一个电子学习项目改善了物理治疗师对腰痛的认知：一项随机试验。

An e-learning program improves low back pain beliefs of physiotherapists: a randomised trial.

作者信息

Magalhães Daniela Silva, McAuley James H, Maher Chris G, Ferreira Erica de Matos Reis, Oliveira Tadeu Emanuel Prado, Mastahinich Mario Efrain Recinos, de Jesus-Moraleida Fabianna Resende, Fukusawa Leandro, Franco Marcia Rodrigues, Pinto Rafael Zambelli

机构信息

Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia; School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.

出版信息

J Physiother. 2025 Jan;71(1):35-41. doi: 10.1016/j.jphys.2024.11.014. Epub 2024 Dec 14.

DOI:10.1016/j.jphys.2024.11.014

PMID:39675949

Abstract

QUESTION

How effective is an e-learning program based on international clinical guidelines in promoting beliefs more aligned with the current evidence for the management of low back pain among physiotherapists?

DESIGN

Randomised controlled trial with concealed allocation and intention-to-treat analysis.

PARTICIPANTS

106 physiotherapists who treat patients with low back pain.

INTERVENTIONS

The experimental group received access to an e-learning program, based on recommendations of clinical practice guidelines for the management of low back pain, over a 6-week period. The program consisted of six units, totalling 15 hours, and was offered in a self-instructional and self-paced format. The control group was instructed to continue their activities as usual.

OUTCOME MEASURES

The primary outcome was beliefs about low back pain measured using the Modified Back Beliefs Questionnaire (MBBQ, -50 worst to 50 best). Secondary outcomes included the Back Pain Attitudes Questionnaire (Back-PAQ, -20 worst to 20 best) and agreement with two statements (1: X-rays or scans are necessary to get the best medical care for low back pain; 2: Everyone with low back pain should have spine imaging). Participants were evaluated at baseline and 6 weeks.

RESULTS

Out of 53 participants allocated to the e-learning program, two completed only the first unit and one did not complete any units, resulting in an overall adherence rate of 94%. Compared with control, the e-learning program improved the MBBQ (MD 8 points, 95% CI 5 to 10) and the Back-PAQ score (MD 3.1 points, 95% CI 1.8 to 4.3). For the imaging beliefs statements, the e-learning program was able to increase the proportion of participants with beliefs aligned with the current evidence (statement 1: RD 38%, 95% CI 21 to 52; statement 2: RD 17%, 95% CI 7 to 29) compared with the control group.

CONCLUSION

The e-learning program based on recommendations of clinical practice guidelines for the management of low back pain improved physiotherapists' beliefs about the management of low back pain.

REGISTRATION

NCT05661968.

摘要

问题

基于国际临床指南的电子学习项目在促使物理治疗师形成与当前腰痛管理证据更相符的信念方面效果如何？

设计

采用隐蔽分组和意向性分析的随机对照试验。

参与者

106名治疗腰痛患者的物理治疗师。

干预措施

实验组在6周内可使用基于腰痛管理临床实践指南建议的电子学习项目。该项目由六个单元组成，共计15小时，采用自学且自定进度的形式提供。对照组按常规继续其活动。

结局指标

主要结局是使用改良后背部信念问卷（MBBQ，最差-50分至最佳50分）测量的关于腰痛的信念。次要结局包括背痛态度问卷（Back-PAQ，最差-20分至最佳20分）以及对两条陈述的认同度（陈述1：为获得最佳腰痛医疗护理，X射线或扫描是必要的；陈述2：每个腰痛患者都应进行脊柱成像）。参与者在基线和6周时接受评估。

结果

在分配到电子学习项目的53名参与者中，2人仅完成了第一单元，1人未完成任何单元，总体依从率为94%。与对照组相比，电子学习项目改善了MBBQ得分（平均差值8分，95%置信区间5至10）和Back-PAQ得分（平均差值3.1分，95%置信区间1.8至4.3）。对于成像信念陈述，与对照组相比，电子学习项目能够提高信念与当前证据相符的参与者比例（陈述1：相对差值38%，95%置信区间21至52；陈述2：相对差值17%，95%置信区间7至29）。