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University of Manitoba

1. do Prado, Tamires Cristina. Evidence-based practice for non-specific low back pain: Canadian physiotherapists’ adherence, beliefs, and perspectives.

Degree: College of Rehabilitation Sciences, 2019, University of Manitoba

Incidence and prevalence of low back pain (LBP) continue to grow in Canada and world- wide; associated psychosocial demands often lead to long-term disability increasing individual and socioeconomic burden. In spite of efforts to develop and update evidence-based clinical practice guidelines (EBCPGs), a gap remains between research findings and physiotherapists’ practice. Registered Canadian physiotherapists (n=525) completed a cross-sectional online survey including demographic and practice characteristics, a clinical scenario, a questionnaire to assess back pain beliefs (PABS-PT), and a scale to measure self-efficacy in implementing evidence-based practice (EPIC). Treatment choices related to the clinical scenario were scored on a 4-point scale according to recent EBCPGs, and 77.3% of respondents were deemed to have higher adherence (score of 3 or 4) to EBCPGs; however, only 29.5% of respondents chose interventions to directly address psychosocial demands. Physiotherapists with higher adherence to EBCPGs had significantly lower biomedical (mean difference: -3.6, p < 0.001, 95% CI(-5.1, - 2.1)) and significantly higher behavioural (mean difference: 2.6, p < 0.001, 95% CI(1.6, 3.6)) scores on the PABS-PT questionnaire compared to the other group; scores on the EPIC scale were no different between the groups (mean difference: 1.7, p = 0.299, 95% CI(-1.5, 4.8)). A binary logistic regression analysis was conducted to identify predictors of group membership. Physiotherapists’ intention to use EBCPGs, subjective norms regarding use of EBCPGs, biomedical beliefs, and having post-graduate training were significant predictors; the latter being the strongest predictor of higher-adherence. Seven Manitoban physiotherapists were interviewed and reported being highly satisfied with the care they have been providing to patients with LBP even when psychosocial issues are present. Interviewees did not perceive a need for immediate change in their practice but described that it is their responsibility to remain up to date with evidence and identify areas that need improvement. Although overall adherence was high, Canadian physiotherapists do not address psychosocial demands of LBP patients as frequently and do not perceive it as an issue that requires practice changes. Further education and training in EBCPGs and how to address psychosocial demands for physiotherapists in Canada is warranted. Advisors/Committee Members: Parsons, Joanne (Physical Therapy) (supervisor), Ripat, Jacquie (Occupational Therapy) (examiningcommittee), Strachan, Shaelyn (Kinesiology and Recreation Management) (examiningcommittee).

Subjects/Keywords: Evidence-based practice; Physiotherapy; Guidelines; Low back pain; Non-specific low back pain; NSLBP; EBP; Clinical behaviour

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

do Prado, T. C. (2019). Evidence-based practice for non-specific low back pain: Canadian physiotherapists’ adherence, beliefs, and perspectives. (Masters Thesis). University of Manitoba. Retrieved from http://hdl.handle.net/1993/34260

Chicago Manual of Style (16th Edition):

do Prado, Tamires Cristina. “Evidence-based practice for non-specific low back pain: Canadian physiotherapists’ adherence, beliefs, and perspectives.” 2019. Masters Thesis, University of Manitoba. Accessed January 19, 2020. http://hdl.handle.net/1993/34260.

MLA Handbook (7th Edition):

do Prado, Tamires Cristina. “Evidence-based practice for non-specific low back pain: Canadian physiotherapists’ adherence, beliefs, and perspectives.” 2019. Web. 19 Jan 2020.

Vancouver:

do Prado TC. Evidence-based practice for non-specific low back pain: Canadian physiotherapists’ adherence, beliefs, and perspectives. [Internet] [Masters thesis]. University of Manitoba; 2019. [cited 2020 Jan 19]. Available from: http://hdl.handle.net/1993/34260.

