Poster Presentation Sydney Spinal Symposium 2019

What are the attitudes and beliefs of exercise-based practitioners toward chronic low back pain in Australia? (#29)

Mitchell Gibbs 1 , Paul Marshall 1
  1. Western Sydney University, Glen Alpine, NSW, Australia

Chronic low back pain (CLBP) is the number one condition worldwide in terms of years lived with disability, or disability adjusted life years (1). Currently, exercise is recommended as a first-line treatment for CLBP. In Australia, Physiotherapists and Accredited Exercise Physiologists (AEP) are the allied health professionals leading exercise prescription for CLBP. However, little is known regarding the attitudes and beliefs of these professionals toward CLBP. Pre-existing attitudes and beliefs of health care practitioners may prevent current evidence and contemporary approaches to CLBP from disseminating to practice. Indeed, the literature has shown biomedical beliefs of practitioners influence clinical decision making that goes against the biopsychosocial model and clinical practice guidelines, such as advocating for bedrest (2). However, the current body of literature surrounding practitioner’s beliefs is both confusing and contradictory. The result of the literature being in this state is a reflection of the inconsistencies present with practitioner’s attitudes and beliefs toward CLBP, and subsequently the clinical decisions of practitioners resulting in treatment choices (3). Furthermore, a direct consequence of these various/conflicting attitudes and beliefs about CLBP is the development of countless intervention modalities such a motor control exercise, movement impairment based exercise, Pilates-based approaches for CLBP, and multiple others, which may become overwhelming to both patients and practitioners. Thus, understanding of practitioner’s beliefs and attitudes toward a biomedical and/or a biopsychosocial approach to management of CLBP is pragmatic to investigating why the burden of CLBP is not reducing.

To further understand the attitudes and beliefs of exercise-based practitioners toward CLBP in Australia, we have conducted a survey of 150 exercise-based practitioners using demographic questions such as years in practice and confidence to treat CLBP, the painattitudes and beliefs scale (4), and vignettes of case study patient examples (5). This research provides initial insight to the attitudes and beliefs of AEPs and provide consideration to multidisciplinary practice due to the inclusion of physiotherapists.

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  2. Buchbinder R, Staples M, Jolley D. Doctors with a special interest in back pain have poorer knowledge about how to treat back pain. Spine. 2009;34(11):1218-26.
  3. Bishop A, Foster NE, Thomas E, Hay EM. How does the self-reported 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.
  4. Ostelo R, Stomp-van den Berg S, Vlaeyen J, Wolters P, De Vet H. Health care provider's attitudes and beliefs towards chronic low back pain: the development of a questionnaire. Manual Therapy. 2003;8(4):214-22.
  5. Overmeer T, Boersma K, Main CJ, Linton SJ. Do physical therapists change their beliefs, attitudes, knowledge, skills and behaviour after a biopsychosocially orientated university course? Journal of Evaluation in Clinical Practice. 2009;15(4):724-32.