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      A cross-sectional investigation of back pain beliefs and fear in physiotherapy and sport undergraduate students

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          Abstract

          Background

          Although low back pain (LBP) beliefs have been well investigated in mainstream healthcare discipline students, the beliefs within sports-related study students, such as Sport and Exercise Science (SES), Sports Therapy (ST), and Sport Performance and Coaching (SPC) programmes have yet to be explored. This study aims to understand any differences in the beliefs and fear associated with movement in students enrolled in four undergraduate study programmes–physiotherapy (PT), ST, SES, and SPC.

          Method

          136 undergraduate students completed an online survey. All participants completed the Tampa Scale of Kinesiophobia (TSK) and Back Beliefs Questionnaire (BBQ). Two sets of two-way between-subjects Analysis of Variance (ANOVA) were conducted for each outcome of TSK and BBQ, with the independent variables of the study programme, study year (1st, 2nd, 3rd), and their interaction.

          Results

          There was a significant interaction between study programme and year for TSK (F(6, 124) = 4.90, P < 0.001) and BBQ (F(6, 124) = 8.18, P < 0.001). Post-hoc analysis revealed that both PT and ST students had lower TSK and higher BBQ scores than SES and SPC students particularly in the 3rd year.

          Conclusions

          The beliefs of clinicians and trainers managing LBP are known to transfer to patients, and more negative beliefs have been associated with greater disability. This is the first study to understand the beliefs about back pain in various sports study programmes, which is timely, given that the management of injured athletes typically involves a multidisciplinary team.

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          Most cited references41

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          Prevention and treatment of low back pain: evidence, challenges, and promising directions

          Anthony Woolf, Judith Turner, Rob Smeets … (2018)
          Many clinical practice guidelines recommend similar approaches for the assessment and management of low back pain. Recommendations include use of a biopsychosocial framework to guide management with initial non-pharmacological treatment, including education that supports self-management and resumption of normal activities and exercise, and psychological programmes for those with persistent symptoms. Guidelines recommend prudent use of medication, imaging, and surgery. The recommendations are based on trials almost exclusively from high-income countries, focused mainly on treatments rather than on prevention, with limited data for cost-effectiveness. However, globally, gaps between evidence and practice exist, with limited use of recommended first-line treatments and inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. Doing more of the same will not reduce back-related disability or its long-term consequences. The advances with the greatest potential are arguably those that align practice with the evidence, reduce the focus on spinal abnormalities, and ensure promotion of activity and function, including work participation. We have identified effective, promising, or emerging solutions that could offer new directions, but that need greater attention and further research to determine if they are appropriate for large-scale implementation. These potential solutions include focused strategies to implement best practice, the redesign of clinical pathways, integrated health and occupational interventions to reduce work disability, changes in compensation and disability claims policies, and public health and prevention strategies.
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            Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017

            Aimin Wu, Lyn March, Xuanqi Zheng … (2020)
            Background Low back pain (LBP) is a common musculoskeletal problem globally. Updating the prevalence and burden of LBP is important for researchers and policy makers. This paper presents, compares and contextualizes the global prevalence and years lived with disability (YLDs) of LBP by age, sex and region, from 1990 to 2017. Methods Data were extracted from the GBD (the Global Burden of Disease, Injuries, and Risk Factors Study) 2017 Study. Age, sex and region-specific analyses were conducted to estimate the global prevalence and YLDs of LBP, with the uncertainty intervals (UIs). Results The age-standardized point prevalence of LBP was 8.20% (95% UI: 7.31–9.10%) in 1990 and decreased slightly to 7.50% (95% UI: 6.75–8.27%) in 2017. The prevalent numbers of people with LBP at any one point in time in 1990 was 377.5 million, and this increased to 577.0 million in 2017. Age-standardized prevalence of LBP was higher in females than males. LBP prevalence increased with age, and peaked around the ages of 80 to 89 years, and then decreased slightly. Global YLDs were 42.5 million (95% UI: 30.2 million–57.2 million) in 1990 and increased by 52.7% to 64.9 million (95% UI: 46.5 million–87.4 million) in 2017. YLDs were also higher in females than males and increased initially with age; they peaked at 35–39 years of age in 1990, before decreasing, whereas in 2017, they peaked at 45–49 years of age, before decreasing. Western Europe had the highest number of LBP YLDs. Conclusions Globally, LBP is the leading global cause of YLDs. Greater attention is urgently needed to mitigate this increasing burden and the impact it is having on health and social systems.
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              The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management.

