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Physical therapy for patients with low back pain in Germany: a survey of current practice

BACKGROUND: Low back pain (LBP) is one of the most common musculoskeletal disorders worldwide. The National Disease Management Guideline (NVL) “Non-specific LBP” is a practical decision-making aid for both physicians and non-medical professionals in Germany to improve quality of health care. Althoug...

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Autores principales: Bahns, Carolin, Happe, Lisa, Thiel, Christian, Kopkow, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214788/
https://www.ncbi.nlm.nih.gov/pubmed/34147077
http://dx.doi.org/10.1186/s12891-021-04422-2
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author Bahns, Carolin
Happe, Lisa
Thiel, Christian
Kopkow, Christian
author_facet Bahns, Carolin
Happe, Lisa
Thiel, Christian
Kopkow, Christian
author_sort Bahns, Carolin
collection PubMed
description BACKGROUND: Low back pain (LBP) is one of the most common musculoskeletal disorders worldwide. The National Disease Management Guideline (NVL) “Non-specific LBP” is a practical decision-making aid for both physicians and non-medical professionals in Germany to improve quality of health care. Although LBP is the most frequent diagnosis resulting in physical therapy treatment, information on the current management of patients with LBP and guideline adherence is limited. The objective of this study was to evaluate the current physical therapy management of patients with LBP in Germany, and to explore guideline adherence to the NVL “Non-specific LBP” recommendations. METHODS: An online survey among physical therapists working in Germany was conducted based on the recommendations given in the NVL “Non-specific LBP”. Participants were recruited using a snowball sampling approach and invited to complete the questionnaire. Guideline adherence was evaluated by comparing the survey findings with the recommendations of the NVL. RESULTS: In total, 1361 physical therapists (41 years of age (SD 11); 839 female, 514 male; 16 years of clinical experience (SD 10)) completed the survey. Fifty percent (n = 675) of our respondents adhered to the recommendations of the NVL on the therapeutic diagnostic process, and 72% (n = 973) to the recommendations concerning treatment. The guideline adherence across the entire management process (i.e., both diagnosis and treatment) of LBP was 38% (n = 513). German physical therapists predominantly provide active interventions, e.g., exercise therapy, but also use interventions with low or conflicting evidence, respectively. Massage and Kinesio Taping were frequently used despite being not recommended. Less than one third of study participants (n = 400, 29%) answered to know the NVL or had dealt with its recommendations. CONCLUSIONS: In the management of LBP, overall guideline adherence among German physical therapists was 38% with higher adherence in the treatment section than in the physical therapeutic diagnostic process. Widespread employment of implementation strategies and removal of existing barriers against the application of evidence-based guidelines could facilitate the transfer of scientific evidence into clinical practice and contribute to optimize the quality of health care. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00012607). Registered 04 October 2017. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-021-04422-2.
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spelling pubmed-82147882021-06-23 Physical therapy for patients with low back pain in Germany: a survey of current practice Bahns, Carolin Happe, Lisa Thiel, Christian Kopkow, Christian BMC Musculoskelet Disord Research BACKGROUND: Low back pain (LBP) is one of the most common musculoskeletal disorders worldwide. The National Disease Management Guideline (NVL) “Non-specific LBP” is a practical decision-making aid for both physicians and non-medical professionals in Germany to improve quality of health care. Although LBP is the most frequent diagnosis resulting in physical therapy treatment, information on the current management of patients with LBP and guideline adherence is limited. The objective of this study was to evaluate the current physical therapy management of patients with LBP in Germany, and to explore guideline adherence to the NVL “Non-specific LBP” recommendations. METHODS: An online survey among physical therapists working in Germany was conducted based on the recommendations given in the NVL “Non-specific LBP”. Participants were recruited using a snowball sampling approach and invited to complete the questionnaire. Guideline adherence was evaluated by comparing the survey findings with the recommendations of the NVL. RESULTS: In total, 1361 physical therapists (41 years of age (SD 11); 839 female, 514 male; 16 years of clinical experience (SD 10)) completed the survey. Fifty percent (n = 675) of our respondents adhered to the recommendations of the NVL on the therapeutic diagnostic process, and 72% (n = 973) to the recommendations concerning treatment. The guideline adherence across the entire management process (i.e., both diagnosis and treatment) of LBP was 38% (n = 513). German physical therapists predominantly provide active interventions, e.g., exercise therapy, but also use interventions with low or conflicting evidence, respectively. Massage and Kinesio Taping were frequently used despite being not recommended. Less than one third of study participants (n = 400, 29%) answered to know the NVL or had dealt with its recommendations. CONCLUSIONS: In the management of LBP, overall guideline adherence among German physical therapists was 38% with higher adherence in the treatment section than in the physical therapeutic diagnostic process. Widespread employment of implementation strategies and removal of existing barriers against the application of evidence-based guidelines could facilitate the transfer of scientific evidence into clinical practice and contribute to optimize the quality of health care. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00012607). Registered 04 October 2017. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-021-04422-2. BioMed Central 2021-06-19 /pmc/articles/PMC8214788/ /pubmed/34147077 http://dx.doi.org/10.1186/s12891-021-04422-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Bahns, Carolin
Happe, Lisa
Thiel, Christian
Kopkow, Christian
Physical therapy for patients with low back pain in Germany: a survey of current practice
title Physical therapy for patients with low back pain in Germany: a survey of current practice
title_full Physical therapy for patients with low back pain in Germany: a survey of current practice
title_fullStr Physical therapy for patients with low back pain in Germany: a survey of current practice
title_full_unstemmed Physical therapy for patients with low back pain in Germany: a survey of current practice
title_short Physical therapy for patients with low back pain in Germany: a survey of current practice
title_sort physical therapy for patients with low back pain in germany: a survey of current practice
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214788/
https://www.ncbi.nlm.nih.gov/pubmed/34147077
http://dx.doi.org/10.1186/s12891-021-04422-2
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