The knowledge of low back pain management between physical therapists and family practice physicians

ABSTRACT

Objectives: The purpose of this study was to compare knowledge in managing patients with low back pain (LBP) between physical therapists and family practice physicians.

Methods: Seventy-three physical therapists and 30 family practice physicians completed standardized examinations assessing knowledge, attitudes, the usefulness of clinical practice guidelines, and management strategies for patients with LBP. Beliefs of physical therapists and family practice physicians about LBP were compared using relative risks and independent t-tests.

Results: Scores related to knowledge, attitudes, and the usefulness of clinical practice guidelines were generally similar between the groups. In addition, there was no difference between the groups for knowledge regarding optimal management strategies for patients with LBP. However, physical therapists were less likely to have difficulty assessing motivation levels of patients with LBP compared to family practice physicians (64.6% vs 26.7%; relative risk: 2.41 [95% confidence interval: 1.30–4.48] and physical therapists were less likely to agree that interventions by health care providers have little positive effect on the natural history of acute LBP (17.8% vs. 50.0%; relative risk: 0.36 [95% confidence interval: 0.19–0.66]).

Discussion: The results of this study may have implications for third-party payers and health care administrators regarding the utilization of physical therapists in the management of patients with LBP in expanded scopes of practice, including direct access and potential placement in primary care clinics.

KEYWORDS:

• Low back pain
• direct access practice
• management strategies

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

NA.

Notes on contributors

Michael Ross

Michael D. Ross, PT, DHSc is an Assistant Professor in the Department of Physical Therapy at Daemen College in Amherst NY and a board-certified Orthopedic Clinical Specialist from the American Board of Physical Therapy Specialties.  Prior to his appointment at Daemen College, Dr. Ross served in the U.S. Air Force for 20 years where he was credentialed as a direct access provider with diagnostic imaging and pharmacological privileges.  He completed his Bachelor's of Science in Physical Therapy from Daemen College, his Doctorate of Health Science in Physical Therapy from the University of Indianapolis, and a Fellowship in Orthopedic Manual Therapy and Musculoskeletal Primary Care from Kaiser Permanente Medical Center in Vallejo, CA.  He has made numerous scientific presentations and has lectured extensively at the entry-level, graduate, and postgraduate levels on medical screening and differential diagnosis in physical therapist practice.  Dr. Ross maintains an active practice for community residents and has published over 140 manuscripts and abstracts related to orthopedic physical therapist practice.  He served as the Editor for the Musculoskeletal Imaging feature of the Journal of Orthopaedic and Sports Physical Therapy from 2008 to 2016 and is a manuscript reviewer for several medical and rehabilitation journals.

Kurtis Adams

Kurtis G. Adams graduated in 2016 from Daemen College with a Doctorate of Physical Therapy. He works in the acute care setting at UC Health Memorial Hospital, Colorado Springs, Colorado focusing on treating patients with orthopedic injuries. Areas of current interest include vestibular rehabilitation and The McKenzie Method.

Kara Engle

Dr. Kara Engle, PT, DPT graduated with a doctoral degree in Physical Therapy from Daemen College in 2016. Kara works for Lattimore Physical Therapy in Rochester, NY, an outpatient orthopedic clinic specializing in rehabilitation of numerous musculoskeletal injuries with primary focus on post-operative recovery.

Travis Enser

Dr. Travis Enser, PT, DPT, graduated with a Doctor of Physical Therapy degree from Daemen College in Amherst, NY in 2016. He currently works for Kindred at Home in Cullman, AL and is pursuing his certification in the McKenzie Method® of Mechanical Diagnosis and Therapy® (MDT).

Allyson Muehlemann

Dr. Allyson Muehlemann, PT, DPT, graduated with a Doctor of Physical Therapy degree from Daemen College in Amherst, NY in 2016. She has worked at Liverpool Physical Therapy in Liverpool, NY, specializing in serving patients with orthopedic disorders. She also worked at the Mayo Clinic Health System in Mankato, MN, specializing in acute care physical therapy. Allyson is currently a physical therapy resident at the Mayo Clinic in Rochester, MN, specializing in neuromuscular disorders.

Ron Schenk

Ron Schenk, PT, PhD, OCS, FAAOMPT, Dip. MDT is a Professor of Physical Therapy at Daemen College in Amherst, NY and is program director for the McKenzie Institute USA Orthopaedic Physical Therapy Residency and the McKenzie and Daemen OMPT Fellowship programs. Dr. Schenk received his BS and MS degrees from Ithaca College and his PhD from the University at Buffalo. Ron is a Fellow of the AAOMPT, and is a Diplomat in Mechanical Diagnosis and Therapy. He has published and presented in relation to is his clinical practice with the Catholic Health System of Buffalo, NY.

Michael Tall

Michael Tall, MD, is an Associate Professor of Radiology at the University of Texas Health Science Center at San Antonio. Mike received his BS and MD degrees from the University of Pittsburgh. He is a retired military physician who has served as a fellowship director in musculoskeletal radiology and as a residency director in diagnostic radiology. He has published and presented in relation to his clinical practice with the Air Force.