An e-learning program improves low back pain beliefs of physiotherapists: a randomised trial
Daniela Silva Magalhães1, James H McAuley2, Chris G Maher3
1Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Question:
How effective is an e-learning program based on international clinical guidelines in promoting beliefs more aligned with the current evidence for the management of low back pain among physiotherapists?
Design:
Randomised controlled trial with concealed allocation and intention-to-treat analysis.
Participants:
106 physiotherapists who treat patients with low back pain.
Interventions:
The experimental group received access to an e-learning program, based on recommendations of clinical practice guidelines for the management of low back pain, over a 6-week period. The program consisted of six units, totalling 15 hours, and was offered in a self-instructional and self-paced format. The control group was instructed to continue their activities as usual.
Outcome Measures:
The primary outcome was beliefs about low back pain measured using the Modified Back Beliefs Questionnaire (MBBQ, -50 worst to 50 best). Secondary outcomes included the Back Pain Attitudes Questionnaire (Back-PAQ, -20 worst to 20 best) and agreement with two statements (1: X-rays or scans are necessary to get the best medical care for low back pain; 2: Everyone with low back pain should have spine imaging). Participants were evaluated at baseline and 6 weeks.
Results:
Out of 53 participants allocated to the e-learning program, two completed only the first unit and one did not complete any units, resulting in an overall adherence rate of 94%. Compared with control, the e-learning program improved the MBBQ (MD 8 points, 95% CI 5 to 10) and the Back-PAQ score (MD 3.1 points, 95% CI 1.8 to 4.3). For the imaging beliefs statements, the e-learning program was able to increase the proportion of participants with beliefs aligned with the current evidence (statement 1: RD 38%, 95% CI 21 to 52; statement 2: RD 17%, 95% CI 7 to 29) compared with the control group.
Conclusion:
The e-learning program based on recommendations of clinical practice guidelines for the management of low back pain improved physiotherapists' beliefs about the management of low back pain.
Registration:
NCT05661968.
