Physiotherapists’ treatment techniques in New Zealand for management of acute nonspecific low back pain and its relationships with treatment outcomes: a pilot study

Abstract

Background: Physiotherapy plays an important role in management of acute nonspecific low back pain (NSLBP). However, there is a relative dearth of information about the current clinical practice for management of NSLBP and its relationships with clinical outcomes of pain and function.

Objective: To investigate the current physiotherapy practice patterns in management of acute NSLBP in New Zealand (NZ), and determine its relationships with clinical outcomes of pain and function.

Methods: A prospective observational cohort study, using data from private physiotherapy clinics, was conducted. Physiotherapists at each clinic completed a treatment summary form at time of discharge. Treatment techniques used and clinical outcome of pain [numeric pain rating scale (NPRS)] and function [Patient-specific Function scale (PSFS)] were extracted from recorded notes. Raw values of NPRS and PSFS were converted to percentage of available change scores and used for further analysis.

Results and Conclusions: A total of 199 data-sets of acute NSLBP patients were included in the analysis. A wide variety of treatment techniques were used by NZ physiotherapists, with joint mobilization being the most popular form of treatment choice (88%), often combined with specific exercises and massage (21%). Linear regression analysis demonstrated a significant positive association between joint mobilization and massage and patient’s function, and pain and function, respectively; whereas, a significant negative association between specific exercises and patient’s function. The most popular form of treatments used by NZ physiotherapists’ lacks support from evidence-based clinical guidelines, but still seems to be effective in reducing pain and improving function.

Keywords:

• Low back pain
• practice patterns
• current practice
• physiotherapy
• New Zealand