Manual physical therapists (MPTs) working in primary care get limited information about patient’s courses of (chronic) low back pain (LBP). Identification of kinesiophobia is mostly based on clinical perception.
OBJECTIVE:
The aim of this study was to evaluate the association between the scores with which manual physical therapists in a primary care setting identify kinesiophobia in patients with low back pain, and the patients’ self-reported measures of kinesiophobia.
METHODS:
The cross-sectional study comprised 104 patients with LBP and 17 MPTs. Patients first independently completed the Tampa Scale for Kinesiophobia (TSK-17). The therapists, blinded to the TSK-scores, rated their perception of a patient’s kinesiophobia using the Visual Analogue Scale-Estimation (VAS-est) and the accuracy of their ratings using the Visual Analogue Scale-Accuracy (VAS-ac). Kendall’s tau b was used to determine the level of correlation between scores on the TSK-17 and the VAS-est.
Get full access to this article
View all access options for this article.
References
1.
HendriksHJMOostendorpRABBernardsATMVan RavensbergCDHeerkensYFNelsonRM. The diagnostic process and indication for physiotherapy: A prerequisite for treatment and outcome evaluation. Phys Ther Rev2000; 5: 29-47.
2.
WCPT. Position Statement. Description of physical therapy. World Confederation for Physical Therapy [Internet] 2014 June [cited 2016 Jan 15] [about 12 pp] Available from: http://www.wcpt.org/policy/ps-descriptionPT.
3.
JonesMRivettD. Clinical reasoning for manual therapists. Edinburgh: Butterworth Heinemann; 2004.
4.
LangridgeNRobertsLPopeC. The clinical reasoning processes of extended scope physiotherapists assessing patients with low back pain. Man Ther2015; 20(6): 745-750.
5.
SmartKDoodyC. The clinical reasoning of pain by experienced musculoskeletal physiotherapists. Man Ther2007; 12(1): 40-49.
6.
PerreaultKDionneCERossignolMPoitrasSMorinD. Inter-professional practices of private-sector physiotherapists for low back pain management: Who, How, and When? Physiother Can2016; 68(4): 323-334.
7.
RousselNANeelsHKuppensKLeysenMKerckhofsENijsJ, et al. History taking by physiotherapists with low back pain patients: Are illness perceptions addressed properly? Disabil Rehabil2015; 26: 1-12.
8.
DerghazarianTSimmondsMJ. Management of low back pain by physical therapists in Quebec: How are we doing? Physiother Can2011; 63(4): 464-473.
9.
AlexandersJAndersonAHendersonS. Musculoskeletal physiotherapists’ use of psychological interventions: A systematic review of therapists’ perceptions and practice. Physiotherapy2015; 101(2): 95-102.
10.
SynnottAO’KeeffeMBunzliSDankaertsWO’SullivanPO’SullivanK. Physiotherapists may stigmatise or feel unprepared to treat people with low back pain and psychosocial factors that influence recovery: a systematic review. J Physiother2015; 61(2): 68-76.
11.
NicholasMKLintonSJWatsonPJMainCJ, “Decade of the Flags” Working Group. Early identification and management of psychological risk factors (“yellow flags”) in patients with low back pain: A reappraisal. Phys Ther2011; 91(5): 737-53.
12.
FosterNEDelittoA. Embedding psychosocial perspectives within clinical management of low back pain: Integration of psychosocially informed management principles into physical therapist practice – challenges and opportunities. Phys Ther2011; 91(5): 790-803.
13.
VlaeyenJWCrombezG. Fear of movement/(re)injury, avoidance and pain disability in chronic low back pain patients. Man Ther1999; 4(4): 187-195.
14.
VlaeyenJWLintonSJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain2000; 85(3): 317-332.
15.
LeeuwMGoossensMELintonSJCrombezGBoersmaKVlaeyenJW. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med2007; 30(1): 77-94.
16.
PistersMLeemrijseC. Het gebruik van aanbevolen meetinstrumenten in de fysiotherapiepraktijk. Weten is nog geen meten! Ned Tijdschr Fysiother2007; 117(5): 176-181.
17.
