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Spinal motion restriction in the emergency healthcare setting: A cross-sectional study of knowledge, attitudes, and
Alaa Oteir1, Majd Husein2, Hossam Alhawatmeh2
1Department of Allied Medical Sciences, Jordan University of Science and Technology, Jordan.
Background:
Spinal motion restriction (SMR) remains a fundamental component of trauma care, yet its routine application has been increasingly questioned. Evidence supporting selective SMR has grown; however, limited data exist on the knowledge, attitudes, and practices of emergency healthcare providers (HCP) across the prehospital and hospital settings, particularly in low- and middle-income settings.
Objective:
This study aimed to examine knowledge, attitudes, and practices (KAP) towards spinal motion restriction (SMR) among prehospital and in-hospital emergency HCPs in Jordan.
Methods:
This is a cross-sectional study using a purpose-built questionnaire. The questionnaire assessed demographics, knowledge, attitudes, and practices regarding SMR. KAP scores were calculated using validated scales with established internal consistency.
Results:
A total of 363 participants completed the questionnaire. The median age was 30 years (IQR 27-33) and most participants were male (85.1%). Approximately three-fifths (59.8%) were working in hospital settings, and only 36.4% reported receiving prior trauma courses. Overall knowledge related to SMR was low to moderate, with limited awareness of validated selective SMR tools; fewer than one-third of participants reported awareness of the Canadian C-Spine Rule (CCR) or NEXUS criteria. Knowledge scores did not differ significantly between trauma-trained and untrained participants but were higher among prehospital HCPs. Attitudes towards SMR were generally neutral and were not significantly associated with training status or work setting. Self-reported practice scores were relatively high, with no significant differences between prehospital and hospital HCPs or trained and untrained HCPS.
Conclusion:
Despite widespread trauma exposure and training, important gaps persist in SMR-related knowledge and decision-rule awareness among emergency HCPs. Neutral attitudes and high self-reported practice scores may mask inconsistent evidence-based decision-making. These findings highlight the need for targeted, competency-based SMR education and system-level alignment across the emergency healthcare setting, with relevance to emergency care systems in the Middle East and North Africa Region (MENA) and other resource-constrained settings.