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Mazyad A Alotaibi,1 Ahmed S Alhowimel,1 Faris A Alodaibi,2 Mohammed Aloraifi3 1Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; 2Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia; 3Salamat Medical Hospital, Department of Physiotherapy, Hail, Saudi ArabiaCorrespondence: Mazyad A Alotaibi, Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia, Tel +966115886354, Email maz.alotaibi@psau.edu.saPurpose: Shared decision-making (SDM) may be interpreted as a set of core values rather than as a consensus definition. This study aimed to explore how SDM between patients and physiotherapists may lead to patient satisfaction.Patients and Methods: A cross-sectional study was conducted to examine the relationship between SDM and patient satisfaction. The study targeted physiotherapists and patients with musculoskeletal pain or disorders. A structured questionnaire (the nine-item Shared Decision-Making Questionnaire) was developed to show the extent to which patients felt involved in the process by scoring nine items from 0 to 5 on a six-point scale. t-tests were performed to estimate differences in SDM perceptions between patients and physiotherapists, and regression analyses were performed to estimate the best predictors of SDM.Results: The questionnaire was completed by a total of 106 patients and nine physiotherapists. The demographic information of the samples was presented with frequency analysis. This study’s findings demonstrate no variations in the final SDM perceptions between patients and physiotherapists, but when SDM was contrasted step-by-step (as items), many variances were discovered. These distinctions reinforce the notion that regardless of the end outcome, the process of reaching a consensus has a distinct profile depending on the type of medical care. Therapists emphasize the first steps, possibly because there is sufficient evidence to make a therapeutic decision. However, patients highlight the final steps, perhaps because the moment for a decision based on the consultation’s nature is approaching.Conclusion: This study demonstrates that SDM is a complex process that must be examined in multiple stages. However, in physiotherapy contexts, this process exhibits extremely different patterns, reflecting a significantly different perspective of the decision-making process.Keywords: physical therapy, decision-making, patient preference, musculoskeletal disorders

Mohammed S Almizani,1 Manar A Alotaibi,1 Modhi F Bin Askar,1 Nuha M Albaqami,1 Reema S Alobaishi,1 Mostafa A Arafa,2,3 Mohammad I Jumaa4,5 1College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Kingdom of Saudi Arabia; 2Kingdom of Saudi Arabia; 3High Institute of Public Health, Alexandria University, Alexandria, Egypt; 4Anatomy Department, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Kingdom of Saudi Arabia; 5College of Medicine, Al-Azhar University, Assiut, EgyptCorrespondence: Mohammed S Almizani, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), 6889 Ibn Rashiq, King Faisal District, Riyadh, Kingdom of Saudi Arabia, Tel +966 532314692, Email M7mdsajdi@gmail.comBackground: In both the preclinical and clinical sciences, anatomy is considered as the foundation of medical education. Anatomy education serves as a foundation for clinical application and future practice of medicine. Health practitioners and students are interested in the adequacy of anatomical knowledge in clinical years since it has a direct impact on medical education and professional clinical practice.Objective: To examine the opinions and attitudes of medical students and clinicians regarding the preclinical and clinical years’ teaching of anatomy and anatomical knowledge to medical students.Methods: Participants in the study, including clinicians and medical students, were required to answer an 8-question, 5-point Likert scale questionnaire to assess their attitudes regarding anatomical knowledge. The maximum score was 40, and the higher the score, the more the positive attitude towards anatomical knowledge. The difference in the mean attitude score between males and females was investigated using the Independent sample t-test.Results: A total of 327 clinicians and 423 students participated in the study. Clinicians and students showed moderately high positive attitude towards anatomical knowledge. The mean statements score for clinicians’ attitudes was 31.4(± 3.4). There was no significant difference between total attitude score means for clinicians and students, p=0.83. Attitude statements attained a significantly higher percentages and were in favor to clinicians in comparison to students, particularly for clinical significance of anatomical knowledge to students in the clinical years, the importance of anatomical knowledge to surgical and non-surgical specialties, and re-teaching special anatomy for students in the clinical years would improve their clinical background. Both clinicians and students expressed low agreement regarding anatomical educational style and quality of study materials.Conclusion: Teaching anatomy to medical students is a continuous process. Therefore, we recommend reforming the anatomy curriculum by vertical integration of anatomy into the clinical rotations, clerkship, and specialist training.Keywords: anatomy, medical education, clinicians, students, Saudi Arabia

