PDF(Pubmed)
Abstract：
BACKGROUND: In Germany, exercise therapy represents the most commonly prescribed physiotherapy service for non-specific, chronic low back pain (NSCLBP). So far, little is known about current practice patterns of German physiotherapists in delivering this intervention. Thus, the aim of this study was to investigate the appropriateness of exercise therapy delivered to NSCLBP patients in German physiotherapy care and to identify practitioner-related drivers of appropriate exercise delivery.
METHODS: We used a vignette-based, exploratory, cross-sectional, online-survey study design (76-items; data collection between May and July 2023). Eligible participants were required to hold a professional degree in physiotherapy and were required to be practicing in Germany. Access links to anonymous online surveys were spread via established German physiotherapy networks, educational platforms, social media, e-mail lists, and snowball sampling. Appropriateness of exercise therapy was calculated by an equally weighted total score (400 points) including scales on shared-decision-making, exercise dose selection, pain knowledge and self-management promotion. \"Appropriate exercise delivery\" was determined by a relative total score achievement of > 80%. \"Partly appropriate exercise delivery\" was determined by a relative total score achievement of 50-79%, and \"inappropriate exercise delivery\" by a score achievement of < 50%. Practitioner-related drivers of exercise appropriateness were calculated by bivariate and multiple linear regression analyses.
RESULTS: 11.9% (N = 35) of 298 physiotherapists\' exercise delivery was considered \"appropriate\", 83.3% (N = 245) was \"partly appropriate\", and 4.8% (N = 14) was \"inappropriate\". In the final multiple regression model, most robust parameters positively influencing appropriate delivery of exercise therapy were increased scientific literacy (B = 10.540; 95% CI [0.837; 20.243]), increased average clinical assessment time (B = 0.461; 95% CI [0.134; 0.789]), increased self-perceived treatment competence (B = 7.180; 95% CI [3.058; 11.302], and short work experience (B = - 0.520; 95% CI [-0.959; - 0.081]).
CONCLUSIONS: Appropriate exercise delivery in NSCLBP management was achieved by only 11.9% of respondents. However, the vast majority of 95.2% of respondents was classified to deliver exercise therapy partly appropriate. Long work experience seemed to negatively affect appropriate exercise delivery. Positive influences were attributed to scientific literacy, the average clinical assessment time per patient as well as the perceived treatment competence in NSCLBP management.
BACKGROUND: Open science framework: https://doi.org/10.17605/OSF.IO/S76MF .
METHODS: We used a vignette-based, exploratory, cross-sectional, online-survey study design (76-items; data collection between May and July 2023). Eligible participants were required to hold a professional degree in physiotherapy and were required to be practicing in Germany. Access links to anonymous online surveys were spread via established German physiotherapy networks, educational platforms, social media, e-mail lists, and snowball sampling. Appropriateness of exercise therapy was calculated by an equally weighted total score (400 points) including scales on shared-decision-making, exercise dose selection, pain knowledge and self-management promotion. \"Appropriate exercise delivery\" was determined by a relative total score achievement of > 80%. \"Partly appropriate exercise delivery\" was determined by a relative total score achievement of 50-79%, and \"inappropriate exercise delivery\" by a score achievement of < 50%. Practitioner-related drivers of exercise appropriateness were calculated by bivariate and multiple linear regression analyses.
RESULTS: 11.9% (N = 35) of 298 physiotherapists\' exercise delivery was considered \"appropriate\", 83.3% (N = 245) was \"partly appropriate\", and 4.8% (N = 14) was \"inappropriate\". In the final multiple regression model, most robust parameters positively influencing appropriate delivery of exercise therapy were increased scientific literacy (B = 10.540; 95% CI [0.837; 20.243]), increased average clinical assessment time (B = 0.461; 95% CI [0.134; 0.789]), increased self-perceived treatment competence (B = 7.180; 95% CI [3.058; 11.302], and short work experience (B = - 0.520; 95% CI [-0.959; - 0.081]).
CONCLUSIONS: Appropriate exercise delivery in NSCLBP management was achieved by only 11.9% of respondents. However, the vast majority of 95.2% of respondents was classified to deliver exercise therapy partly appropriate. Long work experience seemed to negatively affect appropriate exercise delivery. Positive influences were attributed to scientific literacy, the average clinical assessment time per patient as well as the perceived treatment competence in NSCLBP management.
