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Low back pain approaches by physiotherapists

Year 2021, Volume: 8 Issue: 2, 152 - 159, 10.09.2021
https://doi.org/10.15437/jetr.602789

Abstract

Purpose: The aim of this study was to determine how physiotherapists approach to low back pain in Turkey and what is the knowledge of physiotherapists about it.

Methods: A questionnaire survey, include 18 different questions that dispute the preference of treatment and the knowledge of low-back pain, was prepared for physiotherapists. The survey form was sent to the Turkish Physiotherapists Association's mail group, with one-week intervals 4 times. Also, the form was shared on some physiotherapist groups on social media.

Results: The survey form was recorded by 115 physiotherapists. Physiotherapists reported that they more encounter with chronic low-back pain patients, many of them are evaluating the sacroiliac joint, they most commonly use “Mc-Kenzie, Cyriax and Mulligan” concepts for manipulation and mobilizations, they more use “TENS, ultrasound and interferential stimulation” as electrotherapy modalities, and the most preferred treatments are stretching and posture exercises, electrotherapy modalities and lumbar spinal mobilization and manipulation.

Conclusion: The main treatment preference and knowledge of low-back pain of physiotherapists in Turkey was demonstrated in this study. However, a smaller number of physiotherapists were completed the survey form, future researches should reach wider groups for more clear information.

