Management of nonspecific low back pain by physiotherapists in Britain andIreland - A descriptive questionnaire of current clinical practice

Study Design. A descriptive questionnaire of chartered physiotherapists. Objective. To investigate current physiotherapeutic management of low back pain throughout Britain and Ireland. Summary of Background Data. Physiotherapists play a key role in low back pa in management. Although clinical guidelines for best practice have been dev eloped recently, there has been no large-scale attempt to describe current physiotherapeutic treatment approaches within Britain or Ireland. Methods. After semi-structured interviews (n = 6) and two pilot studies (n = 77) were done, postal questionnaires were distributed to four regional cl uster samples of the membership of two physiotherapy professional organizat ions (n = 2654). After two mailings, a random sample of 90 nonresponders we re followed up. Data were analyzed using the Statistical Package for the So cial Sciences (SPSS Ltd., Woking, Surrey, UK), and precision of the survey estimates was assessed by calculation of sampling errors and intraclass cor relation coefficients for cluster sampling. Results. Results were received from 1548 therapists (total response rate, 5 8.3%); of these, 813 reported that they were practicing in settings in whic h they treated patients with low back pain. Analysis of the results indicat ed the overall popularity of the Maitland mobilization and McKenzie approac hes among physiotherapists. Although exercise per se was mentioned frequent ly by respondents, a marked difference in opinion among therapists regardin g the optimal type of exercise for low back pain was obvious. Little eviden ce was demonstrated of the use of manipulation, fitness programs, or multid isciplinary efforts involving behavioral and physical aspects of treatment. Commonly used methods of electrotherapy were interferential therapy, ultra sound, pulsed shortwave diathermy, and transcutaneous electrical nerve stim ulation. Conclusions. The results of this study emphasize the need to evaluate furth er and improve the dissemination of findings regarding the effectiveness of specific physiotherapy approaches for low back pain management.