Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
University of St. Augustine for Health Sciences, Doral, Florida, US.
Spine (Phila Pa 1976). 2017 Nov 1;42(21):E1251-E1258. doi: 10.1097/BRS.0000000000002190.
This was a cross-sectional observational study.
(i) to investigate whether Brazilian physical therapists make clinical decisions for patients with low back pain based upon clinical practice guidelines and (ii) to determine whether the physical therapists are able to recognize differential diagnoses of low back pain associated with red or yellow flags.
Early adherence to clinical practice guidelines may accelerate recovery and reduce the costs associated with low back pain. It is unknown whether Brazilian physical therapists follow clinical practice guidelines to make their clinical decisions in the treatment of patients with low back pain.
The sample consisted of physical therapists from two Brazilian physical therapy associations. The data were collected via electronic survey and face-to-face interviews. The survey was composed of six hypothetical clinical cases of low back pain, which served as a basis to evaluate clinical decisions and adherence to clinical practice guidelines for low back pain. The study participants had 27 possible answers for each clinical case and could choose up to five answers. The results were analyzed in three ways: full adherence, partial adherence, or no adherence to the recommendations from clinical practice guidelines.
A total of 530 physical therapists were invited and 189 participated in the study (response rate = 35.6%). Full adherence to the guidelines was low for all six cases (rates ranging from 5%-24%). Partial adherence to the guidelines was higher when compared with full adherence (rates ranging from 32%-75%). The participants were more likely to identify differential diagnoses associated with yellow flags than with red flags.
Brazilian physical therapists are not using the best available evidence in their clinical decision making for patients with low back pain. Wider dissemination of clinical practice guidelines should be urgently undertaken.
这是一项横断面观察性研究。
（一）调查巴西物理治疗师在为腰痛患者做出临床决策时是否基于临床实践指南，以及（二）确定物理治疗师是否能够识别与红色或黄色征相关的腰痛的鉴别诊断。
早期遵循临床实践指南可能会加速康复并降低腰痛相关的成本。目前尚不清楚巴西物理治疗师是否遵循临床实践指南来做出腰痛患者的临床决策。
该样本由来自两个巴西物理治疗师协会的物理治疗师组成。数据通过电子调查和面对面访谈收集。调查由六个腰痛的假设临床病例组成，这些病例作为评估临床决策和对腰痛临床实践指南的遵循情况的基础。研究参与者对每个临床病例有 27 种可能的答案，最多可以选择 5 种答案。结果以三种方式进行分析：完全遵循、部分遵循或不遵循临床实践指南的建议。
共邀请了 530 名物理治疗师，其中 189 名参加了研究（回应率=35.6%）。对于所有六个病例，完全遵循指南的情况都很低（比率从 5%到 24%不等）。与完全遵循相比，部分遵循指南的情况更高（比率从 32%到 75%不等）。参与者更有可能识别与黄色征相关的鉴别诊断，而不是红色征。
巴西物理治疗师在为腰痛患者做出临床决策时并未使用最佳现有证据。应紧急开展更广泛的临床实践指南传播。
2 级。
