Comparing physical therapy students' attitudes and beliefs regarding chronic low back pain and knee osteoarthritis: an international multi-institutional comparison between 2013 and 2020 academic years

Wouter Munneke; Christophe Demoulin; Nathalie Roussel; Marijke Leysen; C Paul Van Wilgen; Laurent Pitance; Roland R Reezigt; Lennard P Voogt; Wim Dankaerts; Lieven Danneels; Albère J A Köke; Wilfried Cools; Margot De Kooning; Jo Nijs

doi:10.1016/j.bjpt.2024.100592

Comparing physical therapy students' attitudes and beliefs regarding chronic low back pain and knee osteoarthritis: an international multi-institutional comparison between 2013 and 2020 academic years

Braz J Phys Ther. 2024 Jan-Feb;28(1):100592. doi: 10.1016/j.bjpt.2024.100592. Epub 2024 Feb 9.

Authors

Affiliations

¹ Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group (PiM), Belgium; Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium.
² Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium.
³ Department of Physiotherapy and Rehabilitation Sciences (MOVANT), Antwerp, Belgium.
⁴ Pain in Motion International Research Group (PiM), Belgium; Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
⁵ Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group (PiM), Belgium; Transcare, Transdisciplinary Pain Management Center, the Netherlands.
⁶ Neuro-musculoskeletal Lab (NMSK), UCLouvain, Brussels, Belgium; Oral and Maxillofacial Surgery Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
⁷ Department of Physiotherapy, Hanze University of Applied Sciences Groningen, the Netherlands.
⁸ Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group (PiM), Belgium; Department of Physical Therapy, University of Applied Sciences Rotterdam, Rotterdam, the Netherlands.
⁹ Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
¹⁰ Department of Rehabilitation Sciences and Physical Therapy, Universiteit Gent, Ghent, Belgium.
¹¹ Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands; Department of Rehabilitation Medicine, CAPHRI, Maastricht University, Maastricht, the Netherland; Department of Physical Therapy Zuyd University of Applied Sciences, Heerlen, the Netherlands.
¹² Core facility - Support for Quantitative and Qualitative Research (SQUARE), Vrije Universiteit Brussel, Brussels, Belgium.
¹³ Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
¹⁴ Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group (PiM), Belgium; Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Unit of Physiotherapy, University of Gothenburg, Sweden. Electronic address: Jo.nijs@vub.be.

Abstract

Background: In 2013, physical therapy students demonstrated low guideline-adherent recommendations regarding chronic low back pain (CLBP) for spinal pathology, activity, and work.

Objectives: To assess the differences in physical therapy students' attitudes, beliefs, and adherence to guideline recommendations regarding CLBP and knee osteoarthritis between 2013 and 2020.

Methods: In 2013 and 2020, second and fourth-year physical therapy students were recruited from 6 Belgian and 2 Dutch institutions. Attitudes and beliefs regarding CLBP and knee OA were evaluated using the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS), and a questionnaire regarding therapeutic exercise and knee osteoarthritis. A clinical vignette was used to measure guideline-adherent recommendations regarding spinal pathology, activity, and work.

Results: In 2013, 927 second-year and 695 fourth-year students; in 2020, 695 second-year and 489 fourth-year students; were recruited to participate in the study. Compared to 2013, students had less biomedical and stronger biopsychosocial attitudes and beliefs regarding CLBP, more guideline-adherent recommendations for activity, and more biopsychosocial beliefs regarding the benefits of exercise for patients with knee osteoarthritis in both the second and fourth year. Only fourth-year students in 2020 scored significantly better on HC-PAIRS and guideline-adherent recommendation relating to spinal pathology. No differences were found regarding work recommendations.

Conclusions: Between 2013 and 2020, physical therapy students made a positive shift towards a more biopsychosocial approach to CLBP and knee osteoarthritis management. Guideline-adherent recommendations for CLBP concerning activity improved, however, concerning work and spinal pathology, it remained low.

Keywords: Behavior; Biopsychosocial model; Clinical recommendations; Education; Guideline adherence; Pain management.

Publication types

Multicenter Study

MeSH terms

Attitude of Health Personnel
Humans
Low Back Pain* / rehabilitation
Osteoarthritis, Knee*
Physical Therapists*
Physical Therapy Modalities
Students
Surveys and Questionnaires