Treatment of patients of nonspecific chronic low back pain by physical therapists: a cross-sectional study

Marcele Bueno Desconsi; Patrícia Thurow Bartz; Taís Regina Fiegenbaum; Cláudia Tarragô Candotti; Adriane Vieira

doi:10.1590/1809-2950/17003626012019

Authors

Marcele Bueno Desconsi Universidade Federal do Rio Grande do Sul (UFRGS) – Porto Alegre (RS) Brasil https://orcid.org/0000-0001-6594-967X
Patrícia Thurow Bartz Universidade Federal do Rio Grande do Sul (UFRGS) – Porto Alegre (RS) Brasil https://orcid.org/0000-0001-5715-9205
Taís Regina Fiegenbaum Universidade Federal do Rio Grande do Sul (UFRGS) – Porto Alegre (RS) Brasil https://orcid.org/0000-0002-0788-5900
Cláudia Tarragô Candotti Universidade Federal do Rio Grande do Sul. RS. Brasil https://orcid.org/0000-0002-8676-9157
Adriane Vieira Universidade Federal do Rio Grande do Sul (UFRGS) – Porto Alegre (RS) Brasil https://orcid.org/0000-0003-3846-0873

DOI:

https://doi.org/10.1590/1809-2950/17003626012019

Keywords:

Low Back Pain, Physical Therapy Specialty, Attitude, Unified Health System

Abstract

Current studies have investigated the orientation of treatment that physical therapists adopt when treating nonspecific chronic low back pain (CLBP) by assessing their attitudes and beliefs. However, in Brazil, little is known about this subject, especially in the context of the Unified Health System. This study aimed to describe the attitudes and beliefs of the physical therapists working in the Unified Health System treating patients with nonspecific chronic CLBP and to identify the relationship between their demographic and professional characteristics and the treatment guidelines for nonspecific chronic CLBP. This is a cross-sectional population-based study. Data were collected using a demographic and professional questionnaire, and the Pain Attitudes and Beliefs Scale for Physiotherapists. Fortynine physical therapists participated in the study, and the results showed higher agreement with attitudes and beliefs related to a biomedical orientation. The score in this scale was 15.5% higher than in the behavioral one, and the correlation (p<0.05) between the time since graduation and the biopsychosocial treatment orientation was regular and positive. The conclusion was that biomedical beliefs were predominant among the physical therapists who treated nonspecific chronic CLBP in Unified Health System patients. This study also showed physical therapists with more time since graduation were more influenced by the biopsychosocial orientation.

Downloads

Download data is not yet available.

References

Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML,

Genevay S, et al. What low back pain is and why we need to

pay attention. Lancet. 2018;391(10137):2356-2367. doi: 10.1016/

S0140-6736(18)30480-X

Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The

global burden of low back pain: estimates from the Global

Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968-

doi: 10.1136/annrheumdis-2013-204428

Instituto Brasileiro de Geografia e Estatística - IBGE. Pesquisa

Nacional de Saúde 2013: percepção do estado de saúde, estilos

de vida e doenças crônicas [Internet]. Rio de Janeiro: IBGE;

[cited 2019 Jan 23]. Available from: ftp://ftp.ibge.gov.br/

PNS/2013/pns2013.pdf

Hasenbring MI, Rusu AC, Turk DC, editors. From acute to chronic

back pain: risk factors, mechanisms, and clinical implications.

st. ed. Oxford: Oxford University Press. 590p.

van Tulder M, Koes B, Bombardier C. Low back pain. Best

Pract Res Clin Rheumatol. 2002;16(5):761-75. doi: 10.1053/

berh.2002.0267

Koes BW, van Tulder M, Lin CC, Macedo LG, McAuley J, Maher C.

An updated overview of clinical guidelines for the management

of non-specific low back pain in primary care. Eur Spine J.

;19(12):2075-94. doi: 10.1007/s00586-010-1502-y

Hendrick P, Mani R, Bishop A, Milosavljevic S, Schneiders AG.

