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Physiotherapy management of low back pain in India - a survey of self-reported practice.

BACKGROUND
Physiotherapy is commonly used in the management of low back pain and from previous studies appears to be eclectic and not always in line with evidence-based practice. Most previous studies have been conducted in Western countries, and no previous studies have sought to explore physiotherapy management of low back pain in India.


PURPOSE
The aim of this study was to explore the self-reported management strategies employed by physiotherapists in India as it is unknown if these are in line with contemporary guidelines.


METHODS
Study design was a self-completed questionnaire, which was sent to the 350 physiotherapists registered with the Indian Physiotherapy Association in the state of Maharashtra in India. To maximize response rate there was repeat e-mailing and telephone follow-up.


RESULTS
Thirty-eight therapists did not treat patients with back pain and 45 were not working in India and so were excluded. Out of a sample frame of 267 physiotherapists, 186 responded to the e-mailed questionnaire (70%). All therapists reported that they gave some kind of advice to patients, used exercises and electrotherapy, and in addition about half used manual therapy. The majority of therapists used 8-12 sessions of treatment.


CONCLUSIONS
This first mapping of Indian physiotherapy management of low back pain has shown several areas of 'good practice' in line with contemporary guidelines. It also highlighted potential areas of concern regarding evidence-based practice; namely, very common use of passive electrotherapy modalities and potential excessive treatment. This report has implications for physiotherapy practice and education in India.