THERAPIST BELIEFS, KNOWLEDGE, ATTITUDE, BEHAVIOR AND PREFERENCE PRACTICE FOR ASSESSING AND MANAGEMENT OF NECK PAIN. A SYSTEMATIC REVIEW

G. Ploutarchou¹, C. Savva¹, B.S. Alexandrou¹, P. Rentzias¹, I. Christofi¹, K. Pavlou¹, C. Karagiannis¹, C. Giannakou²

¹European University of Cyprus, Health Science, Physiotherapy, Nicosia, Cyprus, ²European University of Cyprus, Health Science, Public Health, Nicosia, Cyprus

Background: Neck pain is one of the most common musculoskeletal disorders that often lead to impairments and activity limitations. Although a variety of assessment tools and therapeutic interventions are widely used to evaluate and treat these limitations, in many cases these options are not consistent with recommended clinical guidelines.

Purpose: To systematically search about beliefs, knowledge, attitude, behaviors and preference practice of therapist for assessing and management of neck pain.

Methods: Five electronic databases were searched using the People Intervention Comparison Outcome model, and reporting of this systematic review adhered to Preferred Reporting Items for Systematic Reviews guidelines with the extended version of Synthesis without Meta-Analysis guidelines. To determine whether finding of the included studies are valid and meaningful we used Newcastle-Ottawa Scale for cross sectional studies or Critical Appraisal Skills Program for qualitative studies.

Results: Nine cross-sectional and two qualitive studies met the inclusion criteria. Results from 1725 therapist showed that therapists mainly use objective rather than subjective measures when assessing neck pain. The most common evaluation measures are range of motion (including quality end feeling, passive range of motion quality, active range using goniometer), quality of movement (Manual muscle test, active motions), and neurological testing. It is reported that although they consider psychosocial factors (stress from work, stress from personal situations, none recovery reasons, fear of movement and anxiety, beliefs about pain, behavior about pain, sickness behaviors) to be decisive for the development and chronicity of neck pain, they do not have the confidence to evaluate them. In regards to therapy, exercise combined with manual therapy seems to be a first-line interventions, while pain education, reassure, counseling and psychological therapies are recommended as supporting interventions.

Conclusions: There is a lack in subjective and objective assessment of the psychosocial despite the fact that it is considered as important factor for the development and chronicity of the pathology.

Implications: Implications: Subjective evaluation should receive more attention in clinical practice since it seems that the inability to evaluate it does not agree with the knowledge that it plays a decisive role in rehabilitation of neck pain. The use of manual therapy and exercise should be enriched as needed.

Funding acknowledgements: No funding

Keywords:
Neck pain
Knowledge
Therapy

Topics:
Musculoskeletal
Musculoskeletal: spine
Pain & pain management

Did this work require ethics approval? No

Reason: Due to systematic review ethic approval not needed