Abstract
BackgroundObservation of movement quality (MQ) is an indelible element in the process of clinical reasoning for patients with non-specific low back pain (NS-LBP). However, the observation and evaluation of MQ in common daily activities are not standardized within allied health care. This study aims to describe how Dutch allied health care professionals (AHCPs) observe and assess MQ in patients with NS-LBP and whether AHCPs feel the need to have a specific outcome measure for assessing MQ in patients with NS-LBP.MethodsIn this cross-sectional digital survey study, Dutch primary care AHCPs (n = 114) answered one open and three closed questions about MQ in NS-LBP management. Qualitative and quantitative analyses were applied.ResultsQualitative analyses of the answers to the open questions revealed four main themes: 1) movement pattern features, 2) motor control features, 3) environmental influences and 4) non-verbal expressions of pain and exertion. Quantitative analyses clearly indicated that AHCPs observe MQ in the diagnostic (92%), therapeutic (91%) and evaluation phases (86%), that they do not apply any objective measurement of MQ and that 63% of the AHCPs consider it important to have a specific outcome measure to assess MQ. The AHCPs expressed added benefits and critical notes regarding clinical reasoning and quality of care.ConclusionAHCPs recognize the importance of observing MQ in the assessment and management of LBP in a standardized way. However, there is no consensus amongst AHCPs how MQ should be standardized. Prior to standardization, it will be important to develop a theoretical framework to determine which observable and measurable dimensions of MQ are most valid and relevant for patients with NS-LBP to include in the assessment.
Highlights
Observation of movement quality (MQ) is an indelible element in the process of clinical reasoning for patients with non-specific low back pain (NS-LBP)
The terms used by the allied health care professionals (AHCPs) refer to the focus of the observation (e.g. ‘I observe the position of the pelvis during walking’) and to their interpretation of the performed quality (e.g. ‘Whether someone moves without experiencing pain’)
Many therapists emphasize the importance of assessing MQ in patients with NS-LBP, the arguments of AHCPs differ with regard to having a specific outcome measure to assess MQ
Summary
Observation of movement quality (MQ) is an indelible element in the process of clinical reasoning for patients with non-specific low back pain (NS-LBP). The observation and evaluation of MQ in common daily activities are not standardized within allied health care. Patient complaints about LBP focus on pain and the limitations that it places on regular activities during daily life, work, sports or leisure time [4,5,6]. Observations of how patients perform daily activities that are problematic due to LBP provide AHCPs with indications for clinical reasoning and for targeting their interventions [7,8,9,10]. The analysis and evaluation of movement quality van Dijk et al BMC Musculoskeletal Disorders (2017) 18:288
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