was used in this study. The study was conducted in the outpatient clinic of the physical therapy department at Zagazig University Hospital and Beni-Suef University Hospital, Egypt. Sample: 40 participants diagnosed with chronic low back pain (lasting for longer than six months). Seven of the 40 dropped out during the follow-up phase for personal or logistical reasons. Tools included sections for demographic characteristics, knowledge and practice assessment; in addition to the Oswestry Disability Index, and Visual Analogue Scale (VAS). Results: The application of an instruction protocol intervention for low back pain was effective in improving patient knowledge and practice, with associated amelioration of the severity of pain and disability among them. The effect was still apparent at the three-month follow-up. Conclusion: It is recommended that the study be replicated using a more robust randomized clinical trial design. Nonetheless, the instruction protocol with the designed booklet may be adopted as an element of the care services offered to patients suffering LBP, given the clear positive effects on patient knowledge, which would undoubtedly help them decide on the most preferential management approach.

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Physical Therapists' Clinical Knowledge of Multidisciplinary Low Back Pain Treatment Guidelines

Abstract: The survey identified varied understanding of CPGs when making decisions that were similar in recommendation to the CPGs. No single predictor for correct responses for LBP CPGs was found.

Cited by 22 publications

References 30 publications

Difference between physical therapist estimation and psychological patient-reported outcome measures in patients with low back pain

Difference between physical therapist estimation and psychological patient-reported outcome measures in patients with low back pain

McKenzie Therapists Adhere More to Evidence-Based Guidelines and Have a More Biopsychosocial Perspective on the Management of Patients with Low Back Pain than General Physical Therapists in Japan

Nursing intervention protocol for adult patients experiencing chronic low back pain

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