Back Pain Survey

Purpose: The primary objective of this study was to survey the knowledge of low back pain (LBP) and physical activity with LBP among those prescribing or delivering physical activity in the community. The secondary objective was to survey their confidence in prescribing physical activity in general as well as their knowledge, attitudes, and practices for promoting physical activity for patients with LBP. Methods: A cross-sectional survey was administered to physiotherapists and physical trainers involved in the delivery of exercise programs in Hamilton, Ontario. One demographic survey and two sets of questionnaires (one for physiotherapists and another version for trainers) were developed to collect data. Data was collected using a modified version of a questionnaire that evaluates knowledge of physical activity guidelines for prescribing physical activity and knowledge of barriers and enablers to exercise, participant’s knowledge of LBP was assessed using the validated Back Beliefs Questionnaire (BBQ), and items from the Örebro LBP screening questionnaire (Örebro) were adapted to evaluate psychological beliefs associated with back pain. Results: A total of 14 (35.9%) physiotherapists and 25 (64.1%) physical trainers completed the survey. Our results demonstrated that both physiotherapists and trainers often assessed their client’s physical activity and were aware of the current Canadian guidelines for physical activity. When prescribing physical activity, physiotherapists and trainers often use tools such as action planning and goal setting, while trainers were more likely to use wearable devices to track physical activity. Both groups demonstrated high confidence in prescribing physical activity, although the perceived exercise intensity that constitutes physical activity was different between groups. Specifically, physiotherapists often agree that a lower intensity of physical activity is enough to meet physical activity recommendations, despite the recommended intensity being moderate physical activity in the current Canadian guidelines. Surprisingly, lack of time and beliefs of patients were not seen as barriers to physical activity promotion. In general, both groups believe that group sessions are not feasible within the context of promoting physical activity, although many community programs are delivered in this format. The results showed that trainers had more pessimistic beliefs about the consequences of LBP compared to physiotherapists. Trainers also had more negative beliefs and attitudes about LBP. The findings may indicate the need for developing a structured education program to improve the attitudes, beliefs, and knowledge of those delivering physical activity programs to patients with LBP in the community to improve the uptake of physical activity in this patient group.

研究目的：本研究的核心目标为，针对社区中开具或提供身体活动服务的人群，开展关于腰痛（low back pain, LBP）及腰痛人群身体活动相关知识的调研；次要目标为评估其开具常规身体活动方案的信心，以及为腰痛患者推广身体活动时的知识、态度与实践情况。
研究方法：本研究针对加拿大安大略省哈密尔顿市参与运动方案实施的物理治疗师（physiotherapist）与体能教练（physical trainer）开展了横断面调查（cross-sectional survey）。我们设计了一份人口统计学调查问卷，以及两套适配不同人群的问卷（分别面向物理治疗师与体能教练）以收集研究数据。数据采集采用经过改良的问卷，该问卷用于评估身体活动处方指南相关知识，以及运动的阻碍与促进因素；腰痛相关知识则通过经过验证的背部信念问卷（Back Beliefs Questionnaire, BBQ）进行评估；此外，我们改编了厄勒布鲁腰痛筛查问卷（Örebro LBP screening questionnaire, Örebro）中的条目，用以评估与背痛相关的心理信念。
研究结果：最终共有14名物理治疗师（占比35.9%）与25名体能教练（占比64.1%）完成了本次调研。结果显示，两类从业者均会常规评估服务对象的身体活动情况，且熟悉当前加拿大的身体活动指南。在开具身体活动方案时，物理治疗师与体能教练通常会使用行动计划、目标设定等工具，而体能教练更倾向于使用可穿戴设备追踪身体活动情况。两类从业者在开具身体活动方案时均表现出较高的信心，但二者对构成有效身体活动的运动强度认知存在差异：具体而言，尽管加拿大现行指南推荐中等强度运动，物理治疗师普遍认为较低强度的身体活动即可达到活动推荐标准。值得注意的是，时间匮乏与患者认知并未被视为推广身体活动的阻碍因素。总体而言，两类从业者均认为在推广身体活动的场景中，团体课程并不可行，尽管当前许多社区项目均采用该组织形式。结果还显示，与物理治疗师相比，体能教练对腰痛后果持有更悲观的信念，且对腰痛的态度与认知也更为负面。本研究结果提示，亟需开发系统化的教育培训项目，以提升社区中为腰痛患者提供身体活动服务的从业者的态度、信念与知识水平，进而改善该患者群体的身体活动参与度。