The influence of low back pain-related attitudes and beliefs on the clinical decision making of physical therapists

ABSTRACT

Background

The LBP-related attitudes and beliefs of clinicians may impact the experience of patients by influencing clinician decision-making and by shaping the attitudes, beliefs, and actions of patients. The purpose of this study was to identify the specific LBP-related attitudes and beliefs of US-based physical therapists and determine if those beliefs correlate with clinical decision-making.

Methods

An electronic survey was sent to US-based physical therapists. Attitudes and beliefs were measured using the Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) and the Pain and Impairment Relationship Scale for Physiotherapists (PABS-PT). The survey also included 2 patient vignettes that collected information about clinical decision-making.

Results

Complete survey responses were recorded from 420 physical therapists. Eleven of the 27 attitude and beliefs questions were answered in a more biomedically oriented way by at least 20% of respondents. Physical therapist low back pain-related attitudes and beliefs were associated with activity and management strategies for both vignettes in the expected direction. Higher scores on HC-PAIRS and PABS-BM were associated with more restrictive work and activity recommendations, lower-intensity exercise choices, biomechanical rationale for manual therapy and motor control exercises, pathoanatomical-focused education, and use of modalities.

Conclusion

Some physical therapists hold biomedically oriented beliefs about the connection between pain and physical activity. Clinician beliefs were associated with activity and work recommendations, and treatment choices. Physical therapists with more biomedically oriented beliefs were more likely to limit physical activity and work, and less likely to incorporate psychologically informed interventions.

KEYWORDS:

• Low back pain
• attitudes
• beliefs
• physical therapist

Disclosure statement

We affirm that we have no financial affiliation (including research funding) or involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript.

Institutional review board approval

This study was approved by the Upstate Medical and Baylor University Institutional Review Boards

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10669817.2024.2346973.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.