Faris A Alodaibi,1 Mazyad A Alotaibi,2 Mohammad A Almohiza,1 Ahmed S Alhowimel2 1Health Rehabilitation Science, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 2Department of Health and Rehabilitation Science, Sattam Bin Abdulaziz University, Al-Kharj, Saudi ArabiaCorrespondence: Faris A Alodaibi, Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, PO Box 22480, Riyadh, 11495, Kingdom of Saudi Arabia, Tel +966 14676176, Fax +966 14676162, Email falodaibi@KSU.EDU.SABackground: Chronic non-communicable diseases and musculoskeletal disorders are primarily associated with poor lifestyle behaviors and underestimated public health issues. Physical therapists have an essential role in promoting health. Still, few studies have described the current role of physical therapy in health promotion to lessen the impact of public health issues and chronic musculoskeletal conditions. Therefore, this study aimed to explore physical therapists’ health promotion in the musculoskeletal practice setting and investigate potential barriers and needed education.Design and Methods: A cross-sectional descriptive study was conducted, using an electronic survey distributed among physical therapists practicing in Saudi Arabia who managed patients with musculoskeletal disorders.Results: A total of 150 physical therapists participated in this survey. The physical therapists dealing with musculoskeletal disorders were, to a fair degree, aware of the importance of lifestyle risk factors related to health and wellness, particularly those relating to physical aspects. However, participants’ knowledge and experience (according to their report) were relatively limited in other lifestyle behaviors such as smoking, nutrition, sleep, and stress management. Participants believed further education/training would be needed to address these behaviors.Conclusion: The participants appreciated the importance of addressing lifestyle factors. Nonetheless, knowledge and experience in health promotion were limited. To optimize the outcome of musculoskeletal patients through health promotion, more training will be needed.Keywords: lifestyle behaviors, health promotion, physical therapy, education and training, musculoskeletal disorders

Ahmed S Alhowimel,1 Mazyad A Alotaibi,1 Dalyah M Alamam,2 Faris A Alodaibi,2 Julie M Fritz3 1Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia; 2Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia; 3Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USACorrespondence: Ahmed S AlhowimelDepartment of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, 11942, Saudi ArabiaTel +966 115886354Email aalhowimel@gmail.com; a.alhowimel@psau.edu.saIntroduction: Healthcare professionals’ beliefs and attitudes towards low back pain management play a significant role during treatment. This is a crucial aspect of primary care physicians working as a first point of contact for people seeking healthcare for low back pain.Aim: To identify the beliefs and behaviors of frontline healthcare professionals (primary care physicians) working in the Riyadh region with regard to low back pain management.Methods: A cross-sectional design was implemented, in which the Pain Attitude and Beliefs Scale (PABS) questionnaire was used along with a low back pain clinical vignette with some questions. The PABS assesses healthcare provider orientations toward low back pain with two subscales: biomedical and behavioral. In total, 400 primary care physicians working in the Riyadh region of Saudi Arabia were invited to participate.Results: The responding primary care physicians (n = 72, response rate = 18%) provided an average score on the behavioral subscale (mean = 31.5± 7.1) that was lower than that on the biomedical subscale (36.5± 7.8) of the PABS. The lower scores in the biomedical subscale are associated with the using of clinical guidelines for low back pain management (χ2 (1) = 4.7, p = 0.03). Moreover, providing guideline-based advices regarding activity and work was more likely to come from those scoring above the mean in the behavioral subscale.Conclusion: The results of this study show that Saudi Arabian primary care physicians manage their patients within a biomedical framework; there is some compliance to the current low back pain clinical guidelines among these physicians, with under/post-graduate education being needed for these professionals to adopt a more biopsychosocial framework during low back pain management.Keywords: low back pain, attitude, behavior, primary care physician, biomedical management, biopsychosocial management, primary care, guidelines adherence, pain, healthcare professional

Ahmed S Alhowimel,1 Mazyad A Alotaibi,1 Aqeel M Alenazi,1 Bader A Alqahtani,1 Mansour A Alshehri,2,3 Dalyah Alamam,4 Faris A Alodaibi4 1Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; 2Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia; 3NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia; 4Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Ahmed S AlhowimelDepartment of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, AlKharj, 11942, Saudi ArabiaTel +966115886354Email aalhowimel@gmail.com; a.alhowimel@psau.edu.saObjective: Previous evidence has recommended conservative interventions as the best treatment in individuals with chronic low back pain (CLBP). However, the influence of psychosocial factors on the treatment outcomes is unclear. Therefore, this systematic review aimed to address the psychosocial factors that influence changes in pain and disability in patients with CLBP after a guideline-based conservative intervention.Methods: Four electronic databases were systematically searched from inception until September 2020 for prospective studies examining the relationship between psychosocial factors and the outcomes of pain and disability after conservative intervention. All included studies were selected, extracted, and critically evaluated by two independent reviewers.Results: In total, 15 studies were included in this systematic review. The results support the link between the baseline fear of movement, depression, self-efficacy, and catastrophizing with future functional disability outcomes after conservative interventions. However, these factors were less likely to predict changes in pain intensity outcomes after conservative interventions. Self-efficacy seems to mediate between some of the baseline psychosocial factors (eg, fear) and future pain and disability.Conclusion: Fear of movement, self-efficacy, catastrophizing and depression were consistently reported to predict disability outcomes irrespective of the type of conservative intervention. This highlights the importance of addressing these factors in conservative management of CLBP.Keywords: chronic low back pain, outcomes, conservative interventions, psychosocial