Knoop J, van Lankveld W, Geerdink F J B, Soer R, Staal J B
HAN University of Applied Sciences, Musculoskeletal Rehabilitation research group, Nijmegen, the Netherlands.
Saxion University of Applied Sciences, Enschede, the Netherlands.
BMC Musculoskelet Disord. 2020 Feb 24;21(1):120. doi: 10.1186/s12891-020-3132-9.
This study aims to explore (i) physiotherapists' current use in daily practice of patient-reported measurement instruments (screening tools and questionnaires) for patients with acute low back pain (LBP), (ii) the underlying reasons for using these instruments, (iii) their perceived influence on clinical decision-making, and (iv) the association with physiotherapist characteristics (gender, physiotherapy experience, LBP experience, overall e-health affinity).
Survey study among Dutch physiotherapists in a primary care setting. A sample of 650 physiotherapists recruited from LBP-related and regional primary care networks received the survey between November 2018 and January 2019, of which 85 (13%) completed it.
Nearly all responding physiotherapists (98%) reported using screening tools or other measurement instruments in cases of acute LBP; the Quebec Back Pain Disability Scale (64%) and the STarT Back Screening Tool (61%) are used most frequently. These instruments are primarily used to evaluate treatment effect (53%) or assess symptoms (51%); only 35% of the respondents mentioned a prognostic purpose. Almost three-quarters (72%) reported that the instrument only minimally impacted their clinical decision-making in cases of acute LBP.
Our survey indicates that physiotherapists frequently use patient-reported measurement instruments in cases of acute LBP, but mostly for non-prognostic reasons. Moreover, physiotherapists seem to feel that current instruments have limited added value for clinical decision-making. Possibly, a new measurement instrument (e.g., screening tool) needs to be developed that does fit the physiotherapist's needs and preferences. Our findings also suggest that physiotherapist may need to be more critical about which measurement instrument they use and for which purpose.
本研究旨在探讨：（i）物理治疗师在日常实践中对急性下腰痛（LBP）患者使用患者报告的测量工具（筛查工具和问卷）的现状；（ii）使用这些工具的潜在原因；（iii）他们认为这些工具对临床决策的影响；以及（iv）与物理治疗师特征（性别、物理治疗经验、LBP经验、整体电子健康亲和力）的关联。
对荷兰基层医疗环境中的物理治疗师进行调查研究。2018年11月至2019年1月期间，从与LBP相关的和地区基层医疗网络中招募了650名物理治疗师作为样本，其中85名（13%）完成了调查。
几乎所有回复的物理治疗师（98%）报告在急性LBP病例中使用筛查工具或其他测量工具；魁北克腰痛残疾量表（64%）和STarT Back筛查工具（61%）使用最为频繁。这些工具主要用于评估治疗效果（53%）或评估症状（51%）；只有35%的受访者提到有预后目的。近四分之三（72%）的人报告说，该工具在急性LBP病例中对他们的临床决策影响极小。
我们的调查表明，物理治疗师在急性LBP病例中经常使用患者报告的测量工具，但主要是出于非预后原因。此外，物理治疗师似乎觉得当前的工具对临床决策的附加价值有限。可能需要开发一种新的测量工具（如筛查工具），以符合物理治疗师的需求和偏好。我们的研究结果还表明，物理治疗师可能需要对他们使用的测量工具及其用途更加审慎。