BACKGROUND: Open science framework: https://doi.org/10.17605/OSF.IO/S76MF .
摘要：
背景：在德国，运动疗法代表了最常用的非特异性物理治疗服务，慢性腰背痛（NSCLBP）。到目前为止,对德国物理治疗师提供这种干预的当前实践模式知之甚少。因此，这项研究的目的是调查在德国理疗护理中为NSCLBP患者提供运动疗法的适当性,并确定与医生相关的适当运动疗法的驱动因素.
方法：我们使用了基于小插图的，探索性,横截面,在线调查研究设计（76项；2023年5月至7月之间的数据收集）。符合条件的参与者必须持有物理治疗专业学位，并必须在德国执业。匿名在线调查的访问链接通过已建立的德国理疗网络传播，教育平台,社交媒体,电子邮件列表，和滚雪球采样。运动疗法的适宜性是通过平均加权总分（400分）来计算的，包括共同决策的量表。运动剂量选择，疼痛知识和自我管理的提升。“适当的运动交付”是由相对总分成就>80％确定的。“部分适当的锻炼交付”由相对总分50-79%的成就决定，和“不适当的运动交付”，得分<50%。通过双变量和多元线性回归分析计算与锻炼适当性相关的驱动因素。
结果：在298名物理治疗师中，11.9％（N=35）的运动分娩被认为是“适当的”，83.3%(N=245)是“部分适当的”，4.8%(N=14)是“不合适的”。在最终的多元回归模型中，对适当实施运动疗法有积极影响的最强有力的参数是科学素养的提高(B=10.540;95%CI[0.837;20.243])，平均临床评估时间增加(B=0.461；95%CI[0.134；0.789])，自我感知的治疗能力提高(B=7.180；95%CI[3.058；11.302]，工作经验短（B=-0.520；95%CI[-0.959；-0.081]）。
结论：在NSCLBP管理中，只有11.9%的受访者实现了适当的运动分娩。然而,95.2%的受访者中,绝大多数被归类为提供部分合适的运动疗法.长期的工作经验似乎会对适当的锻炼产生负面影响。积极的影响归因于科学素养，每名患者的平均临床评估时间以及在NSCLBP管理中的感知治疗能力。
背景：开放科学框架：https://doi.org/10.17605/OSF。IO/S76MF。
方法：我们使用了基于小插图的，探索性,横截面,在线调查研究设计（76项；2023年5月至7月之间的数据收集）。符合条件的参与者必须持有物理治疗专业学位，并必须在德国执业。匿名在线调查的访问链接通过已建立的德国理疗网络传播，教育平台,社交媒体,电子邮件列表，和滚雪球采样。运动疗法的适宜性是通过平均加权总分（400分）来计算的，包括共同决策的量表。运动剂量选择，疼痛知识和自我管理的提升。“适当的运动交付”是由相对总分成就>80％确定的。“部分适当的锻炼交付”由相对总分50-79%的成就决定，和“不适当的运动交付”，得分<50%。通过双变量和多元线性回归分析计算与锻炼适当性相关的驱动因素。
结果：在298名物理治疗师中，11.9％（N=35）的运动分娩被认为是“适当的”，83.3%(N=245)是“部分适当的”，4.8%(N=14)是“不合适的”。在最终的多元回归模型中，对适当实施运动疗法有积极影响的最强有力的参数是科学素养的提高(B=10.540;95%CI[0.837;20.243])，平均临床评估时间增加(B=0.461；95%CI[0.134；0.789])，自我感知的治疗能力提高(B=7.180；95%CI[3.058；11.302]，工作经验短（B=-0.520；95%CI[-0.959；-0.081]）。
结论：在NSCLBP管理中，只有11.9%的受访者实现了适当的运动分娩。然而,95.2%的受访者中,绝大多数被归类为提供部分合适的运动疗法.长期的工作经验似乎会对适当的锻炼产生负面影响。积极的影响归因于科学素养，每名患者的平均临床评估时间以及在NSCLBP管理中的感知治疗能力。
背景：开放科学框架：https://doi.org/10.17605/OSF。IO/S76MF。
