The association between education, practice, post-professional training and physical therapists' attitudes and beliefs regarding low back pain management: A cross sectional survey study

Several recent initiatives have aimed to align physical therapists' (PTs) understanding and management of low back pain (LBP) with the biopsychosocial model of health and illness.

The purpose of this study was to determine whether entry-level education, practice setting, experience, or post-professional training is associated with attitudes and beliefs of United States (US) PTs about LBP management, despite these initiatives.

A cross-sectional online survey was distributed to a sample of US PTs that included the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) and the Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS). Linear regression was used to quantify the association between education, experience, post-professional training, and practice setting with PTs attitudes and beliefs.

Of 412 respondents, those with a Bachelor's/Master's scored significantly higher on the PABS-Bio (β = 2.5, 95 % CI = 0.76-4.3, p = 0.005) and HC-PAIRS (β = 2.7, 95 % CI = 0.7-4.6, p = 0.006) and lower on the PABS-Psy (β = 1.7, 95 % CI = -2.7-0.7, p < 0.001) compared to those with a DPT/tDPT. Those who did not undertake post-professional training scored higher on the PABS-Bio (β = 3.7, 95 % CI = 1.4-6.1, p = 0.002) and HC-PAIRS (β = 3.9, 95 % CI = 1.2-6.6, p = 0.005). Therapists licensed 20+ years and working in settings besides outpatient had stronger biomedical beliefs.

Highest degree, post-professional training, years licensed, and practice setting were all significantly associated with attitudes and beliefs of practicing PTs in the US regarding LBP management. This study highlights the need for further investigation into education for improving PTs' attitudes and beliefs around LBP amidst diverse practice settings and experience.