TITLE:
McKenzie Therapists Adhere More to Evidence-Based Guidelines and Have a More Biopsychosocial Perspective on the Management of Patients with Low Back Pain than General Physical Therapists in Japan
AUTHORS:
Hiroshi Takasaki, Takeshi Saiki, Yoshihiro Iwasada
KEYWORDS:
Clinical Behavior, Clinical Decision Making, Clinical Guidelines, Low Back Pain, Mechanical Diagnosis and Therapy
JOURNAL NAME:
Open Journal of Therapy and Rehabilitation,
Vol.2 No.4,
November
18,
2014
ABSTRACT: Design: Cross-sectional. Objective: Aim 1 was to preliminarily explore the contributions of the following factors to adherence to LBP practice guidelines using regression modeling: 1) the credential qualification of Mechanical Diagnosis and Therapy (MDT); 2) balance of biomedical and behavioral (i.e. biopsychosocial) oriented approach for low back pain (LBP); 3) demographics; 4) academic degree and 5) the attitude towards updating information for evidence-based clinical practice. Aim 2 was to investigate whether therapists credentialed in MDT (Cred.MDT) were more behavioral oriented and less biomedical oriented than general physical therapists. Summary of Background Data: LBP practice guidelines are not adhered to by every physical therapist. MDT is a behavioral modification approach. Thus, it was hypothesized that the Cred.MDT therapist was more behavioral oriented and more adherent to LBP practice guidelines compared with general physical therapists. Methods: One-hundred-twenty Cred.MDT therapists and 2000 general physical therapists in Japan were contacted. For regression modeling, the dependent variable was adherent to guidelines using a questionnaire with a vignette. Independent variables included balance of biomedical and behavioral perspectives for LBP using the Pain Attitudes and Beliefs Scale for Physiotherapist (PABS-PT), demographics, academic degree and the attitude towards updatinginformation for evidence-based clinical practice. The ratio of the two mean scores of the biomedical and behavioral subscales in the PABS-PT was compared between the Cred.MDT therapist group and the general physical therapists group. Results: Data of 46 general physical therapists and 44 Cred.MDT therapists were available. The Cred.MDT therapist group was significantly (P