title: Practice patterns when treating patients with low back pain: a survey of physical therapists.
abstract: Low back pain (LBP), is a common musculoskeletal problem, affecting 75-85% of adults in their lifetime. Direct costs of LBP in the USA were estimated over 85 billion dollars in 2005 resulting in a significant economic burden for the healthcare system. LBP classification systems and outcome measures are available to guide physical therapy assessments and intervention. However, little is known about which, if any, physical therapists use in clinical practice. The purpose of this study was to identify the use of and barriers to LBP classification systems and outcome measures among physical therapists in one state. A mixed methods study using a cross-sectional cohort design with descriptive qualitative methods was performed. A survey collected both quantitative and qualitative data relevant to classification systems and outcome measures used by physical therapists working with patients with LBP. Physical therapists responded using classification systems designed to direct treatment predominantly. The McKenzie method was the most frequent approach to classify LBP. Barriers to use of classification systems and outcome measures were lack of knowledge, too limiting and time. Classification systems are being used for decision-making in physical therapy practice for patients with LBP. Lack of knowledge and training seems to be the main barrier to the use of classification systems in practice. The Oswestry Disability Index and Numerical Pain Scale were the most commonly used outcome measures. The main barrier to their use was lack of time. Continuing education and reading the literature were identified as important tools to teach evidence-based practice to physical therapists in practice.
authors.affiliation: Division of Physical Therapy, Baptist Health Rehab , Lexington, KY , USA .
authors.forename: Claire
authors.initials: C
authors.lastname: Davies
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Nitz
authors.forename: Carl G
authors.initials: CG
authors.lastname: Mattacola
authors.forename: Patrick
authors.initials: P
authors.lastname: Kitzman
authors.forename: Dana
authors.initials: D
authors.lastname: Howell
authors.forename: Kert
authors.initials: K
authors.lastname: Viele
authors.forename: David
authors.initials: D
authors.lastname: Baxter
authors.forename: Dorothy
authors.initials: D
authors.lastname: Brockopp
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000145:classification* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D059825:Physical Therapists / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D011361:Professional Competence; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States
keywords: Classification systems; low back pain; outcome measures