Department of Exercise Science, Concordia University, Montreal, QC.
Duke Clinical Research Institute and Department of Orthopaedic Surgery, Duke University, Durham, NC.
J Athl Train. 2019 Jul;54(7):772-779. doi: 10.4085/1062-6050-430-17. Epub 2019 Aug 6.
Low back pain (LBP) remains a societal burden due to consistently high rates of recurrence and chronicity. Recent evidence suggested that a provider's treatment orientation influences patient beliefs, the clinical approach, and subsequently, rehabilitation outcomes.
To characterize American athletic trainer (AT) and Canadian athletic therapist (C-AT) treatment orientations toward LBP.
Cross-sectional study.
Online survey.
A total of 273 ATs (response rate = 13.3%) and 382 C-ATs (response rate = 15.3%).
MAIN OUTCOME MEASURE(S): Participants completed demographic questions and the Pain Attitudes and Beliefs Scale (PABS) for ATs/C-ATs. The PABS measures the biomedical and biopsychosocial treatment orientation of health care providers and is scored on a 6-point Likert scale. Descriptive statistics characterized the participants; tests and 1-way analyses of variance identified differences between group means; and Spearman correlations assessed relationships between the biomedical and biopsychosocial scores and age, number of LBP patients per year, and years of experience.
Athletic trainers treating 9 to 15 LBP patients per year had higher biomedical scores (35.0 ± 5.7) than ATs treating 16 to 34 (31.9 ± 5.5, = .039) or >34 (31.7 ± 8.6, .018) LBP patients per year. The C-ATs treating 16 to 34 (31.8 ± 6.3, = .038) and >34 (31.0 ± 6.7, < .001) LBP patients per year had lower biomedical scores than those treating ≤8 LBP patients per year (34.8 ± 5.9). The C-ATs with ≤5 years of experience had higher biomedical scores than those with 10 to 15 (31.0 ± 6.7, = .011) and 16 to 24 (29.8 ± 7.5, < .001) years of experience. Canadian athletic therapists treating the general public had higher (31.7 ± 4.0) biopsychosocial scores than ATs treating athletes (31.3 ± 3.5, = .006). The C-ATs ≤35.6 years of age had higher biomedical scores (33.1 ± 5.9) than those >35.6 years of age (30.5 ± 7.0, < .001).
Athletic trainers and C-ATs who treated more LBP patients per year were more likely to score low on a biomedical treatment orientation subscale. Because this orientation has predicted poor outcomes in other health care providers, further research is needed to determine the effects of ATs' and C-ATs' biomedical orientations on rehabilitation outcomes.
由于腰痛（LBP）的复发率和慢性率持续居高不下，它仍是一个社会负担。最近的证据表明，提供者的治疗方向会影响患者的信念、临床方法，进而影响康复结果。
描述美国运动训练师（AT）和加拿大运动治疗师（C-AT）对 LBP 的治疗方向。
横断面研究。
在线调查。
共有 273 名 AT（回应率=13.3%）和 382 名 C-AT（回应率=15.3%）。
参与者完成了人口统计学问题和疼痛态度与信念量表（PABS）的 AT/C-AT 部分。PABS 衡量医疗保健提供者的生物医学和生物心理社会治疗方向，并在 6 点李克特量表上进行评分。描述性统计数据描述了参与者；检验和单向方差分析确定了组均值之间的差异；Spearman 相关性评估了生物医学和生物心理社会评分与年龄、每年治疗的 LBP 患者数量和经验年限之间的关系。
每年治疗 9 至 15 名 LBP 患者的 AT 具有更高的生物医学评分（35.0 ± 5.7），而每年治疗 16 至 34 名（31.9 ± 5.5， =.039）或>34 名（31.7 ± 8.6，.018）LBP 患者的 AT 则较低。每年治疗 16 至 34 名（31.8 ± 6.3， =.038）和>34 名（31.0 ± 6.7，<.001）LBP 患者的 C-AT 生物医学评分低于每年治疗≤8 名 LBP 患者的 C-AT（34.8 ± 5.9）。经验年限≤5 年的 C-AT 生物医学评分高于经验年限为 10 至 15 年（31.0 ± 6.7，<.001）和 16 至 24 年（29.8 ± 7.5，<.001）的 C-AT。治疗普通公众的加拿大运动治疗师（C-AT）的生物心理社会评分（31.7 ± 4.0）高于治疗运动员的 AT（31.3 ± 3.5，=.006）。年龄≤35.6 岁的 C-AT 具有更高的生物医学评分（33.1 ± 5.9），而年龄>35.6 岁的 C-AT 则较低（30.5 ± 7.0，<.001）。
每年治疗更多 LBP 患者的 AT 和 C-AT 更有可能在生物医学治疗方向子量表上得分较低。由于这种方向已预测其他医疗保健提供者的预后不良，因此需要进一步研究以确定 AT 和 C-AT 的生物医学方向对康复结果的影响。
