Attitudes and beliefs on low back pain in physical therapy education: A cross-sectional study

Abstract

Background: Prescription behavior in low back pain (LBP) differs between physical therapists with a biomedical versus a biopsychosocial belief, despite the presence of clinical guidelines. Objective: To examine (1) the beliefs of physical therapy students and their adherence to clinical LBP guidelines in Belgium and the Netherlands; (2) whether the beliefs and attitudes of physical therapy students change during education; (3) whether beliefs are related to guideline adherence; (4) whether beliefs and attitudes differ with or without a personal history of LBP. Methods: A cross-sectional design included students in the 2nd and 4th year of physical therapy education in 6 Belgian and 2 Dutch institutions. To quantify beliefs, the Pain Attitudes and Beliefs Scale, the Health Care Providers' Pain and Impairment Relationship Scale, and a clinical case vignette were used. Results: In total, 1624 students participated. (1) Only 47% of physical therapy students provide clinical guidelines' consistent recommendations for activity and 16% for work. (2) 2nd year students score higher on the biomedical subscales and lower on the psychosocial subscale. 4th year students make more guideline consistent recommendations about work and activity. (3) Students with a more biopsychosocial belief give more guideline adherent recommendations. (4) Personal experience with LBP is not associated with different beliefs or attitudes.

Pain Neurophysiology Knowledge Enhances Attitudes toward Biopsychosocial Management of Low Back Pain among Japanese Physical Therapists

“…A more pronounced biomedical orientation (indicating a belief that pain and disability result from a specific structural impairment and that treatment should be selected to address this impairment) negatively influences patient outcomes, resulting in less compliance with the clinical practice guidelines for LBP. [1][2][3] In Japan, Takasaki et al 4) found that therapists credentialed in Mechanical Diagnosis and Therapy (MDT), an internationally standardized postgraduate clinical qualification, were more biopsychosocially oriented and less biomedically oriented than other physical therapists. It was also found that possession of a postgraduate academic degree was a contributing factor for compliance with clinical practice guidelines in examinations using established clinical vignettes.…”

“…A more pronounced biomedical orientation (indicating a belief that pain and disability result from a specific structural impairment and that treatment should be selected to address this impairment) negatively influences patient outcomes, resulting in less compliance with the clinical practice guidelines for LBP. 1 , 2 , 3 )…”

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

“…As previously indicated, professional education behaves as a key element in introducing new biopsychosocial paradigms of LBP care paradigms into clinical practice. Currently, new works such as Leysen et al (2021) and found useless beliefs about back sensitivity and the need for protection among physiotherapy students and developed crosssectional studies to evaluate changes in attitudes and beliefs during their training [22,23].…”

A cross-sectional investigation of back pain beliefs and fear in physiotherapy and sport undergraduate students

“…Evidence suggests that LBP beliefs are already present in the emerging HCP workforce [ 16 ], which suggests that educational factors play an important role in the formation of such beliefs. To date, beliefs related to LBP have been investigated in students enrolled in HCP disciplines such as physiotherapy (PT) [ 17 – 21 ], medicine [ 22 – 24 ], nursing [ 17 , 19 , 20 ], pharmacy [ 22 ], chiropractic [ 22 ], occupational therapy (OT) [ 19 , 22 ], and midwifery [ 23 ].…”