Primary Faculty Mentor Name

Nancy Gell

Project Collaborators

Mariana Wingood, DPT, PT, Sharon Henry, PT, PHD

Status

Graduate

Student College

College of Nursing and Health Sciences

Program/Major

Physical Therapy

Primary Research Category

Health Sciences

Presentation Title

Physical Activity for Patients with Chronic Low Back Pain: What are Physical Therapists Prescribing? A Mixed-Methods Study

Time

1:10 PM

Location

Mildred Livak Ballroom

Abstract

Background: The benefits of physical activity in the management of chronic low back pain (CLBP are supported by a number of systematic reviews and clinical practice guidelines. Physical therapists are in an ideal position to promote physical activity to patients with CLBP. However, the practice and documentation of physical activity prescription by physical therapists to patients with CLBP are not well known.

Methods: This study employed a mixed methods design. In 2019, 18 practicing physical therapists from mixed regions in the U.S. were interviewed about their experiences prescribing physical activity to patients with chronic low back pain. These interviews were recorded, transcribed, coded, and analyzed thematically. Documentation of physical activity prescription by physical therapists from a single health system was examined. Data was abstracted from the electronic medical records (EMR) for 18 patients with CLBP (n=57 encounters).

Results: Interviews revealed that physical activity prescriptions applying the FITT (frequency, intensity, type, and time) principles were generally reserved for previously active patients, whereas prescriptions emphasizing non-structured movement were typically suggested for patients without a physical activity history. Based on the EMR analysis, 67% (12/18) documented physical activity history at baseline, 5% (3/57) of sessions had documentation of physical activity prescription with at least one FITT component, and 32% (18/57) documented general movement discussions.

Conclusion: Preliminary results suggest that while physical therapists acknowledge the importance of physical activity with their CLBP patients, this does not translate to including the recommended FITT components in physical activity prescription. An emphasis on providing physical activity guidance based on therapist-perceived receptiveness of the patient is evident. Physical therapists tend to favor incorporating FITT components for patients with a physical activity history over those without. Therefore, those who might benefit most from FITT components may not receive them.

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Physical Activity for Patients with Chronic Low Back Pain: What are Physical Therapists Prescribing? A Mixed-Methods Study

Background: The benefits of physical activity in the management of chronic low back pain (CLBP are supported by a number of systematic reviews and clinical practice guidelines. Physical therapists are in an ideal position to promote physical activity to patients with CLBP. However, the practice and documentation of physical activity prescription by physical therapists to patients with CLBP are not well known.

Methods: This study employed a mixed methods design. In 2019, 18 practicing physical therapists from mixed regions in the U.S. were interviewed about their experiences prescribing physical activity to patients with chronic low back pain. These interviews were recorded, transcribed, coded, and analyzed thematically. Documentation of physical activity prescription by physical therapists from a single health system was examined. Data was abstracted from the electronic medical records (EMR) for 18 patients with CLBP (n=57 encounters).

Results: Interviews revealed that physical activity prescriptions applying the FITT (frequency, intensity, type, and time) principles were generally reserved for previously active patients, whereas prescriptions emphasizing non-structured movement were typically suggested for patients without a physical activity history. Based on the EMR analysis, 67% (12/18) documented physical activity history at baseline, 5% (3/57) of sessions had documentation of physical activity prescription with at least one FITT component, and 32% (18/57) documented general movement discussions.

Conclusion: Preliminary results suggest that while physical therapists acknowledge the importance of physical activity with their CLBP patients, this does not translate to including the recommended FITT components in physical activity prescription. An emphasis on providing physical activity guidance based on therapist-perceived receptiveness of the patient is evident. Physical therapists tend to favor incorporating FITT components for patients with a physical activity history over those without. Therefore, those who might benefit most from FITT components may not receive them.