Attitudes and beliefs towards low back pain (LBP) among physiotherapists in Spain

  1. Pérez, Sebastián Eustaquio Martín
  2. González, Lucía Llanos
  3. Acevedo, Irene Acosta
  4. Barrera, Raúl Bilbao
  5. Pérez, José Luis Alonso
  6. Romero, Eleuterio Atanasio Sánchez
  7. Reina, María Dolores Sosa
  8. Pérez, Isidro Miguel Martín
  9. Villafañe, Jorge Hugo
  1. 1 Universidad Europea de Canarias
    info

    Universidad Europea de Canarias

    Orotava, España

    ROR https://ror.org/051xcrt66

  2. 2 Universidad Europea de Madrid
    info

    Universidad Europea de Madrid

    Madrid, España

    ROR https://ror.org/04dp46240

  3. 3 Onelife Center, Multidisciplinary Pain Treatment Center
  4. 4 Universidad de La Laguna
    info

    Universidad de La Laguna

    San Cristobal de La Laguna, España

    ROR https://ror.org/01r9z8p25

  5. 5 IRCCS Fondazione Don Carlo Gnocchi, Milan
Mostrar afiliaciones +
Revista:
Bulletin of Faculty of Physical Therapy

ISSN: 1110-6611,  2536-9660

Año de publicación: 2022

Volumen: 27

Número: 1

Tipo: Artículo

DOI: 10.1186/S43161-022-00112-9 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Bulletin of Faculty of Physical Therapy

Objetivos de desarrollo sostenible

Resumen

BackgroundThe aim of this study is to investigate the attitudes and beliefs of Spanish physiotherapists towards the diagnosis and management of low back pain (LBP). A descriptive, cross-sectional study was conducted according to STROBE guidelines from December 18, 2021, to May 2022. An online survey was developed based on Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), a reliable and validated self-administered instrument developed to assess the strength of two possible treatment orientations of physiotherapists towards the diagnosis and management of LBP. Respondents were selected through a non-probabilistic convenience sampling technique, and the selection criteria were (1) active physiotherapists with no restrictions on gender and length of service, (2) physical therapists who have worked in both public and private environments, and (3) physiotherapists who have been officially registered with no restriction on the place of practice in Spain. Survey data was obtained and analyzed using the SPSS Statistic 28 (IBM®) statistical software.ResultsThree hundred eighty-one questionnaires were finally included (F;n=151, M;n=230). In relation to the diagnosis, the respondents indicated that the tissue damage was sufficient to explain widespread and lasting pain, but rather that it was due to psychological factors. In addition, for those surveyed, the diagnosis should not focus exclusively on imaging tests but on clinical symptoms and signs. However, the weak relationship between objective damage and perceived pain intensity, as well as the weak relationship between posture and the development or worsening of LBP, did not seem to be clear to physiotherapists. From the point of view of treatment, we can indicate that professionals are committed to maintaining adequate and individualized physical activity as a first-line treatment in pain management.ConclusionsMost physiotherapists in Spain have up-to-date knowledge of the biopsychosocial model of pain care. However, regarding attitudes and beliefs towards LBP, there are still contents and behaviors based on spine protective paradigms that are not conducive to active pain management.