References

  • 1. Moffett, J. K., RIchardson, G., Sheldon, T., et al. Back pain: its management and costs to society. No. 129chedp; 1995.
  • 2. Frost H, Lamb SE, Doll HA, et al. Randomised controlled trial of physiotherapy compared with advice for low back pain. Bmj 2004;329:708.
  • 3. Bener A, Dafeeah EE, Alnaqbi K, et al. An epidemiologic analysis of low back pain in primary care: a hot humid country and global comparison." J Prim Care Community Health. 2013;4:220-227.
  • 4. Maniadakis, N., & Gray, A. The economic burden of back pain in the UK. Pain. 2000;84:95-103.
  • 5. Manca, A., Dumville, J. C., Torgerson, D. J.,et al. Randomized trial of two physiotherapy interventions for primary care back and neck pain patients: cost–effectiveness analysis. Rheumatology. 2007;46:1495-1501.
  • 6. Battié, M. C., Cherkin, D. C., Dunn, R., et al. Managing low back pain: attitudes and treatment preferences of physical therapists. Phys Ther. 1994;74:219-226.
  • 7. Erdoğanoğlu Y, Kerem Günel M, Çetin A. Kronik bel ağrısı olan kadınlarda farklı egzersiz uygulamalarının etkinliğinin araştırılması. Fizyoter Rehabil. 2012;23:125-136.
  • 8. Eisenberg, D. M., Buring, J. E., Hrbek, A. L., et al. A model of integrative care for low-back pain. J. Altern. Complement. Med. 2012;18:354-362.
  • 9. Van Tulder MW, Koes BW, Bouter LM. Conservative Treatment of Acute and Chronic Nonspecific Low Back Pain: A Systematic Review of Randomized Controlled Trials of the Most Common Interventions. Spine. 1997;22:2128-2156.
  • 10. Koes BW, Van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. Bmj. 2006;332:1430–1434.
  • 11. Poitras, S., Blais, R., Swaine, B., et al. Management of work-related low back pain: a population-based survey of physical therapists. Phys Ther. 2005;85:1168-1181.
  • 12. Foster, N. E., Thompson, K. A., Baxter, G. D., et al. Management of nonspecific low back pain by physiotherapists in Britain and Ireland: a descriptive questionnaire of current clinical practice. Spine. 1999;24:1332-1342.
  • 13. Howard W. Makofsky, Spinal Manuel Therapy-Second Edition. 2010;141-153.
  • 14. Aydoğan Arslan, S., & Erbahçec, F. Bel Ağrısında Farklı Fizyoterapi Programlarının Ağrı, Endurans ve Yaşam Kalitesi Üzerine Etkinliği. Firat Tip Dergisi. 2016;21:84-90
  • 15. Kulaber A, Yılmaz H, Yavuzer M. Kronik Bel ağrılı Hastalarda Fizyoterapi Uygulamalarının Etkinliği. Haliç Üniversitesi Sağlık Bilimleri Dergisi. 2019;1:28-17.
  • 16. Moffett J, McLean S. The role of physiotherapy in the management of non-specific back pain and neck pain. Rheumatology. 2006;45(4):371-378.
  • 17. Britt H, Miller GJ, Knox S, et al. General practice activity in Australia. Canberra, University of Sydney and the Australian Institute of Health and Welfare; 2001;2000-2001.
  • 18. Sayer G, Britt H, Horn F, et al. Measures of health and health care delivery in general practice in Australia. Canberra, University of Sydney and the Australian Institute of Health and Welfare. 2000.
  • 19. Hansen, F. R., Bendix, T., Skov, P., et al. Intensive, dynamic back-muscle exercises, conventional physiotherapy, or placebo-control treatment of low-back pain. A randomized, observer-blind trial. Spine. 1993;18:98-108.
  • 20. Linda J. Vorvick, MD Medline Plus. Chiropractic care for back pain. 2011. Erişim: 23.08.2019. http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000416.htm.
  • 21. Carey TS, Garrett JM, Jackman AM. Beyond the good prognosis: examination of an inception cohort of patients with chronic low back pain. Spine. 2000;25:115-120.
  • 22. Borenstein DG. Chronic low back pain. Rheum Dis Clin North Am. 1996;22:439-456.
  • 23. Comer CM, Redmond AC, Bird HA, et al. Assessment and management of neurogenic claudication associated with lumbar spinal stenosis in a UK primary care musculoskeletal service: a survey of current practice among physiotherapists. BMC Musculoskelet Disord. 2009;10:121.
  • 24. Cibulka MT. The treatment of the sacroiliac joint component to low back pain: a case report. Phys Ther. 1992;72:917-922.
  • 25. Dolunay ET, Can F. Sakroiliak eklem disfonksiyonunun tedavisinde sakroiliak ortez ve egzersiz uygulamasının sonuçları. Fizyoterapi Rehabilitasyon. 2005;16:113-119.
  • 26. Laslett M, Young SB, Aprill CN et al. Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Australian Journal of Physiotherapy. 2003;49:89-97.
  • 27. Gotlieb D. Cape Town August. The Clinical Examination of the Rheumatic disease patient. 2005. Erişim: 03.08.2019 http://www.arthritis.co.za/the%20clinical%20examination%20technique.html.
  • 28. Cyriax, J. H., & Cyriax, P. Cyriax's illustrated manual of orthopaedic medicine. Elsevier Health Sciences. 1996.
  • 29. Donaldson, M., Petersen, S., Cook, C., et al. A prescriptively selected nonthrust manipulation versus a therapist-selected nonthrust manipulation for treatment of individuals with low back pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2016;46:243-250.
  • 30. Courtney, C. A., Clark, J. D., Duncombe, A. M., et al. Clinical presentation and manual therapy for lower quadrant musculoskeletal conditions. J Man Manip Ther. 2011;19:212-222.
  • 31. Oral, A., & Ketencİ, A. Radiküler Bel Ağrılarının Tedavisinde Fiziksel Tıp ve Rehabilitasyon Yaklaşımları: En Uygun ve Etkin Tedavinin Belirlenmesi Amacıyla Kanıtların Gözden Geçirilmesi ve Güncel Öneriler. Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi. 2013;59:57-68.
  • 32. Chiradejnant A, Maher CG, Latimer J et al. Efficacy of “therapist-selected” versus “randomly-selected” mobilisation techniques for the treatment of low back pain: A randomised controlled trial. Aust J Physiother. 2003;49:233-241.
  • 33. Gracey JH, McDonough SM, Baxter GD. Physiotherapy management of low back pain: a survey of current practice in Northern Ireland. Spine. 2002;27:406-411.
  • 34. Daykin AR, Richardson B. Physiotherapists’ Pain Beliefs and Their Influence on the Management of Patients With Chronic Low Back Pain. Spine. 2004;29:783-795.
  • 35. Almeida, M., Saragiotto, B., Richards, B., et al. Primary care management of non‐specific low back pain: key messages from recent clinical guidelines. Med J Aust. 2018;208:272-275.
  • 36. Foster, N. E., Anema, J. R., Cherkin, D., et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 2018;391:2368-2383.

Fizyoterapistlerin bel ağrısına yaklaşımları

Year 2021, Volume: 8 Issue: 2, 152 - 159, 10.09.2021
https://doi.org/10.15437/jetr.602789

Abstract

Amaç: Türkiye’deki fizyoterapistlerin bel ağrısına yaklaşımlarını, konuyla ilgili bilgi düzeylerini, bakış açılarını, tedavi tercihlerini ortaya koymak ve güncel bir bakış açısı oluşturabilmektir.

