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Alnaser T1,2, May S2
1Ministry of Health, Physical Therapy, Alamiri Hospital, Kuwait, Kuwait, 2Sheffield Hallam University, Physical Therapy, Sheffield, United Kingdom
Background: Low back pain (LBP) is a major health issue worldwide (Hoy et al., 2012). Exercise therapy is the most effective intervention that is widely recommended for both acute and chronic LBP conditions (Rainville et al., 2004). Fear avoidance beliefs of health care providers are associated with their clinical experience and education approach (Ostelo, et al., 2003). Nijes et al. (2013) recommended to addressing therapists' attitudes and beliefs regarding chronic musculoskeletal pain would improve intervention outcomes. Additionally, poor health care strategies to manage LBP produce socio-economic issues and further complicate health conditions (Hoy et al., 2012; Landry et al., 2008; & Byrne, Doody & Hurley, 2006). Therefore, it is important to explore LBP beliefs among physiotherapists, and their clinical behavior; as investigated by studies previously. However, there is no literature that explores the attitudes and beliefs of Kuwaiti physiotherapists regarding exercise therapy for LBP and, how, or whether they address the associated factors.
Purpose: To identify the attitudes and beliefs of Kuwaiti physiotherapists toward exercise therapy for treating patients with LBP. To identify the associated characteristics of the physiotherapists.
Methods: All Kuwaiti physiotherapists, except physiotherapists specialised in paediatrics made up the study population (n=275). They received a link to an online questionnaire (SurveyMonkey) through messages. The survey consisted of three sections: the first section included three filter questions; the second section was for physiotherapists´ characteristics and their treatment preferences; and the third section was the English version of the Tampa scale of Kinesiophopia for Health care practitioners (TSK-HC-EV), which included 17 attitude and belief statements. Data were analyzed using IBM SPSS (version 24).
Results: Sixty-two (54%) Kuwaiti physiotherapists do not have fear-avoidance beliefs regarding exercises in treating patients with LBP. There were no statistically significant differences in gender (P= 0.32). There was a significant difference by educational qualification (P=0.004), with the highest mean scores on the scale for Bachelor holders. There were no significant differences by clinical experience on the mean TSK-HC-EV score (P=0.22). Physiotherapists´ personal experience with LBP did not affect the score (P=0.70). Kuwaiti physiotherapists who are not fear-avoidant from using exercises for LBP have a tendency to use manual therapy (P=0.025) and the McKenzie approach (P=0.05).
Conclusion(s): This study shows that physiotherapists´ beliefs and attitudes are influenced by their level and type of education. Doctor of Philosophy holders were the lowest responders on the TSK-HC-EV scale followed by masters' holders. Higher levels of education can reduce physiotherapists concerns for the possibility of back injury to their patients through exercises. Further study that addresses the impact of the physiotherapists´ beliefs on the LBP intervention outcome and patients´ beliefs in Kuwait clinical practice is recommended.
Implications: The finding of this study supports the idea of applying biopsychosocial focused education in undergraduate education. Moreover, continuing higher education for Kuwaiti physiotherapists has been suggested. While, it is important to change positively physiotherapists' beliefs and attitudes toward exercises in treating LBP patients. Hence considerations should be given to physiotherapy higher education approaches in Kuwait.
Keywords: Low back pain, Fear, Exercise
Funding acknowledgements: There are no funding considerations to complete this study.
Purpose: To identify the attitudes and beliefs of Kuwaiti physiotherapists toward exercise therapy for treating patients with LBP. To identify the associated characteristics of the physiotherapists.
Methods: All Kuwaiti physiotherapists, except physiotherapists specialised in paediatrics made up the study population (n=275). They received a link to an online questionnaire (SurveyMonkey) through messages. The survey consisted of three sections: the first section included three filter questions; the second section was for physiotherapists´ characteristics and their treatment preferences; and the third section was the English version of the Tampa scale of Kinesiophopia for Health care practitioners (TSK-HC-EV), which included 17 attitude and belief statements. Data were analyzed using IBM SPSS (version 24).
Results: Sixty-two (54%) Kuwaiti physiotherapists do not have fear-avoidance beliefs regarding exercises in treating patients with LBP. There were no statistically significant differences in gender (P= 0.32). There was a significant difference by educational qualification (P=0.004), with the highest mean scores on the scale for Bachelor holders. There were no significant differences by clinical experience on the mean TSK-HC-EV score (P=0.22). Physiotherapists´ personal experience with LBP did not affect the score (P=0.70). Kuwaiti physiotherapists who are not fear-avoidant from using exercises for LBP have a tendency to use manual therapy (P=0.025) and the McKenzie approach (P=0.05).
Conclusion(s): This study shows that physiotherapists´ beliefs and attitudes are influenced by their level and type of education. Doctor of Philosophy holders were the lowest responders on the TSK-HC-EV scale followed by masters' holders. Higher levels of education can reduce physiotherapists concerns for the possibility of back injury to their patients through exercises. Further study that addresses the impact of the physiotherapists´ beliefs on the LBP intervention outcome and patients´ beliefs in Kuwait clinical practice is recommended.
Implications: The finding of this study supports the idea of applying biopsychosocial focused education in undergraduate education. Moreover, continuing higher education for Kuwaiti physiotherapists has been suggested. While, it is important to change positively physiotherapists' beliefs and attitudes toward exercises in treating LBP patients. Hence considerations should be given to physiotherapy higher education approaches in Kuwait.
Keywords: Low back pain, Fear, Exercise
Funding acknowledgements: There are no funding considerations to complete this study.
Topic: Musculoskeletal: spine; Pain & pain management; Education: continuing professional development
Ethics approval required: Yes
Institution: SHEFFIELD HALLAM UNIVERSITY, KUWAIT MINISTRY OF HEALTH
Ethics committee: The Health and Wellbeing ethics committee, the Scientific Research committee
Ethics number: 2
All authors, affiliations and abstracts have been published as submitted.