Therapist knowledge, adherence and use of low back pain

guidelines to inform clinical decisions – a national survey of

manipulative and sports physiotherapists in New Zealand. Man

Ther. 2013;18(2):136-42. doi: 10.1016/j.math.2012.09.002

Fullen BM, Baxter GD, Doody C, Daly LE, Hurley DA. General

practitioners’ attitudes and beliefs regarding the management

of chronic low back pain in Ireland: a cross-sectional

national survey. Clin J Pain. 2011;27(6):542-9. doi: 10.1097/

AJP.0b013e31821771e2

Derghazarian T, Simmonds MJ. Management of low back pain

by physical therapists in Quebec: how are we doing? Physiother

Can. 2011;63(4):464-73. doi: 10.3138/ptc.2010-04P

Sit RW, Yip BH, Chan DC, Wong SY. Primary care physicians’

attitudes and beliefs towards chronic low back pain: an Asian

study. PLoS One. 2015;10(1):e0117521. doi: 10.1371/journal.

pone.0117521

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 Fisioter. 2012;16(3):248-

doi: 10.1590/S1413-35552012005000014

Magalhães MO, Costa LOP, Ferreira Ml, Machado LAC. Testes

clinimétricos de dois instrumentos que mensuram atitudes

e crenças de profissionais de saúde sobre a dor lombar

crônica. Rev Bras Fisioter. 2011;15(3):249-56. doi: 10.1590/

S1413-35552011000300012

Callegari-Jacques SM. Bioestatística: princípios e aplicações.

st ed. Porto Alegre: Artmed, 2007; 264 p.

Buchbinder R, van Tulder M, Öberg B, Costa LM, Woolf A,

Schoene M, et al. Low back pain: a call for action. Lancet.

;391(10137):2384-8. doi: 10.1016/S0140-6736(18)30488-4

Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross

DP, et al. Prevention and treatment of low back pain:

evidence, challenges, and promising directions. Lancet.

;391(10137):2368-83. doi: 10.1016/S0140-6736(18)30489-6

Ostelo RW, Stomp-van den Berg SG, Vlaeyen JW, Wolters PM,

de Vet HC. Health care provider’s attitudes and beliefs towards

chronic low back pain: the development of a questionnaire. Man

Ther. 2003;8(4):214-22. doi: 10.1016/S1356-689X(03)00013-4

Houben RM, Ostelo RW, Vlaeyen JW, Wolters PM, Peters M,

Stomp-van den Berg SG. Health care providers’ orientations

towards common low back pain predict perceived harmfulness

of physical activities and recommendations regarding return

to normal activity. Eur J Pain. 2005;9(2):173-83. doi: 10.1016/j.

ejpain.2004.05.002

Bishop A, Foster NE, Thomas E, Hay EM. How does the selfreported clinical management of patients with low back pain

relate to the attitudes and beliefs of health care practitioners?

A survey of UK general practitioners and physiotherapists.

Pain. 2008;135(1-2):187-95. doi: 10.1016/j.pain.2007.11.010

Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, KlaberMoffett J, KovacS F, et al. Chapter 4. European guidelines for the

management of chronic nonspecific low back pain. Eur Spine

J. 2006;15(Suppl 2):192-300. doi: 10.1007/s00586-006-1072-1

Darlow B, Fullen BM, Dean S, Hurley DA, Baxter GD, Dowell A.

The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and

outcomes of patients with low back pain: a systematic review.

Eur J Pain. 2012;16(1):3-17. doi: 10.1016/j.ejpain.2011.06.006

Waddell G, Burton AK. Concepts of rehabilitation for the

management of low back pain. Best Pract Res Clin Rheumatol.

;19(4):655-70. doi: 10.1016/j.berh.2005.03.008

Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences

in chronic musculoskeletal pain: a state of the art. Pain.

;85(3):317-32. doi: 10.1016/S0304-3959(99)00242-0

Maher C, Underwood M, Buchbinder R. Non-specific

low back pain. Lancet. 2017;389(10070):736-47. doi:

S0140-6736(16)30970-9

Treatment of patients of nonspecific chronic low back pain by physical therapists: a cross-sectional study

Authors

DOI:

Keywords:

Abstract

Downloads

References

Downloads

Published

Issue

Section

License

How to Cite

Keywords

Language

Information