Yöntem: Araştırmacılar tarafından fizyoterapistlere yönelik 18 soruluk bir anket hazırlandı. Anket, “Türkiye Fizyoterapistler Derneği’nin mail grubuna birer hafta arayla 4 kere gönderildi. Sosyal medyada yer alan fizyoterapi ile ilgili gruplara da anketin ulaştırılması sağlandı ve fizyoterapistler tarafından doldurulan tüm formlar analiz edildi.

Bulgular: Ankete toplam 115 fizyoterapist katıldı. Çalışmada fizyoterapistlerin, daha çok kronik bel ağrısıyla karşılaştığı, sakroiliak eklem değerlendirmesini büyük oranda yaptığı, mobilizasyon manipulasyon yöntemlerinden daha çok “McKenzie, Cyriax ve Mulligan” konseptlerini tercih ettikleri, elektroterapi modalitelerinden en çok “TENS, ultrason ve enterferans akımı” tercih ettiği, tedavi seçeneklerinde daha çok germe ve postür egzersizlerini, elektroterapi modalitelerini ve spinal mobilizasyonu kullandıkları bulunmuştur.

Sonuç: Çalışmamızdan elde ettiğimiz sonuçlar Türkiye'deki fizyoterapistlerin bel ağrısına yaklaşımlarını ortaya koymaktadır. Çalışmanın daha net sonuçlar verebilmesi için daha çok sayıda fizyoterapiste ulaşılması gerektiğini düşünmekteyiz.