              Howard Leventhal, L Alison Phillips, Edith Burns (2016)
              The Common-Sense Model of Self-Regulation (the "Common-Sense Model", CSM) is a widely used theoretical framework that explicates the processes by which patients become aware of a health threat, navigate affective responses to the threat, formulate perceptions of the threat and potential treatment actions, create action plans for addressing the threat, and integrate continuous feedback on action plan efficacy and threat-progression. A description of key aspects of the CSM's history-over 50 years of research and theoretical development-makes clear the model's dynamic underpinnings, characteristics, and assumptions. The current article provides this historical narrative and uses that narrative to highlight dynamic aspects of the model that are often not evaluated or utilized in contemporary CSM-based research. We provide suggestions for research advances that can more fully utilize these dynamic aspects of the CSM and have the potential to further advance the CSM's contribution to medical practice and patients' self-management of illness.
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                Author and article information

                Contributors
                Cameron Black:
                ORCID: https://orcid.org/0000-0001-8140-9403
                Role: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Adrian Mallows: Role: ConceptualizationRole: MethodologyRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Sally Waterworth: Role: Project administrationRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Paul Freeman: Role: Project administrationRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Edward Hope:
                ORCID: https://orcid.org/0000-0001-6416-1354
                Role: Project administrationRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Bernard X. W. Liew:
                ORCID: https://orcid.org/0000-0002-7057-7548
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Project administrationRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Ravi Shankar Yerragonda Reddy: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS One
                Journal ID (publisher-id): plos
                Title: PLOS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 20 April 2023
                Publication date Collection: 2023
                Volume: 18
                Issue: 4
                Electronic Location Identifier: e0284754
                Affiliations
                [1 ] Occupational Health and Wellbeing, Buckinghamshire Healthcare NHS Trust, Stoke Mandeville Hospital, Aylesbury, United Kingdom
                [2 ] School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
                King Khalid University, SAUDI ARABIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0001-8140-9403
                https://orcid.org/0000-0001-6416-1354
                https://orcid.org/0000-0002-7057-7548
                Article
                Publisher ID: PONE-D-22-34229
                DOI: 10.1371/journal.pone.0284754
                PMC ID: 10118113
                PubMed ID: 37079578
                SO-VID: e427b14e-2d25-412c-8418-ccac34b4876e
                Copyright © © 2023 Black et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 14 December 2022
                Date accepted : 8 April 2023
                Page count
                Figures: 2, Tables: 1, Pages: 10
                Funding
                The author(s) received no specific funding for this work.
                Categories
                Subject: Research Article
                Subject: Medicine and Health Sciences
                Subject: Clinical Medicine
                Subject: Signs and Symptoms
                Subject: Pain
                Subject: Medicine and Health Sciences
                Subject: Sports and Exercise Medicine
                Subject: Biology and Life Sciences
                Subject: Sports Science
                Subject: Sports and Exercise Medicine
                Subject: Medicine and Health Sciences
                Subject: Complementary and Alternative Medicine
                Subject: Exercise Therapy
                Subject: People and Places
                Subject: Population Groupings
                Subject: Professions
                Subject: Medical Personnel
                Subject: People and Places
                Subject: Population Groupings
                Subject: Educational Status
                Subject: Undergraduates
                Subject: Research and Analysis Methods
                Subject: Mathematical and Statistical Techniques
                Subject: Statistical Methods
                Subject: Analysis of Variance
                Subject: Physical Sciences
                Subject: Mathematics
                Subject: Statistics
                Subject: Statistical Methods
                Subject: Analysis of Variance
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Psychometrics
                Subject: Social Sciences
                Subject: Psychology
                Subject: Psychometrics
                Subject: Medicine and Health Sciences
                Subject: Health Care
                Subject: Physiotherapy
                Custom metadata
                Data Availability All relevant data are within the paper and its Supporting Information files.

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