Patient-physiotherapist agreement in low back pain

Agreement between patients' and health professionals' perceptions has been shown to be low to moderate for different aspects of the patients' pain experience. Little is known, however, about patient-physiotherapist agreement in low back pain. The study objectives were to describe patient-physiotherapist agreement for low back pain intensity and functional limitations, and to identify correlates of agreement. A cross-sectional design was used. Seventy-eight patients with acute/subacute nonspecific low back pain and their respective physiotherapists were included in the study. After the initial physiotherapy consultation, patients and physiotherapists completed a Numerical Rating Scale and the Roland-Morris Disability Questionnaire. Intraclass correlation coefficients (ICC) were used to measure chance-corrected agreement. Patients' and physiotherapists' mean ratings were also compared using paired t tests. Multiple regression analyses were conducted to identify factors associated with agreement measures. The level of agreement was moderate for pain intensity (ICC = 0.55, 95% confidence interval [CI]: 0.38-0.69) and functional limitations (ICC = 0.56, 95% CI: 0.22-0.74). Both variables were rated significantly (P < .05) lower by the physiotherapists than by the patients. Higher ratings by the patients for pain and functional limitations were related to higher differences in perceptions between patients and physiotherapists. This report shows that physiotherapists' perceptions of their patients' pain intensity and functional limitations often differ from their patients'.

The findings of this study indicate that there are frequent discrepancies between patients' and physiotherapists' perceptions of the patients' low back pain experience. Gaining a better understanding of the level of patient-physiotherapist agreement and identifying the correlates of agreement may help improve physiotherapists' interventions with people with low back pain.