How do manual handling advisors and physiotherapists construct their back beliefs, and do safe lifting posture beliefs influence them?

Musculoskelet Sci Pract. 2019 Feb;39:101-106. doi: 10.1016/j.msksp.2018.11.009. Epub 2018 Dec 1.


Background: The Back-Pain Attitudes (Back-PAQ) questionnaire measures back beliefs across 6 domains. Our previous study showed that manual handling advisors (MHAs) have more negative beliefs than physiotherapists (PTs), and those who think straight back lifting is safer than a rounder back have more negative beliefs. However, exactly which domains of the Back-PAQ are most negative is unknown.

Objectives: Gain deeper understanding of how MHAs and PTs construct their back beliefs, and relate this safe lifting posture beliefs.

Design: Data was collected via an electronic survey.

Method: Participants' back beliefs were collected via the Back-PAQ. They were also asked to select the safest lifting posture from four options: two with a straight back; two with a rounder back. Back beliefs were analysed in the 6 domains that construct the Back-PAQ. Relationships were investigated using multiple linear and regression models.

Results: 400 PTs and MHAs completed the survey. MHAs scored higher (more negative beliefs) than PTs across all 6 domains, and those who perceive straight back lifting as safest scored higher across five of the 6 domains. The belief to keep active with back pain was common among all groups, but MHAs and those who prefer straight back lifting believe the back is vulnerable and more in need of protection.

Conclusion: While all believe staying active is beneficial for back pain, residual negative beliefs regarding the vulnerability of the spine persist. Education campaigns may need to emphasise a 'trust your back' message rather than a 'protect your back' message while encouraging activity.

Keywords: Back beliefs; Back pain; Lifting technique; Manual handling.

MeSH terms

  • Adult
  • Attitude to Health
  • Back Injuries / prevention & control*
  • Female
  • Humans
  • Lifting / adverse effects*
  • Low Back Pain / prevention & control*
  • Male
  • Middle Aged
  • Moving and Lifting Patients
  • Occupational Health
  • Physical Therapists*
  • Posture / physiology*
  • Safety Management*
  • Young Adult