Private practitioners`use of exercise therapy in lower back pain

Z Strydom,M M Bester,M Faure

doi:10.4102/sajp.v61i2.171

Z Strydom, M M Bester + Show 1 more

Open Access

https://doi.org/10.4102/sajp.v61i2.171

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Abstract

Introduction: Lower back pain (LBP) is a common problem treated by physiotherapists. Recent research confirms the need for a more dynamic approach, to the management of this condition and includes progressive activity and exercise. The current use of exercise therapy for people with LBP and the implementation of evidence based practice in this field in South Africa, is unknown. As 80% of physiotherapists in South Africa offer services in private sector, the purpose of the study was to determine the use of this modality by physiotherapists. The specific aims were to determine how many physiotherapists utilise exercise therapy, how much therapy time is spent on it and how the modality is applied. This information can determine whether there is a need for continuing professional development in this area.Method: A stratified random sample of 489 South African physiotherapists was selected to take part in a survey by means of a questionnaire. Data was analysed descriptively and relationships between categories were analysed using Chi-square tests (p<5).Results: A response rate of 85% was reached. All but one physiotherapist used exercise therapy however, only 16% of the physiotherapists spent more than half of the course of treatment on exercise therapy. Most respondents (96%) specified dosages, 95% progressed exercises, but only 46% alwaysre-assess exercises at follow-up visits. Homeexercises are often prescribed, but group exercises are seldom used.Conclusion: South African physiotherapists in private practice use exercise therapy as a treatment modality for people with LBP. Inconsistencies concerning the implementation and time spent on exercises, suggests the need for continual professional development in this area

Highlights

Lower back pain (LBP) is a common problem treated by physiotherapists
Of the physiotherapists spent more than half of the course of treatment on exercise therapy
Lower back pain (LBP) is a common problem resulting in health, social and economic implications in the western world (Staal et al 2002, Schneiders et al 1998, Underwood and Morgan 1998)

Summary

Introduction

Lower back pain (LBP) is a common problem treated by physiotherapists. Recent research confirms the need for a more dynamic approach, to the management of this condition and includes progressive activity and exercise. The specific aims were to determine how many physiotherapists utilise exercise therapy, how much therapy time is spent on it and how the modality is applied. This information can determine whether there is a need for continuing professional development in this area. The ensuing differing degrees of disability can lead to physical, psychological, economic and social implications for the individual (Wheeler and Hanley 1995) These authors state that physical de-conditioning due to ongoing mobility limitation as a result of LBP, can lead to a reduction in muscle strength, soft tissue mobility and cardiovascular fitness. While the evidence for the effectiveness of many of these methods is limited, research suggests the need for a more dynamic approach towards progressive activity and exercises (Annamalai 1999, Frost et al 1995)

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