Providing services for acute low-back pain: A survey of Australian physiotherapists

Jennifer L. Keating, Joanne E. McKenzie, Denise A. O'Connor, Simon French, Bruce F. Walker, Melanie Charity, Matthew J. Page, Sally E. Green

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: To determine whether physiotherapists avoid lumbar X-rays for acute non-specific low back
pain and advise people to stay active.
Methods: We conducted a cross sectional survey of Australian physiotherapists. 880 physiotherapists
were randomly sampled from Victoria (495), South Australia (158), and Western Australia (227). Physiotherapists
were asked which investigations they would order and interventions they would provide for
five acute low back pain (LBP) presentations described in vignettes. Four of the five vignettes represented
people who would not require a plain lumbar X-ray and would benefit from advice to stay active; one
described a patient with a suspected vertebral fracture and would require a plain X-ray. Participants
selected from a list of response options or provided free text responses.
Results: Questionnaires were completed by 203 of 567 potentially eligible physiotherapists (response
rate 36%). Across the four vignettes where an X-ray was not indicated, 75% (95%CI 71e78%) of physiotherapists
reported they would practice concordant with the guidelines and not order an X-ray, and 62%
(95%CI 57e66%) provided advice to stay active.
Conclusions: Most physiotherapists report intended compliance with recommendations in Australian
clinical practice guidelines (CPGs) regarding avoiding the use of X-rays and providing advice to stay
active for people with simple acute low back pain, given a vignette based scenario. The majority of
respondents reported that they would not advise bed rest. Possible opportunities to further enhance
compliance need to be developed and tested to reinforce the role of CPGs in informing physiotherapy
practice.
Original languageEnglish
Pages (from-to)145-152
Number of pages8
JournalManual Therapy
Volume22
DOIs
Publication statusPublished - Apr 2016

Keywords

  • Survey
  • Acute low back pain
  • Physiotherapists
  • Clinical practice guideline
  • Behaviour

Cite this

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title = "Providing services for acute low-back pain: A survey of Australian physiotherapists",
abstract = "Objective: To determine whether physiotherapists avoid lumbar X-rays for acute non-specific low backpain and advise people to stay active.Methods: We conducted a cross sectional survey of Australian physiotherapists. 880 physiotherapistswere randomly sampled from Victoria (495), South Australia (158), and Western Australia (227). Physiotherapistswere asked which investigations they would order and interventions they would provide forfive acute low back pain (LBP) presentations described in vignettes. Four of the five vignettes representedpeople who would not require a plain lumbar X-ray and would benefit from advice to stay active; onedescribed a patient with a suspected vertebral fracture and would require a plain X-ray. Participantsselected from a list of response options or provided free text responses.Results: Questionnaires were completed by 203 of 567 potentially eligible physiotherapists (responserate 36{\%}). Across the four vignettes where an X-ray was not indicated, 75{\%} (95{\%}CI 71e78{\%}) of physiotherapistsreported they would practice concordant with the guidelines and not order an X-ray, and 62{\%}(95{\%}CI 57e66{\%}) provided advice to stay active.Conclusions: Most physiotherapists report intended compliance with recommendations in Australianclinical practice guidelines (CPGs) regarding avoiding the use of X-rays and providing advice to stayactive for people with simple acute low back pain, given a vignette based scenario. The majority ofrespondents reported that they would not advise bed rest. Possible opportunities to further enhancecompliance need to be developed and tested to reinforce the role of CPGs in informing physiotherapypractice.",
keywords = "Survey, Acute low back pain, Physiotherapists, Clinical practice guideline, Behaviour",
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Providing services for acute low-back pain : A survey of Australian physiotherapists. / Keating, Jennifer L.; McKenzie, Joanne E.; O'Connor, Denise A.; French, Simon; Walker, Bruce F.; Charity, Melanie; Page, Matthew J.; Green, Sally E.

In: Manual Therapy, Vol. 22, 04.2016, p. 145-152.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Providing services for acute low-back pain

T2 - A survey of Australian physiotherapists

AU - Keating, Jennifer L.

AU - McKenzie, Joanne E.

AU - O'Connor, Denise A.

AU - French, Simon

AU - Walker, Bruce F.

AU - Charity, Melanie

AU - Page, Matthew J.

AU - Green, Sally E.

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N2 - Objective: To determine whether physiotherapists avoid lumbar X-rays for acute non-specific low backpain and advise people to stay active.Methods: We conducted a cross sectional survey of Australian physiotherapists. 880 physiotherapistswere randomly sampled from Victoria (495), South Australia (158), and Western Australia (227). Physiotherapistswere asked which investigations they would order and interventions they would provide forfive acute low back pain (LBP) presentations described in vignettes. Four of the five vignettes representedpeople who would not require a plain lumbar X-ray and would benefit from advice to stay active; onedescribed a patient with a suspected vertebral fracture and would require a plain X-ray. Participantsselected from a list of response options or provided free text responses.Results: Questionnaires were completed by 203 of 567 potentially eligible physiotherapists (responserate 36%). Across the four vignettes where an X-ray was not indicated, 75% (95%CI 71e78%) of physiotherapistsreported they would practice concordant with the guidelines and not order an X-ray, and 62%(95%CI 57e66%) provided advice to stay active.Conclusions: Most physiotherapists report intended compliance with recommendations in Australianclinical practice guidelines (CPGs) regarding avoiding the use of X-rays and providing advice to stayactive for people with simple acute low back pain, given a vignette based scenario. The majority ofrespondents reported that they would not advise bed rest. Possible opportunities to further enhancecompliance need to be developed and tested to reinforce the role of CPGs in informing physiotherapypractice.

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SN - 1356-689X

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