€ Ver financiación

Información de financiación

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors

Referencias bibliográficas

  • Vlaeyen JWS, Maher CG, Wiech K, Van Zundert J, Meloto CB, Diatchenko L, et al. Low back pain. Nat Rev Dis Primers. 2018;4(1):52. https://doi.org/10.1038/s41572-018-0052-1.
  • Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976–82. https://doi.org/10.1097/j.pain.0000000000001939.
  • Kusnanto H, Agustian D, Hilmanto D. Biopsychosocial model of illnesses in primary care: a hermeneutic literature review. J Family Med Prim Care. 2018;7(3):497–500. https://doi.org/10.4103/jfmpc.jfmpc_145_17.
  • Waddell G. 1987 Volvo award in clinical sciences. A new clinical model for the treatment of low-back pain. Spine (Phila Pa 1976). 1987;12(7):632–44. https://doi.org/10.1097/00007632-198709000-00002.
  • Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ. 2015;350:h444. https://doi.org/10.1136/bmj.h444.
  • Fagundes FR, de Melo do Espírito Santo C, de Luna Teixeira FM, Tonini TV, Cabral CM. Effectiveness of the addition of therapeutic alliance with minimal intervention in the treatment of patients with chronic, nonspecific low back pain and low risk of involvement of psychosocial factors: a study protocol for a randomized controlled trial (TalkBack trial). Trials. 2017;18(1):49. https://doi.org/10.1186/s13063-017-1784-z.
  • Ferreira PH, Ferreira ML, Maher CG, Refshauge KM, Latimer J, Adams RD. The therapeutic alliance between clinicians and patients predicts outcome in chronic low back pain. Phys Ther. 2013;93(4):470–8. https://doi.org/10.2522/ptj.20120137.
  • Forbes R, Ingram M. New-graduate physiotherapists’ readiness for practice and experiences of managing chronic pain; a qualitative study. Physiother Theory Pract. 2021;37(11):1177–84. https://doi.org/10.1080/09593985.2019.1692394.
  • Sanders T, Foster NE, Bishop A, Ong BN. Biopsychosocial care and the physiotherapy encounter: physiotherapists’ accounts of back pain consultations. BMC Musculoskelet Disord. 2013;14:65. https://doi.org/10.1186/1471-2474-14-65.
  • Sharma S, Abbott JH, Jensen MP. Why clinicians should consider the role of culture in chronic pain. Braz J Phys Ther. 2018;22(5):345–6. https://doi.org/10.1016/j.bjpt.2018.07.002.
  • Pottkotter K, Hazlett M, Mansfield C, Ford K, Rethman K, Fritz J, et al. Understanding social determinants of health and physical therapy outcomes in patients with low back pain: a scoping review protocol. Musculoskeletal Care. 2022. https://doi.org/10.1002/msc.1624.
  • Magalhães MO, Costa LO, Cabral CM, Machado LA. Attitudes and beliefs of Brazilian physical therapists about chronic low back pain: a cross-sectional study. Rev Bras Fis. 2012;16(3):248–53. https://doi.org/10.1590/s1413-35552012005000014.
  • Eland ND, Kvåle A, Ostelo RWJG, de Vet HCW, Strand LI. Discriminative validity of the pain attitudes and beliefs scale for physical therapists. Phys Ther. 2019;3(99):339–53. https://doi.org/10.1093/ptj/pzy139h.
  • Gardner T, Refshauge K, Smith L, McAuley J, Hübscher M, Goodall S. Physiotherapists’ beliefs and attitudes influence clinical practice in chronic low back pain: a systematic review of quantitative and qualitative studies. J Physiother. 2017;63(3):132–43. https://doi.org/10.1016/j.jphys.2017.05.017.
  • Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811–6. https://doi.org/10.3174/ajnr.A4173.
  • Oliveira CB, Maher CG, Pinto RZ, Traeger AC, Lin CC, Chenot JF, et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018;27(11):2791–803. https://doi.org/10.1007/s00586-018-5673-2.
  • George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, et al. Interventions for the management of acute and chronic low back pain: revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1-CPG60. https://doi.org/10.2519/jospt.2021.0304.
  • Swain CTV, Pan F, Owen PJ, Schmidt H, Belavy DL. No consensus on causality of spine postures or physical exposure and low back pain: a systematic review of systematic reviews. J Biomech. 2020;102:109312. https://doi.org/10.1016/j.jbiomech.2019.08.006.
  • Kripa S, Kaur H. Identifying relations between posture and pain in lower back pain patients: a narrative review. Bull Fac Phys Ther. 2021;26:34. https://doi.org/10.1186/s43161-021-00052-w.
  • Christe G, Nzamba J, Desarzens L, Leuba A, Darlow B, Pichonnaz C. Physiotherapists’ attitudes and beliefs about low back pain influence their clinical decisions and advice. Musculoskelet Sci Pract. 2021;53:102382. https://doi.org/10.1016/j.msksp.2021.102382.
  • Alshehri MA, Alzahrani H, Alotaibi M, Alhowimel A, Khoja O. Physiotherapists’ pain attitudes and beliefs towards chronic low back pain and their association with treatment selection: a cross-sectional study. Open. 2020;10:e037159. https://doi.org/10.1136/bmjopen-2020-037159.
  • Leysen M, Nijs J, Van Wilgen P, Demoulin C, Dankaerts W, Danneels L, et al. Attitudes and beliefs on low back pain in physical therapy education: a cross-sectional study. Braz J Phys Ther. 2021;25(3):319–28. https://doi.org/10.1016/j.bjpt.2020.08.002.
  • Christe G, Darlow B, Pichonnaz C. Changes in physiotherapy students’ beliefs and attitudes about low back pain through pre-registration training. Arch Physiother. 2021;11(1):13. https://doi.org/10.1186/s40945-021-00106-1.