A survey identifies the association between clinical specialization and adherence to evidence-based practice guidelines for low back pain among American physical therapists

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A survey identifies the association between clinical specialization and adherence to evidence-based practice guidelines for low back pain among American physical therapists

Clinical practice guidelines can improve the process and outcomes of patient care in low back pain (LBP) and need for better adherence to an LBP guideline. To manage nonspecific LBP in routine physical therapy practice, the American Physical Therapy Association (APTA) elaborated on strategies with regards to evidence-based practice guideline for LBP. This guideline describes an association of LBP with mobility deficit, leg pain and a directional preference, coordination impairment (lumbar instability) and fear-avoidance behavior.

Recently, an electronic cross-sectional survey was done to assess the adherence of 'American physical therapists' of the Orthopedic Section of the APTA, to the clinical practice guidelines (CPGs) for LBP.

For this survey, investigators approached 1861 members of the Orthopedic Section of the APTA and 1000 members of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT).

Participants were made to choose the treatment from 4 clinical vignettes: 1) LBP with mobility deficit, 2) Coordination impairment, 3) Leg pain (directional preference), 4) Fear-avoidance behavior.

The investigator used logistic regression analysis method to compare adherence towards guideline among physical therapists with qualifications including orthopedic clinical specialists (PTOs), fellows of the AAOMPT (PTFs), PTOs and PTFs (PTFOs), and physical therapists without clinical specialization, but with a musculoskeletal interest (PTMSs).

Survey results showed that overall 410 physical therapists completed all sections of the survey (142 PTOs, 110 PTFOs, 74 PTFs and 84 PTMSs). It was estimated that adherence to the APTA's, CPG was highest for LBP associated with leg pain and a directional preference (72.2%), LBP with mobility deficit (57.1%), LBP with coordination impairment (46.1%) and fear-avoidance behavior (29.5%). PTFOs physical therapists were found to comprise better adherence to the CPG for LBP than PTMSs for all four patient vignettes. Orthopedic clinical specialists had better adherence to the CPG for LBP related to of mobility deficit and fear-avoidance behavior compared to PTMSs.

It was concluded that better adherence was seen among PTFOs and PTOs physical therapists to the CPG compared to PTMSs. The preliminary results revealed the need for further education on the CPG for LBP management, especially for managing LBP with coordination impairment and fear-avoidance behavior.

Source:

Journal of Orthopaedic & Sports Physical Therapy

Link to the source:

http://www.jospt.org/doi/pdf/10.2519/jospt.2017.6561

Original title of article:

Clinical Specialization and Adherence to Evidence-Based Practice Guidelines for Low Back Pain Management: A Survey of United States Physical Therapists

Authors:

Ladeira CE, Cheng MS, et al.

SearchTags: 
Clinical practice guidelines, Low back pain, American physical therapists
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