Council of Science Editors:

do Prado TC. Evidence-based practice for non-specific low back pain: Canadian physiotherapists’ adherence, beliefs, and perspectives. [Masters Thesis]. University of Manitoba; 2019. Available from: http://hdl.handle.net/1993/34260

2. Draper-Rodi, Jerry. Effects of an e-learning programme on osteopaths' back pain attitudes : a mixed methods feasibility study.

Degree: PhD, 2016, University of Bedfordshire

i. Background Guidelines recommend the biopsychosocial (BPS) model for managing non-specific low back pain (NSLBP) but the best method for teaching this model is unclear. Printed material and face-to-face learning have limited effects on practitioners' attitudes to back pain. An alternative way is needed and e-learning is a promising option. E-learning is becoming an important part of teaching, but little guidance is available to the osteopathic profession. ii. Purpose This study had four aims. First to assess the feasibility of running a main trial to test the effectiveness of an e-learning programme on the BPS model for NSLBP on experienced practitioners' attitudes to back pain; secondly, to assess the acceptability of the e-learning programme and the use of the internet as a mode of CPD; thirdly to provide an effect size estimate; and finally to explore the participants' views on the e-learning programme and its possible impact on their reported behaviour. iii. Methods First a scoping review of the BPS factors and assessment methods for NSLBP was conducted. It informed the content of an e-learning programme that was designed and developed, and informed by a behaviour change model and an e-learning developmental model. An explanatory mixed methods feasibility study was conducted: first, a pilot Randomised Controlled Trial (RCT) assessed experienced osteopaths' attitudes before and after the intervention, using the Pain Attitudes and Beliefs Scale (PABS) and the Attitudes to Back Pain Scale for musculoskeletal practitioners (ABS-mp); then semi-structured interviews explored participants' views on the e-learning programme and its possible impact on their reported practice behaviours. ii iv. Results 45 osteopaths, each with at least 15 years of experience consented to, and took part in, the study. The two trial arms were: a 6-week e-learning programme (intervention group) and a waiting-list group (control group). 9 participants were interviewed for the qualitative strand. The feasibility of conducting a main trial was good, the intervention was well accepted and the adherence to the intervention was good. An effect size estimate was calculated to inform sample size for a main trial. In the qualitative strand, participants' views on the BPS model fell in with the themes of being Not structural enough, being Part of existing practice and being Transformative. v. Conclusion(s) This study provided new knowledge that had not been reported before in several areas: · how an e-learning programme for experienced manual practitioners should be developed, · a new intervention was reported (e-learning programme), including its design and acceptability, · osteopaths' views on using the internet as a form of CPD, · information on the challenges faced in implementing a BPS approach.

Subjects/Keywords: e-learning; osteopathy; NSLBP; BPS; randomised control trial; back pain; X360 Academic studies in Specialist Education

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Draper-Rodi, J. (2016). Effects of an e-learning programme on osteopaths' back pain attitudes : a mixed methods feasibility study. (Doctoral Dissertation). University of Bedfordshire. Retrieved from http://hdl.handle.net/10547/623342

Chicago Manual of Style (16th Edition):

Draper-Rodi, Jerry. “Effects of an e-learning programme on osteopaths' back pain attitudes : a mixed methods feasibility study.” 2016. Doctoral Dissertation, University of Bedfordshire. Accessed January 19, 2020. http://hdl.handle.net/10547/623342.

MLA Handbook (7th Edition):

Draper-Rodi, Jerry. “Effects of an e-learning programme on osteopaths' back pain attitudes : a mixed methods feasibility study.” 2016. Web. 19 Jan 2020.

Vancouver:

Draper-Rodi J. Effects of an e-learning programme on osteopaths' back pain attitudes : a mixed methods feasibility study. [Internet] [Doctoral dissertation]. University of Bedfordshire; 2016. [cited 2020 Jan 19]. Available from: http://hdl.handle.net/10547/623342.

Council of Science Editors:

Draper-Rodi J. Effects of an e-learning programme on osteopaths' back pain attitudes : a mixed methods feasibility study. [Doctoral Dissertation]. University of Bedfordshire; 2016. Available from: http://hdl.handle.net/10547/623342

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