title: Physiotherapists' Beliefs About Whiplash-associated Disorder: A Comparison Between Singapore and Queensland, Australia.
abstract: OBJECTIVE
  Healthcare providers' beliefs may play a role in the outcome of whiplash-associated disorders (WAD), a condition which is proposed to be culturally dependent. Clinical practice guidelines recommend an active approach for the management of WAD, which is often delivered by physiotherapists. However, there is no data on physiotherapists' whiplash beliefs. Our primary objective was to determine physiotherapists' beliefs from Queensland (Australia) and Singapore, two cultures with differing prevalence of chronic musculoskeletal pain and chronic WAD.
  
  
  METHODS
  A pen and paper survey of musculoskeletal physiotherapists practicing in Queensland and Singapore was conducted. Participants completed questionnaires consisting of patient vignettes and statements inquiring knowledge and attitudes towards WAD. Chi-square tests of significance were used to compare the responses of physiotherapists from both samples.
  
  
  RESULTS
  Ninety-one (response rate 45%) Queensland-based and 94 (response rate 98%) Singapore-based physiotherapists participated in the study. The beliefs in the management strategies for the patient vignettes were generally consistent with practice guidelines. A higher proportion of Queensland-based physiotherapists expected permanent disabilities for the patient vignette depicting chronic WAD (Queensland: 55% Singapore: 28% Pearson chi-sq 18.76, p < 0.005).Up to 99% of the physiotherapists from both samples believed in encouragement of physical activity, the effectiveness of exercise and multimodal physiotherapy for WAD. Significantly higher proportions of Singapore-based physiotherapists believed in ordering radiographs for acute WAD (Pearson chi-sq 41.98, p < 0.001) and also believed in a psychogenic origin of chronic WAD (Pearson chi-sq 22.57, p  0.001).
  
  
  CONCLUSIONS
  The majority of beliefs between physiotherapists in Queensland and Singapore were similar but there were specific differences. Physiotherapists' whiplash beliefs in Queensland and Singapore did not clearly reflect the difference in prevalence of chronic musculoskeletal pain or chronic WAD in Queensland and Singapore.
authors: National University Hospital, Physiotherapy Section, Department of Rehabilitation, Singapore, Singapore.|The University of Queensland, School of Health and Rehabilitation Sciences St Lucia, Brisbane, Queensland, Australia.
authors: Tze Siong
authors: TS
authors: Ng
authors: The University of Queensland, Centre of National Research on Disability and Rehabilitation Medicine (CONROD), Herston, Brisbane, QLD Australia.
authors: Ashley
authors: A
authors: Pedler
authors: The University of Queensland, School of Health and Rehabilitation Sciences St Lucia, Brisbane, Queensland, Australia.
authors: Bill
authors: B
authors: Vicenzino
authors: Griffith Health Institute, Griffith University, Parklands, Queensland, Australia.
authors: Michele
authors: M
authors: Sterling
mesh_terms: D019468:Disease Management; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D059825:Physical Therapists / Q000523:psychology*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011793:Queensland / Q000453:epidemiology; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014911:Whiplash Injuries / Q000453:epidemiology / Q000628:therapy*
keywords: pain; physiotherapy; practice/service settings