{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T16:11:30Z","timestamp":1776701490598,"version":"3.51.2"},"reference-count":76,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Regional Development Fund","award":["Interreg FWVl NOMADe\u2014N\u00b0 4.7.360"],"award-info":[{"award-number":["Interreg FWVl NOMADe\u2014N\u00b0 4.7.360"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: While pain is influenced by multiple factors including psychosocial factors, previous research has shown that physiotherapists still favour a biomedical approach. Purpose: To evaluate: (1) how physiotherapists explain the patient\u2019s chronic non-specific low back pain (LBP); (2) whether physiotherapists use one or multiple influencing factors, and (3) whether these factors are framed in a biopsychosocial or biomedical approach. Materials and methods: This exploratory qualitative study uses a vignette depicting chronic non-specific LBP and employs a flexible framework analysis. Physiotherapists were asked to mention contributing factors to the pain based on this vignette. Five themes were predefined (\u201cBeliefs\u201d, \u201cPrevious experiences\u201d, \u201cEmotions\u201d, \u201cPatients behaviour\u201d, \u201cContextual factors\u201d) and explored. Results: Physiotherapists use very brief explanations when reporting contributing factors to chronic pain (median 13 words). Out of 670 physiotherapists, only 40% mentioned more than two different themes and 2\/3rds did not see any link between the patients\u2019 misbeliefs and pain. Only a quarter of the participants mentioned the patient\u2019s worries about pain and movement, which is considered to be an important influencing factor. Conclusion: The lack of a multifactorial approach and the persistent biomedical beliefs suggest that it remains a challenge for physiotherapists to fully integrate the biopsychosocial framework into their management of chronic LBP.<\/jats:p>","DOI":"10.3390\/ijerph20105828","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T02:27:04Z","timestamp":1684204024000},"page":"5828","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["How Do Physiotherapists Explain Influencing Factors to Chronic Low Back Pain? A Qualitative Study Using a Fictive Case of Chronic Non-Specific Low Back Pain"],"prefix":"10.3390","volume":"20","author":[{"given":"Rob","family":"Vanderstraeten","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8494-4919","authenticated-orcid":false,"given":"Antoine","family":"Fourr\u00e9","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium"},{"name":"Department of Neurosciences, Universit\u00e9 de Mons, 7000 Mons, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaline","family":"Demeure","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Demoulin","sequence":"additional","affiliation":[{"name":"Department of Sport and Rehabilitation Sciences, University of Liege, EVAREVA, 4000 Liege, Belgium"},{"name":"Faculty of Motricity Sciences, UCLouvain, 1348 Louvain-la-Neuve, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jozef","family":"Michielsen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium"},{"name":"Anatomy and Research Centre (ASTARC), University Hospital of Antwerp, Antwerp Surgical Training, 2650 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4762-1907","authenticated-orcid":false,"given":"Sibyl","family":"Anthierens","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5509-3406","authenticated-orcid":false,"given":"Hilde","family":"Bastiaens","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7409-878X","authenticated-orcid":false,"given":"Nathalie","family":"Roussel","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1533-2500.2011.00466.x","article-title":"Higher Incidence of Common Diagnoses in Patients with Low Back Pain in Primary Care","volume":"12","author":"Bartholomeeusen","year":"2011","journal-title":"Pain Pract."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S0140-6736(99)01312-4","article-title":"Epidemiological features of chronic low-back pain","volume":"354","author":"Andersson","year":"1999","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S0034-8910.2015049005874","article-title":"Prevalence of chronic low back pain: Systematic review","volume":"49","author":"Meucci","year":"2015","journal-title":"Rev. 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