Physiotherapists implicitly evaluate bending and lifting with a round back as dangerous

Abstract

© 2018 Elsevier Ltd. Background: Beliefs can be assessed using explicit measures (e.g. questionnaires) that rely on information of which the person is ‘aware’ and willing to disclose. Conversely, implicit measures evaluate beliefs using computer-based tasks that allow reduced time for introspection thus reflecting ‘automatic’ associations. Thus far, physiotherapists’ beliefs about back posture and safety have not been evaluated with implicit measures. Objectives: (1) Evaluate implicit associations between bending lifting back posture (straight-back vs round-back) and safety (safe vs danger); (2) Explore correlations between implicit and explicit measures of beliefs towards vulnerability of the back. Design: Exploratory cross-sectional quantitative study. Methods: 47 musculoskeletal physiotherapists completed explicit measures of fear of movement (TSK-HC), back beliefs (BackPAQDanger) and beliefs related to bending and lifting back posture and safety (BSB). An Implicit Association Test (IAT) was used to assess implicit associations between (i) images of people bending/lifting with a ‘round-back’ or with a ‘straight-back’ posture, and (ii) words representing ‘safety’ and ‘danger’. A one-sample t-test assessed the degree and direction of the sample's IAT score. Cohen's d provided an effect size of the estimated bias. Correlation between IAT and each explicit measure was assessed using Pearson's coefficient. Results: The sample displayed an implicit association between ‘round-back’ and ‘danger’ (µ = 0.213, 95% CI [0.075-0.350], p =.003), with an effect size magnitude of 0.45. There were fair to moderate correlations between IAT and BSB (r = 0.320, 95% CI [0.036-0.556], p =.029) and, IAT and BackPAQDanger (r = 0.413, 95%CI [0.143-0.626], p =.004). Conclusions: Physiotherapists displayed an implicit bias towards bending and lifting with a round-back as dangerous.