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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Physical therapists’ ability to identify psychological factors and their self-reported competence to manage chronic low back pain
Authors: Probst, Michel
Brunner, Emanuel
Meichtry, André
O’Sullivan, Kieran
Baldew, Se-Sergio
Dankaerts, Wim
DOI: 10.1093/ptj/pzy012
Published in: Physical Therapy
Volume(Issue): 98
Issue: 6
Page(s): 471
Pages to: 479
Issue Date: 1-Jun-2018
Publisher / Ed. Institution: Oxford University Press
ISSN: 0031-9023
Language: English
Subject (DDC): 615.82: Physical therapy
617.5: Orthopaedic surgery
Abstract: Background: In the management of chronic low back pain (LBP), identifying and managing more patients who are at high risk and who have psychological barriers to recovery is important yet difficult. Objective: The objective of this study was to test physical therapists’ ability to allocate patients into risk stratification groups, test correlations between therapists’ assessments of psychological factors and patient questionnaires, and explore relationships between psychological factors and therapists’ self-reported competence to manage patients with chronic LBP. Design: This was a pragmatic, observational study. Methods: Patients completed the STarT Back Tool (SBT, for risk stratification), the Four-Dimensional Symptom Questionnaire (distress, depression, anxiety), and the Tampa Scale of Kinesiophobia (kinesiophobia) prior to the intake session. After this session, physical therapists estimated patient prognostic risk using the 3 SBT categories and rated patient psychological factors using a 0-to-10 scale. Finally, therapists reported their self-reported competence to manage the patient. Intraclass and Spearman rank correlations tested correlations between therapists’ intuitive assessments and patient questionnaires. A linear-mixed model explored relationships between psychological factors and therapists’ self-reported competence. Results: Forty-nine patients were managed by 20 therapists. Therapists accurately estimated SBT risk allocation in only 41% of patients. Correlations between therapist perceptions and patient questionnaires were moderate for distress (r = 0.602) and fair for depression (r = 0.304) and anxiety (r = 0.327). There was no correlation for kinesiophobia (r = −0.007). Patient distress was identified as a negative predictor of therapists’ self–reported competence. Limitations: This was a cross-sectional study, conducted in only 1 center. Conclusions: Physical therapists were not very accurate at allocating patients into risk stratification groups or identifying psychological factors. Therapists’ self-reported competence in managing patients was lowest when patients reported higher distress.
Further description: Erworben im Rahmen der Schweizer Nationallizenzen (
Fulltext version: Published version
License (according to publishing contract): Licence according to publishing contract
Restricted until: 2022-01-01
Departement: School of Health Sciences
Organisational Unit: Institute of Physiotherapy (IPT)
Appears in collections:Publikationen Gesundheit

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