Adherence to key domains in low back pain guidelines: A cross-sectional study of Danish physiotherapists.
Maja Husted, Camilla B Rossen, Tue S Jensen and 2 others
PMID 32537859WHAT IT FOUND
Danish physiotherapists strictly adhered to guidelines for assessing psychosocial risk factors but were cautious with activity and work advice.
Public clinic therapists showed better adherence than private ones, who had far shorter first consultations. Passive treatments like heat and electrotherapy were rarely used.
Key findings
01Adherence to guidelines for activity and work was low, with only 6% to 32% strictly in line for activity and 16% to 53% for work across two patient vignettes.
02Public physiotherapists adhered significantly more strictly to guidelines for assessing psychosocial risk factors than private physiotherapists in both vignettes.
03The most common treatments were exercise instruction and education about the benign nature of low back pain, while passive treatments like electrotherapy were used by only 1% to 3% of therapists.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The response rate was low at 29%, and only 22% of private physiotherapists responded compared to 85% of public ones, meaning the results may not represent the private sector. The study used hypothetical vignettes rather than observing actual patient interactions, and previous research shows poor correlation between vignette responses and what patients report being advised. The survey was self-reported and participants were not blinded, which may lead to socially desirable answers that overestimate guideline adherence.
The easy way to misread this
Do not assume these adherence rates reflect real-world practice. The study used hypothetical vignettes, and the low response rate from private clinics means the findings may be biased toward therapists who are already engaged in professional development.