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Background: Low back pain (LBP) affects many people globally. Its aetiology is not clear. Patients lack knowledge of its contributing factors and have negative perception about their LBP. This study aimed to identify knowledge, attitudes and beliefs regarding the perceived contributing factors to LBP among patients attending physiotherapy outpatient departments in Malawi. This information can possibly facilitate planning of a LBP education programme in Malawi. Methods: A quantitative cross-sectional survey was conducted, using a six-part self-administered questionnaire with questions on demographic information, participants’ attitudes and beliefs regarding their LBP, knowledge about the course and causes of LBP, beliefs regarding nine contributing factors to LBP (identified in a Delphi study) and the sources of the participants’ knowledge. Data were analysed descriptively using the Statistical Package for Social Sciences (version 19.0). A Chi-square test was used to determine any association between variables (alpha 0.05). All ethical procedures were strictly followed. Results: Most participants (186, 91.2 %) did not manage to answer all six questions regarding knowledge correctly and were regarded as ‘partially knowledgeable’ about the course and causes of LBP. More than half (67%) portrayed negative attitudes and beliefs about LBP in general. The findings also showed a statistically significant relationship between knowledge, attitudes and beliefs (p = 0.04). Conclusion: This study highlighted that many patients with LBP in Malawi are not adequately knowledgeable about LBP and hold negative attitudes and beliefs regarding their LBP. Therefore, LBP management programmes in Malawi should include education programmes aimed at empowering patients with knowledge regarding LBP, as well as changing their negative attitudes and beliefs about their pain. Patients’ understanding of the cause and nature of their pain may enhance the achievement of treatment goals.

PURPOSE: There is a paucity of data on effects of motor-level stimulation using Transcutaneous Electrical Nerve Stimulator (TENS) on ipsilateral quadriceps femoris group of muscles. The effect is also unknown on the untrained contralateral quadriceps femoris. The primary purpose of this study was to determine the effect of TENS on quadriceps muscle strength at the stimulated ipsilateral and un-stimulated contra-lateral extremities. METHODS: Participants were 50 apparently healthy undergraduate. They were recruited using sample of convenience. The right quadriceps group of muscles were stimulated for 15 minutes twice a week for 8 weeks using motor-level stimulation parameters (frequency of 85 Hz and pulse width of 100 microseconds) while the left lower limbs (control) were not stimulated. The right and left quadriceps muscle strengths were quantified using tensiometer; at onset and after 8 weeks. The data were analysed using the descriptive and inferential statistics (paired t-test and ANOVA). Alpha level was set at 0.05. RESULTS: The initial and final left strengths of the un-stimulated quadriceps muscles were 311.46 ± 58.84N and 395.60 ± 100.71N at onset and after 8 weeks respectively. After 8 weeks the un-stimulated left quadriceps strength was significantly greater than the initial value (t=-7.63, p < 0.001). Similarly, the initial and final right quadriceps strength (stimulated limb) were 351.51 ± 117.68N and 471.31 ± 112.19N; at onset and after 8 weeks respectively. The post stimulation strength of the right quadriceps was also significantly higher than the pre-intervention strength (t=-10.25, p < 0.001). However, the increment in quadriceps strength between right and left extremities after 8 weeks was insignificant (t =-1.35, p=0.18). There was also significant increase in the girth of the right quadriceps (t= -6.08, p=0.001) after 8 weeks. CONCLUSION: We concluded that there were increments in both strength and muscle size of the stimulated right quadriceps using motor level stimulation parameters of TENS modality. The un-stimulated contralateral quadriceps strength also increased after 8 weeks. This implied that there was cross-training effect at the contralateral quadriceps group of muscles. [ABSTRACT FROM AUTHOR]