SwinkelsRAvan PeppenRPWittinkHCustersJWBeurskensAJ. Current use and barriers and facilitators for implementation of standardized measures in physical therapy in the Netherlands. BMC Musculoskelet Disord2011; 12: 106.
18.
KoriSHMillerRPToddDD. Kinesiophobia: A new view of chronic pain behavior. Pain Manag1990; 3: 35-43.
19.
NijsJRousselNPaul van WilgenCKökeASmeetsR. Thinking beyond muscles and joints: Therapists’ and patients’ attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment. Man Ther2013; 18(2): 96-102.
20.
ValjakkaALSalanteräSLaitilaAJulkunenJHagelbergNM. The association between physicians’ attitudes to psychosocial aspects of low back pain and reported clinical behaviour: A complex issue. Scan J Pain2013; 4(1): 25-30.
21.
StaigerTOJarvikJGDeyoRAMartinBBraddockCH 3. BRIEF REPORT: Patient-physician agreement as a predictor of outcomes in patients with back pain. J Gen Intern Med2005; 20: 935-937.
22.
CedraschiCRobertJPerrinEFischerWGoergDVischerTL. The role of congruence between patient and therapist in chronic low back pain patients. J Manipulative Physiol Ther1996; 19: 244-249.
23.
CalleyDQJacksonSCollinsHGeorgeSZ. Identifying patient fear-avoidance beliefs by physical therapists managing patients with low back pain. J Orthop Sports Phys Ther2010; 40(12): 774-783.
24.
OostendorpRAElversHMikołajewskaELaekemanMvan TrijffelESamwelH, et al. Manual physical therapists’ use of biopsychosocial history taking in the management of patients with back or neck pain in clinical practice. The Scientific World Journal2015; Article ID 170463.
25.
VlaeyenJWKole-SnijdersAMBoerenRG, van EekH. Fear of movement/ (re)injury in chronic low back pain and its relation to behavioral performance. Pain1995; 62(3): 363-372.
26.
Swinkels-MeewisseEJSwinkelsRAVerbeekALVlaeyenJWOostendorpRA. Psychometric properties of the Tampa Scale for Kinesiophobia and the fear-avoidance beliefs questionnaire in acute low back pain. Man Ther2003; 8(1): 29-36.
27.
WeversMELoweNK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health1990; 13: 227-236.
28.
McCormackHMHorneDJSheatherS. Clinical applications of visual analogue scales: a critical review. Psychol Med1988; 18(4): 1007-1019.
29.
PortneyLGWatkinsMP. Foundations of clinical research. Applications to practice. Norwalk: Connecticut; Appleton & Lange; 1993.
30.
QasemMCanbyG. Are physiotherapists able to identify patients’ psychosocial problems related to their treatment? A critical evaluation of research. IJPOT2016; 10(1): 104-107.
31.
BealesDKendellMChangRPHåmsøMGregoryLRichardsonK, et al. Association between the 10 item Örebro musculoskeletal pain screening questionnaire and physiotherapists’ perception of the contribution of biopsychosocial factors in patients with musculoskeletal pain. Man Ther2016; 23: 48-55.
32.
BishopAFosterNEThomasEHayEM. How does the self-reported clinical management of patients with low back pain relate to the attitudes and beliefs of health care practitioners? A survey of UK general practitioners and physiotherapists. Pain2008; 135(1-2): 187-195.
33.
DaubsMDPatelAAWillickSEKendallRWHansenPPetronDJ, et al. Clinical impression versus standardized questionnaire: The spinal surgeon’s ability to assess psychological distress. J Bone Joint Surg Am2010; 92(18): 2878-2883.
34.
OsteloRWVlaeyenJW. Attitudes and beliefs of health care providers: Extending the fear-avoidance model. Pain2008; 135(1-2): 3-4.
35.
DaykinARRichardsonB. Physiotherapists’ pain beliefs and their influence on the management of patients with chronic low back pain. Spine (Phila Pa 1976)2004; 29(7): 783-795.
36.
JeffreyJEFosterNE. A qualitative investigation of physical therapists’ experiences and feelings of managing patients with nonspecific low back pain. Phys Ther2012; 92(2): 266-278.
37.
World Health Organization. International Classification of Functioning, Disability and Health. Geneva: WHO; 2001.
38.
