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BackgroundObjectiveMethodsResultsConclusionsHealthcare providers’ attitudes and beliefs can influence how patients with persistent musculoskeletal pain are treated. A biopsychosocial approach is more effective than a purely biomedical approach. Ensuring healthcare professionals have appropriate pain science education (PSE) is essential for successful treatment outcomes.To validate the Spanish version of the Knowledge and Attitudes of Pain (KNAP-SP) questionnaire among Spanish physiotherapists and students and analyze its psychometric properties.From May to October 2022, two independent teams adapted the KNAP questionnaire from English to both European and Hispanic-Spanish. A cross-sectional validation study was conducted with 517 physiotherapists examining internal consistency (Cronbach’s alpha), structural validity (exploratory factor analysis), and construct validity (hypothesis testing). Longitudinal analyses assessed test–retest reliability (intraclass correlation coefficient [ICC2,1; n = 63]) and responsiveness following a PSE intervention using Receiver Operating Characteristic (ROC) curve analysis and hypothesis testing (n = 70).The KNAP-SP showed strong internal consistency [overall α coefficient = 0.86; domain 1 (α = 0.82); domain 2 (α = 0.70)], explaining 32.3% of the variance. Construct validity was supported by 75% of the hypotheses. Test–retest reliability was high (ICC2,1 = 0.84). KNAP-SP’s responsiveness was confirmed by ROC analysis (area under the curve [AUC] = 0.87 [95% CI: 0.79–0.96, p-value <.01]) and accepting 75% of prior hypotheses. The minimal clinically important change was 6.96 points. No floor or ceiling effects were detected.The KNAP-SP, with robust psychometric properties and successful adaptation and validation, is a valuable tool for assessing pain knowledge and attitudes among Spanish-speaking physiotherapists. [ABSTRACT FROM AUTHOR]

Introduction: Although experienced raters show good reproducibility1 of Pressure Pain Thresholds (PPT) in most body locations2, it is unknown if inexperienced physiotherapy students perform comparably. Recruiting students as raters would increase opportunities for the student's development and the design of studies. Methods: A total of 175 participants were measured by ten undergraduate students using either a Wagner (n = 87) or Somedic (n = 88) digital algometer on four body locations; the lower leg, upper leg, arm and neck. Each student measured a subsample of ~9 participants. Agreement (reported as a coefficient of variance; standard error of measurement divided by the average threshold) and reliability (intraclass correlation (ICC)) were measured for both the individual rater and the total group. Results: Agreement ranged from 9-17% per body location, whereas individual raters differed from the group result from -7.9% up to +6.6%. Reliability was good to excellent, ICCs (1,1) ranging from 0.88 to 0.95. Individual ICCs (2,1) were between 0.00 to 0.99. Discussion: Reproducibility of the total group was good; however, it varies per student. Even though reliability is affected by group variance differences, agreement parameters also show individual differences. PPTs seem rater dependent, which may explain different findings in the literature. Consequently, using reproducibility values of other studies/raters should be done cautiously. Students may be recruited as research assistants to perform PPTs. Process evaluation: Organising raters and participants together is challenging. Using parallel rooms with observational tools helped. Dependency on raters was a threat, resulting in an excluded rater due to sickness. [ABSTRACT FROM AUTHOR]

Introduction: In 2013, a study showed low guideline adherence regarding chronic low back pain (CLBP) in physiotherapy students concerning activity and work recommendations (47% and 16%)1. The aim of this study is to investigate if the 2020' physiotherapy students'attitudes and beliefs regarding CLBP and osteoarthritis (OA) and the guideline adherence have changed since 2013, by using the same protocol. Methods: Physiotherapy students in their 2nd and 4th year of education from 6 Belgian and 2 Dutch institutions participated. The attitudes and beliefs regarding CLBP and OA were measured using the Pain attitudes and beliefs scale (BAPS), the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and a questionnaire regarding therapeutic exercise and knee OA. A clinical case vignette was used to measure the guideline adherence regarding CLBP. Results: In total, 2738 students participated, 1624 in 2013 and 1114 in 2020. Compared to 2013, students in 2020 scored lower on a biomedical orientation (p < 0.001) and higher on psychosocial orientations (p < 0.001) regarding CLBP and OA. Medium effect size (cohens'd = 0.548) was found on the psychosocial orientation of the PABS, other differences only had small effect sizes. In 2020, 54% provided clinical guidelines' consistent recommendations for activity and 28% for work, which significantly improved compared to 2013. Discussion: A positive shift occurred towards a more biopsychosocial approach between students of 2013 and 2020. However, the improved guideline adherence concerning activity and work recommendations remains low. Process evaluation: Additional clinical case vignette to measure clinical recommendations regarding OA would have strengthen this study. [ABSTRACT FROM AUTHOR]

Introduction: Low back pain (LBP) is the leading cause of disability in the world1. Among many first-line healthcare providers, patients seek help from a physiotherapist. Increasing numbers of physiotherapy practices have information about LBP on their website. At this moment, in the Netherlands, the quality of this information is unknown. Objective: To what extent is the information on physiotherapy websites about LBP conform LBP guidelines, and the biopsychosocial model? Methods: Cross sectional study design; the content of all existing physiotherapy websites within the Netherlands were studied. Predetermined criteria for content analysis were developed according guidelines and biopsychosocial model. A biomedical score was given with 0 psychosocial factors, limited biopsychosocial with 1-2 psychosocial factors, or fairly biopsychosocial when 3 or more psychosocial factors were mentioned. Descriptive statistics were applied. Results: 8607 entries were identified. After removal of duplicates and entries without information, 834 physiotherapy websites remained. 449 websites contained information about LBP. Most websites, 63.9% described a biomedical explanation regarding the causes of LBP, 27.7% limited biopsychosocial and 8.5% gave a fairly biopsychosocial explanation. Discussion: The minority of the physiotherapy websites within the Netherlands contained information about LBP. Of the websites with information, the majority of the information did not met current guidelines or biopsychosocial explanations. The provided information on a physiotherapy practice website is mostly not according the current state of evidence. Process evaluation: The data shown in this abstract were based on preliminary results and analysis. [ABSTRACT FROM AUTHOR]

Background: Access to pain education for healthcare professionals is an International Association for the Study of Pain's key recommendation to improve pain care. The content of preregistration and undergraduate physical therapy pain curricula, however, is highly variable., Objective: This study aimed to develop a list, by consensus, of essential pain-related topics for the undergraduate physical therapy curriculum., Methods: A modified Delphi study was conducted in four rounds, including a Delphi Panel ( N = 22) consisting of in pain experienced lecturers of preregistration undergraduate physical therapy of Universities of Applied Sciences in the Netherlands, and five Validation Panels. Round 1: topics were provided by the Delphi Panel, postgraduate pain educators, and a literature search. Rounds 2-4: the Delphi Panel rated the topics and commented. All topics were analyzed in terms of importance and degree of consensus. Validation Panels rated the outcome of Round 2., Results: The Delphi Panel rated 257, 146, and 90 topics in Rounds 2, 3, and 4, respectively. This resulted in 71 topics judged as "not important," 97 as "important," and 89 as "highly important." In total, 63 topics were rated as "highly important" by the Delphi Panel and Validation Panels., Conclusion: A list was developed and can serve as a foundation for the development of comprehensive physical therapy pain curricula.