References

  • 1. Moffett, J. K., RIchardson, G., Sheldon, T., et al. Back pain: its management and costs to society. No. 129chedp; 1995.
  • 2. Frost H, Lamb SE, Doll HA, et al. Randomised controlled trial of physiotherapy compared with advice for low back pain. Bmj 2004;329:708.
  • 3. Bener A, Dafeeah EE, Alnaqbi K, et al. An epidemiologic analysis of low back pain in primary care: a hot humid country and global comparison." J Prim Care Community Health. 2013;4:220-227.
  • 4. Maniadakis, N., & Gray, A. The economic burden of back pain in the UK. Pain. 2000;84:95-103.
  • 5. Manca, A., Dumville, J. C., Torgerson, D. J.,et al. Randomized trial of two physiotherapy interventions for primary care back and neck pain patients: cost–effectiveness analysis. Rheumatology. 2007;46:1495-1501.
  • 6. Battié, M. C., Cherkin, D. C., Dunn, R., et al. Managing low back pain: attitudes and treatment preferences of physical therapists. Phys Ther. 1994;74:219-226.
  • 7. Erdoğanoğlu Y, Kerem Günel M, Çetin A. Kronik bel ağrısı olan kadınlarda farklı egzersiz uygulamalarının etkinliğinin araştırılması. Fizyoter Rehabil. 2012;23:125-136.
  • 8. Eisenberg, D. M., Buring, J. E., Hrbek, A. L., et al. A model of integrative care for low-back pain. J. Altern. Complement. Med. 2012;18:354-362.
  • 9. Van Tulder MW, Koes BW, Bouter LM. Conservative Treatment of Acute and Chronic Nonspecific Low Back Pain: A Systematic Review of Randomized Controlled Trials of the Most Common Interventions. Spine. 1997;22:2128-2156.
  • 10. Koes BW, Van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. Bmj. 2006;332:1430–1434.
  • 11. Poitras, S., Blais, R., Swaine, B., et al. Management of work-related low back pain: a population-based survey of physical therapists. Phys Ther. 2005;85:1168-1181.
  • 12. Foster, N. E., Thompson, K. A., Baxter, G. D., et al. Management of nonspecific low back pain by physiotherapists in Britain and Ireland: a descriptive questionnaire of current clinical practice. Spine. 1999;24:1332-1342.
  • 13. Howard W. Makofsky, Spinal Manuel Therapy-Second Edition. 2010;141-153.
  • 14. Aydoğan Arslan, S., & Erbahçec, F. Bel Ağrısında Farklı Fizyoterapi Programlarının Ağrı, Endurans ve Yaşam Kalitesi Üzerine Etkinliği. Firat Tip Dergisi. 2016;21:84-90
  • 15. Kulaber A, Yılmaz H, Yavuzer M. Kronik Bel ağrılı Hastalarda Fizyoterapi Uygulamalarının Etkinliği. Haliç Üniversitesi Sağlık Bilimleri Dergisi. 2019;1:28-17.
  • 16. Moffett J, McLean S. The role of physiotherapy in the management of non-specific back pain and neck pain. Rheumatology. 2006;45(4):371-378.
  • 17. Britt H, Miller GJ, Knox S, et al. General practice activity in Australia. Canberra, University of Sydney and the Australian Institute of Health and Welfare; 2001;2000-2001.
  • 18. Sayer G, Britt H, Horn F, et al. Measures of health and health care delivery in general practice in Australia. Canberra, University of Sydney and the Australian Institute of Health and Welfare. 2000.
  • 19. Hansen, F. R., Bendix, T., Skov, P., et al. Intensive, dynamic back-muscle exercises, conventional physiotherapy, or placebo-control treatment of low-back pain. A randomized, observer-blind trial. Spine. 1993;18:98-108.
  • 20. Linda J. Vorvick, MD Medline Plus. Chiropractic care for back pain. 2011. Erişim: 23.08.2019. http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000416.htm.
  • 21. Carey TS, Garrett JM, Jackman AM. Beyond the good prognosis: examination of an inception cohort of patients with chronic low back pain. Spine. 2000;25:115-120.
  • 22. Borenstein DG. Chronic low back pain. Rheum Dis Clin North Am. 1996;22:439-456.
  • 23. Comer CM, Redmond AC, Bird HA, et al. Assessment and management of neurogenic claudication associated with lumbar spinal stenosis in a UK primary care musculoskeletal service: a survey of current practice among physiotherapists. BMC Musculoskelet Disord. 2009;10:121.
  • 24. Cibulka MT. The treatment of the sacroiliac joint component to low back pain: a case report. Phys Ther. 1992;72:917-922.
  • 25. Dolunay ET, Can F. Sakroiliak eklem disfonksiyonunun tedavisinde sakroiliak ortez ve egzersiz uygulamasının sonuçları. Fizyoterapi Rehabilitasyon. 2005;16:113-119.
  • 26. Laslett M, Young SB, Aprill CN et al. Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Australian Journal of Physiotherapy. 2003;49:89-97.
  • 27. Gotlieb D. Cape Town August. The Clinical Examination of the Rheumatic disease patient. 2005. Erişim: 03.08.2019 http://www.arthritis.co.za/the%20clinical%20examination%20technique.html.
  • 28. Cyriax, J. H., & Cyriax, P. Cyriax's illustrated manual of orthopaedic medicine. Elsevier Health Sciences. 1996.
  • 29. Donaldson, M., Petersen, S., Cook, C., et al. A prescriptively selected nonthrust manipulation versus a therapist-selected nonthrust manipulation for treatment of individuals with low back pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2016;46:243-250.
  • 30. Courtney, C. A., Clark, J. D., Duncombe, A. M., et al. Clinical presentation and manual therapy for lower quadrant musculoskeletal conditions. J Man Manip Ther. 2011;19:212-222.
  • 31. Oral, A., & Ketencİ, A. Radiküler Bel Ağrılarının Tedavisinde Fiziksel Tıp ve Rehabilitasyon Yaklaşımları: En Uygun ve Etkin Tedavinin Belirlenmesi Amacıyla Kanıtların Gözden Geçirilmesi ve Güncel Öneriler. Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi. 2013;59:57-68.
  • 32. Chiradejnant A, Maher CG, Latimer J et al. Efficacy of “therapist-selected” versus “randomly-selected” mobilisation techniques for the treatment of low back pain: A randomised controlled trial. Aust J Physiother. 2003;49:233-241.
  • 33. Gracey JH, McDonough SM, Baxter GD. Physiotherapy management of low back pain: a survey of current practice in Northern Ireland. Spine. 2002;27:406-411.
  • 34. Daykin AR, Richardson B. Physiotherapists’ Pain Beliefs and Their Influence on the Management of Patients With Chronic Low Back Pain. Spine. 2004;29:783-795.
  • 35. Almeida, M., Saragiotto, B., Richards, B., et al. Primary care management of non‐specific low back pain: key messages from recent clinical guidelines. Med J Aust. 2018;208:272-275.
  • 36. Foster, N. E., Anema, J. R., Cherkin, D., et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 2018;391:2368-2383.
There are 36 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Umut Bahçacı 0000-0002-2567-4795

Tuğba Kuru Çolak 0000-0002-3263-2278

Gönül Acar 0000-0002-6964-6614

Publication Date September 10, 2021
Submission Date August 6, 2019
Published in Issue Year 2021 Volume: 8 Issue: 2

Cite

Vancouver Bahçacı U, Kuru Çolak T, Acar G. Fizyoterapistlerin bel ağrısına yaklaşımları. JETR. 2021;8(2):152-9.