A Delphi study investigating consensus among expert physiotherapists in relation to the management of low back pain

Musculoskeletal Care. 2008 Dec;6(4):197-210. doi: 10.1002/msc.126.


Objectives: Low back pain (LBP) affects a large proportion of the adult population, with over 90% of people expected to experience symptoms associated with it. LBP is one of the most common conditions managed by primary health care practitioners, and physiotherapists are the largest professional group responsible for its management. Clinical guidelines exist for the management of LBP and are based on the best available evidence. However, there is currently no consensus on the actual physiotherapy management of this condition.

Methods: A three-round Delphi study was conducted among expert physiotherapists (n = 34). A focus group was initially convened to review the key questions, developed following a review of the literature. An expert panel then produced their responses, which were ranked in subsequent rounds, using a five-point Likert scale, until a predetermined point of consensus was reached.

Results: The results of this study indicated that it is possible to establish consensus among expert clinicians in relation to the management of LBP, with consensus reached on 64 (67.3%) of the 95 responses identified. The results also showed that, in general, physiotherapy management within the location studied conformed to current LBP evidence-based clinical guidelines. In addition, the expert panel identified the importance of a biopsychosocial approach to LBP management.

Conclusions: Although the study identified that consensus existed in relation to many aspects of physiotherapy management of LBP, it was also noted that confusion existed in relation to several key areas of practice, highlighting the need for further work.

Publication types

  • Validation Study

MeSH terms

  • Consensus
  • Delphi Technique*
  • Evidence-Based Practice
  • Focus Groups
  • Humans
  • Low Back Pain / therapy*
  • Physical Therapy Specialty / methods*
  • Physical Therapy Specialty / standards*
  • Practice Guidelines as Topic
  • Referral and Consultation / standards*