Physiotherapists’ beliefs and attitudes influence clinical practice in chronic low back pain: a systematic review

Physiotherapists’ beliefs and attitudes influence clinical practice in chronic low back pain: a systematic review

What influence do physiotherapists’ beliefs and attitudes about chronic low back pain have on their clinical management of people with chronic low back pain? This question was answered by using a systematic review design with data from quantitative and qualitative studies. Quantitative and qualitative studies were included if they investigated an association between physiotherapists’ attitudes and beliefs about chronic low back pain and their clinical management of people with chronic low back pain.

Five quantitative and five qualitative studies were included. Quantitative studies used measures of treatment orientation and fear avoidance to indicate physiotherapists’ beliefs and attitudes about chronic low back pain. Quantitative studies showed that a higher biomedical orientation score (indicating a belief that pain and disability result from a specific structural impairment, and treatment is selected to address that impairment) was associated with: advice to delay return to work, advice to delay return to activity, and a belief that return to work or activity is a threat to the patient. Physiotherapists’ fear avoidance scores were positively correlated with: increased certification of sick leave, advice to avoid return to work, and advice to avoid return to normal activity. Qualitative studies revealed two main themes attributed to beliefs and attitudes of physiotherapists who have a relationship to their management of chronic low back pain: treatment orientation and patient factors.

Both quantitative and qualitative studies showed a relationship between treatment orientation and clinical practice. The inclusion of qualitative studies captured the influence of patient factors in clinical practice in chronic low back pain. There is a need to recognise that both beliefs and attitudes regarding treatment orientation of physiotherapists, and therapist-patient factors need to be considered when introducing new clinical practice models, so that the adoption of new clinical practice is maximised.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.
Scott BuxtonResearch article posted by: Scott Buxton

Scott is editor of Physiospot so expect to see his work popping up frequently. Away from the keyboard he is a physiotherapist specialising in geriatrics.

Speak Your Mind

*