{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:45:18Z","timestamp":1792161918455,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evidence\u2010based management of low back pain remains inconsistent, particularly in developing settings, where clinicians' beliefs and contextual factors may influence practice. Research specifically examining how physiotherapists in the Maldives manage LBP is scarce, highlighting the need for context\u2010specific evidence to guide both clinical practice and policy development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore physiotherapists' beliefs, clinical reasoning, and barriers to evidence\u2010based management of low back pain in the Maldives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A convergent mixed method design was employed. Quantitative data were collected using the Back Pain Attitudes Questionnaire (Back\u2010PAQ), while semi\u2010structured interviews explored clinical reasoning and perceived barriers. Data were analysed using descriptive statistics and thematic analysis, and findings were integrated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Physiotherapists demonstrated moderate levels of unhelpful beliefs, reflected in a spectrum of clinical reasoning patterns ranging from structurally oriented and procedural approaches to more patient\u2010centred strategies. However, the implementation of evidence\u2010based care was inconsistent and influenced by limited access to continuing professional development, resource constraints, and patient expectations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates that physiotherapists in the Maldives exhibit moderate level of unhelpful beliefs towards low back pain, reflected in a spectrum of clinical reasoning patterns ranging from structurally oriented to more patient\u2010centred approaches. The presence of more evidence\u2010aligned practices may, in part, reflect the diverse educational backgrounds of a workforce that includes a substantial proportion of foreign\u2010trained clinicians. However, the consistent implementation of evidence\u2010based care remains constrained by contextual factors, including limited access to continuing professional development and system\u2010level barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/msc.70276","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:55:01Z","timestamp":1792158901000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Beliefs to Practice: A Mixed Methods Study of Clinical Reasoning and Barriers to Evidence\u2010Based Management of Back Pain Among Physiotherapists"],"prefix":"10.1002","volume":"24","author":[{"given":"Mirufa","family":"Mohamed","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences Faculty of Health Sciences Maldives National University  Mal\u00e9 Maldives"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6834-0656","authenticated-orcid":false,"given":"Ammar","family":"Suhail","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences Faculty of Health Sciences Maldives National University  Mal\u00e9 Maldives"},{"name":"Faculty of Life and Health Sciences Institute of Nursing and Health Ulster University  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.12968\/ijtr.2021.0149"},{"key":"e_1_2_11_3_1","volume-title":"Maldives: Overcoming the Challenges of a Small Island State: Country Diagnostic Study","author":"Asian Development 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