JosephsonIBulowPHedbergB. Physiotherapists’ clinical reasoning about patients with non-specific low back pain, as described by the International Classification of Functioning, Disability and Health. Disabil Rehabil2011; 33: 2217-2228.
39.
KirschneckMKirchbergerIAmannECiezaA. Validation of the comprehensive ICF core set for low back pain: The perspective of physical therapists. Man Ther2011; 16: 364-372.
40.
GlockerCKirchbergerIGlasselAFincziczkiAStuckiGCiezaA. Content validity of the comprehensive international classification of functioning, disability and health (ICF) core set for low back pain from the perspective of physicians: A Delphi survey. Chronic Illn2013; 9: 57-72.
41.
VlaeyenJWde JongJGeilenMHeutsPHvan BreukelenG. Graded exposure in vivo in the treatment of pain-related fear: A replicated single-case experimental design in four patients with chronic low back pain. Behav Res Ther2001; 39(2): 151-166.
42.
VlaeyenJW, de JongJGeilenMHeutsPH, van BreukelenG. The treatment of fear of movement/(re)injury in chronic low back pain: further evidence on the effectiveness of exposure in vivo. Clin J Pain2002; 18(4): 251-261.
43.
LintonSJBoersmaKJanssonMOvermeerTLindblomKVlaeyenJW. A randomized controlled trial of exposure in vivo for patients with spinal pain reporting fear of work-related activities. Eur J Pain2008; 12(6): 722-730.
44.
KuglerKWijnJGeilenMde JongJVlaeyenJWS. The Photograph series of Daily Activities (PHODA). CD-ROM Version 1.0., Institute for Rehabilitation Research and School for Physiotherapy Heerlen, The Netherlands, 1999.
45.
LeeuwMGoossensME, van BreukelenGJBoersmaKVlaeyenJW. Measuring perceived harmfulness of physical activities in patients with chronic low back pain: The Photograph Series of Daily Activities–short electronic version. J Pain2007; 8(11): 840-849.
46.
KenensRJHingstmanL. Cijfers uit de registratie van fysiotherapeuten: peiling 1 januari 2010. Utrecht: NIVEL; 2011.
47.
BekkeringGEvan TulderMWHendriksEJKoopmanschapMAKnolDLBouterLM, et al. Implementation of clinical guidelines on physical therapy for patients with low back pain: Randomized trial comparing patient outcomes after a standard and active implementation strategy. Phys Ther2005; 85(6): 544-555.
48.
PerreaultKDionneCERossignolMMorinD. Interprofessional practices of physiotherapists working with adults with low back pain in Québec’s private sector: Results of a qualitative study. BMC Musculoskelet Disord2014 May 17; 15: 160.
49.
LiLCBombardierC. Physical therapy management of low back pain: An exploratory survey of therapist approaches. Phys Ther2001; 81(4): 1018-1028.
50.
GreenAJJacksonDAKlaber-MoffetJA. An observational study of physiotherapists’ use of cognitive-behavioral principles in the management of patients with back and neck pain. Physiotherapy2008; 94(4): 306-313.
51.
DarlowBFullenBMDeanSHurleyDABaxterGDDowellA. The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: A systematic review. Eur J Pain2012; 16(1): 3-17.
52.
Van TulderMBeckerABekkeringTBreenA, del RealMTHutchinsonA, et al. COST B13 Working Group on guidelines for the management of acute low back pain in primary care. Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J2006; 15(Suppl 2): S169-S191.
53.
AiraksinenOBroxJICedraschiCHildebrandtJKlaber-MoffettJKovacsF, et al. COST B13 Working Group on guidelines for chronic low back pain. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J2006; 15(Suppl 2): S192-S300.
54.
BekkeringGEHendriksHJMKoesBWOostendorpRABOsteloRWJGThomassenJ et al. KNGF-richtlijn Lage-rugpijn. Nederlands Tijdschrift voor Fysiotherapie2005; 115(1): 1-20.
55.
StaalJBHendriksEJMHeijmansMKiersHLutgers-BoomsmaAMRuttenG, et al. KNGF-richtlijn Lage rugpijn. Amersfoort: Koninklijk Nederlands Genootschap voor Fysiotherapie; 2013.
