Abstract
Background: Low Back Pain (LBP) makes up a large proportion of referrals to physiotherapy worldwide. Thus training in its effective assessment and management is essential. With psychosocial yellow flags having been recognised as the strongest predictors of chronicity in LBP, guidelines on the management of LBP emphasise the importance of assessing and managing yellow flags. Aim: The aim of this research was to explore whether physiotherapy students were able to assess risk of chronicity based on the presence of yellow flags in descriptions of people with LBP.Method: A postal semi-structured questionnaire based on clinicalvignettes was sent to all the Level 3 physiotherapy students studying at Queen Margaret University College, Edinburgh.Results: The survey was responded to by 15 of the students (35%). The respondents overestimated risk of chronic LBP from the vignettes. Evaluation of risk for chronicity was based on few yellow flags i.e. the strongest predictors of chronicity were not effectively interpreted resulting in incorrect determination of risk for chronic LBP. All respondents included at least one risk factor not supported by the evidence. Conclusions: Physiotherapy students in this study did not appear to respond appropriately to the presence ofyellow flags in the presented vignettes.
Highlights
Low Back Pain (LBP) – that is pain occurring below the twelfth rib and above the inferior gluteal folds; afflicts between 4% and 33% of the worldwide population at any one time (Woolf and Pfleger, 2003)
A postal semi-structured questionnaire based on clinical vignettes was sent to all the Level 3 physiotherapy students studying at Queen Margaret University College, Edinburgh
Evaluation of risk for chronicity was based on few yellow flags i.e. the strongest predictors of chronicity were not effectively interpreted resulting in incorrect determination of risk for chronic LBP
Summary
Low Back Pain (LBP) – that is pain occurring below the twelfth rib and above the inferior gluteal folds; afflicts between 4% and 33% of the worldwide population at any one time (Woolf and Pfleger, 2003) This high prevalence of LBP has financial implications for both the individual and the state. Psychosocial factors recognised to increase the risk of LBP becoming chronic have been dubbed “yellow flags” and this term is commonly used by physiotherapists. These psychosocial factors are many and varied and include people’s beliefs about what has happened to them, beliefs about their pain and their beliefs about how work will affect their pain (Linton and Hallden, 1998). With psychosocial yellow flags having been recognised as the strongest predictors of chronicity in LBP, guidelines on the management of LBP emphasise the importance of assessing and managing yellow flags
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