Manual Therapy
Volume 10, Issue 1 , Pages 38-43, February 2005

Do Norwegian manual therapists provide management for patients with acute low back pain in accordance with clinical guidelines?

  • Liv Inger Strand

      Affiliations

    • Department of Public Health and Primary Health Care, Section for Physiotherapy Science, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway
    • Corresponding Author InformationCorresponding author. Tel.: +47-55586123, fax: +47-55586139.
    • ,
  • Alice Kvale

      Affiliations

    • Department of Public Health and Primary Health Care, Section for Physiotherapy Science, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway
    • ,
  • Målfrid Råheim

      Affiliations

    • Department of Public Health and Primary Health Care, Section for Physiotherapy Science, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway
    • ,
  • Anne Elisabeth Ljunggren

      Affiliations

    • Department of Public Health and Primary Health Care, Section for Physiotherapy Science, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway

Received 8 December 2003; received in revised form 4 May 2004; accepted 8 July 2004.

Abstract 

Manual therapists (MTs) are specialized in examining and treating patients with low back pain (LBP). The aim of the study was to investigate if patients’ consultations with Norwegian MTs are in accordance with clinical guidelines for the management of acute LBP. Semi-structured interviews were conducted based on observation of the first consultation. Twenty-two MT students observed two consultations, and thereafter interviewed MTs (convenience sample) about clinical findings, information, advice and specific therapeutic procedures given. The interviews were tape-recorded, transcribed, and organized. Forty-two reports were derived from 34MTs (12% of all in Norway). The MTs commonly informed the patients of main clinical findings. The intention to eliminate fear avoidance was specifically mentioned in 43% of the interviews. Advice of being active in daily life activities was given to 50% of the patients, and 43% were advised to avoid particular pain provoking movements. Working ability and sick leave was considered in only 20% of those employed. The most frequent treatment modalities recommended were home-exercises (69%) and a combination of joint mobilization and individually tailored exercises (48%). To some extent the MTs acted according to main points of clinical guidelines. However, functioning at the participation level was little emphasized in the consultations.

Keywords: Clinical guidelines, Acute low back pain, Manual therapists

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PII: S1356-689X(04)00069-4

doi:10.1016/j.math.2004.07.003

Manual Therapy
Volume 10, Issue 1 , Pages 38-43, February 2005

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