Evaluation of therapists’ individual characteristics’ influence on recommendations to CLBP patients
Dr Cyrille BURRUSa, Ms Jessica DUCKIb, Ms Marie-Laure CONNAISSAb, Mr Bertrand LEGERb, Mr Philippe TERRIERb, Mr Philippe VUISTINERb, Dr François LUTHIc
a Clinique Romande de Réadaptation SuvaCare, 1950 Sion, Suisse, b Institut de Recherche en Réadaptation, 1950 Sion, Suisse, c Service de réadaptation de l’appareil locomoteur, Clinique romande de réadaptation Suvacare, 1950 Sion, Suisse
This study measured different therapists’ biopsychosocial parameters and their influence on treatment recommendations for chronic low back pain (CLBP) patients. Based on previous studies and with a biopsychosocial approach, this work aimed to understand the variations in recommendations depending on personal dispositions.
82 therapists (aged 37 ± 11 years, 34 men/ 48 women) were recruited within our rehabilitation clinic (CRR). Their physical activity was objectively assessed by tri-axial accelerometry and questionnaires have been used to evaluate the following variables: subjective physical activity (BAECKE), pain attitudes and beliefs (TSK and POAM-P), anxiety and depression (HADS), uncertainty intolerance (EII) and social desirability (MC-SDS). Objective stress level was measured by salivary cortisol.
In order to measure the variability in recommendations, 3 validated vignettes for CLBP patients management were distributed.
Behavioural patterns coping with pain (Avoidance, Overdoing and Pacing) do occur in therapists (10% Avoidance, 47% Pacing and 43% Overdoing) and do affect recommendations’ application. These 3 different patterns are also related to age, sex, BMI, depression and physical activity. Others relations are currently being analysed.
This study suggests that we could categorise therapists depending onidiosyncratics variablespersonal dispositions. This classification would determine recommendations orientation for physical and professional activity. For future research studies, it would be interesting to deal in depth with these relations in order to individualize recommendations to get a better rehabilitation procedure.
Maureen J Simmonds, Tamar Derghazarian, and Johan WS Vlaeyen, 'Physiotherapists’ Knowledge, Attitudes, and Intolerance of Uncertainty Influence Decision Making in Low Back Pain', The Clinical journal of pain, 28 (2012), 467-74.
Keywords : Beliefs and attitudes; low back pain; therapists; activity and participation