Changes in physiotherapy students’ beliefs and attitudes about low back pain through pre-registration training

Abstract

Background Implementation of best-practice care for patients with low back pain (LBP) is an important issue. Physiotherapists’ who hold unhelpful beliefs are less likely to adhere to guidelines and may negatively influence their patients’ beliefs. Pre-registration education is critical in moving towards a biopsychosocial model of care. This study aimed to investigate the changes in 2nd year physiotherapy students’ beliefs about LBP after a module on spinal pain management and determine whether these changes were maintained at the end of academic training. Methods During three consecutive calendar years, this longitudinal cohort study assessed physiotherapy students’ beliefs with the Back Pain Attitudes Questionnaires (Back-PAQ) in their 1st year, before and after their 2nd year spinal management learning module, and at the end of academic training (3rd year). Unpaired t-tests were conducted to explore changes in Back-PAQ score. Results The mean response rate after the spinal management module was 90% (128/143 students). The mean (± SD) Back-PAQ score was 87.73 (± 14.21) before and 60.79 (± 11.44) after the module, representing a mean difference of − 26.95 (95%CI − 30.09 to − 23.80, p < 0.001). Beliefs were further improved at the end of 3rd year (− 7.16, 95%CI − 10.50 to − 3.81, p < 0.001). Conclusions A spinal management learning module considerably improved physiotherapy students’ beliefs about back pain. Specifically, unhelpful beliefs about the back being vulnerable and in need of protection were substantially decreased after the module. Improvements were maintained at the end of academic training one-year later. Future research should investigate whether modifying students’ beliefs leads to improved clinical practice in their first years of practice.

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

“…This was because the lack of female participants in the PT group was present across all year groups, but significance was detected largely in the 3 rd year group. The cross-sectional nature precludes making within-subject inferences about whether the back pain beliefs and fear levels of a student improve across study years [ 25 ]. Given that the study programmes investigated in this study may differ in their curricula across different HEIs, extrapolating our findings nationally and internationally should be done with caution.…”

“…It has been reported that PT students had more positive beliefs about LBP than medical, OT, and pharmacy students [ 22 ], as well as more positive beliefs about the harmfulness of common daily activities than OT and nursing students, respectively [ 19 ], but there was no differentiation among academic year groups. Understanding the effect of the study year and its possible interaction across different degree programmes may be important given research has reported an improvement in positive beliefs about LBP across study years [ 25 ]. Beliefs about LBP can also be affected by the course, with one study reporting that PT students had more positive LBP attitudes than non-healthcare students, although the nature of non-healthcare programmes were not provided [ 21 ].…”

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].…”

What influences graduate medical students’ beliefs of lower back pain? A mixed methods cross sectional study

“…Negative views regarding chronic pain have also been found in medical students [ 15 ]. Despite these findings, beliefs and attitudes towards pain and LBP amongst healthcare and medical students have been shown to improve during study, demonstrating the effectiveness of education [ 24 , 38 , 39 ]. For example, medical students have been found to believe LBP myths including ‘back pain is likely to be caused by heavy lifting’.…”