Nudelman Yaniv, Pincus Tamar, Ami Noa Ben
Department of Physical Therapy, Ariel University, Ariel, Israel.
Maccabi Healthcare Services, Department of Physical Therapy, Tel-Aviv, Israel.
Phys Ther. 2025 Apr 2;105(4). doi: 10.1093/ptj/pzaf007.
This study aimed to investigate the association of physical therapists' attitudes and beliefs about low back pain (LBP) with treatment outcomes within a publicly funded health care system.
Data from a national outpatient physical therapy service provider were analyzed. Functional status data were collected at intake and discharge. The Attitudes to Back Pain Scale in Musculoskeletal Practitioners questionnaire was used to assess physical therapists' attitudes. Multilevel regression models were employed to examine the effects of physical therapists' attitudes while controlling for patient and physical therapist characteristics.
The study included 68 physical therapists and 1043 patients. The physical therapist level explained a small portion of the variance in patients' function (4%-10%). A more biomedically oriented attitude was associated with a slightly lower patient function level (β = -.08), but patient characteristics largely influenced this effect. Other attitude factors were not significantly associated with function. Sensitivity analyses aligned with the main findings.
The study suggests that physical therapists' attitudes have a limited impact on LBP treatment outcomes within a publicly funded health care system. While a more biomedically oriented attitude was associated with slight negative effects, the clinical relevance is questionable. Further research in diverse settings is needed to validate and contextualize these findings. The study underscores the importance of considering patient-level factors and health care system context in interpreting practitioner effects on treatment outcomes.
Patient characteristics are more significant in explaining functional outcomes than physical therapists' characteristics and attitudes. A marginally small association was observed, indicating that a more biomedically oriented attitude among physical therapists was linked to slightly lower patient functioning. Despite the observed association, the clinical relevance of physical therapists' attitudes in LBP treatment outcomes remains modest.
本研究旨在调查在公共资助的医疗保健系统中，物理治疗师对腰痛（LBP）的态度和信念与治疗结果之间的关联。
分析了来自一家全国性门诊物理治疗服务提供商的数据。在患者入院和出院时收集功能状态数据。使用《肌肉骨骼从业者腰痛态度量表》问卷来评估物理治疗师的态度。采用多水平回归模型来检验物理治疗师态度的影响，同时控制患者和物理治疗师的特征。
该研究纳入了68名物理治疗师和1043名患者。物理治疗师层面解释了患者功能差异的一小部分（4%-10%）。更倾向于生物医学的态度与患者功能水平略低相关（β = -0.08），但患者特征在很大程度上影响了这一效应。其他态度因素与功能无显著关联。敏感性分析与主要发现一致。
该研究表明，在公共资助的医疗保健系统中，物理治疗师的态度对腰痛治疗结果的影响有限。虽然更倾向于生物医学的态度与轻微负面影响相关，但其临床相关性值得怀疑。需要在不同环境中进行进一步研究以验证并结合这些发现的背景。该研究强调了在解释从业者对治疗结果的影响时考虑患者层面因素和医疗保健系统背景的重要性。
患者特征在解释功能结果方面比物理治疗师的特征和态度更显著。观察到的关联极小，表明物理治疗师中更倾向于生物医学的态度与患者功能略低有关。尽管观察到了这种关联，但物理治疗师的态度在腰痛治疗结果中的临床相关性仍然不大。
