Comparing the impact of interactive versus traditional e-learning on physiotherapists’ knowledge, attitudes, and clinical decision-making in low back pain management: a randomized controlled trial

Fourré, Antoine;Michielsen, Jef;Ris, Laurence;Darlow, Ben;Roussel, Nathalie;et.al.
(2025) Journal of Manual & Manipulative Therapy — Vol. 33, n° 6, p. 505-518 (2025)

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Authors
  • Fourré, Antoineorcid-logoUCLouvain
    Author
  • Michielsen, Jeforcid-logoUniversity Hospital
    Author
  • Ris, Laurenceorcid-logoUniversity of Mons
    Author
  • Darlow, Benorcid-logoUniversity of Otago
    Author
  • Roussel, Nathalieorcid-logoUniversity of Antwerp
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Abstract
Introduction Despite the recommendations to use a bio-psycho-social framework, many physiotherapists still manage their patients mainly from a biomedical point of view. The purpose of this study was to analyze the impact of two different e-learning interventions on knowledge, attitudes and clinical decision making of physiotherapists managing low back pain (LBP) to increase guideline-consistent care. Methods Physiotherapists were allocated (1/1) either to an experimental or a traditional e-learning intervention. Baseline and post-intervention assessment included the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS), Back Pain Attitudes Questionnaire (Back-PAQ), Neurophysiology of Pain Questionnaire (NPQ) and a clinical vignette. Participants had two weeks to complete the post-intervention assessment. Statistics were processed using ANCOVA and Fisher’s t-tests. Results 419 physiotherapists were included in the analysis. Mean scores of HC-PAIRS, Back-PAQ and NPQ significantly improved post-intervention in both groups. There was a significant effect of the intervention type (experimental versus traditional) on the scores of HC-PAIRS (p < .001; η2p = .243) and Back-PAQ (p < .001; η2p = .135), but not on NPQ scores. Return to work recommendations assessed with the clinical vignette were significantly more guideline-consistent in the experimental group (p < .001) post-intervention. Conclusion An interactive e-learning intervention which includes concrete clinical examples and focused on patient’s reassurance, self-management and importance of screening psycho-social factors had more impact than a traditional e-learning intervention to enhance physiotherapists’ knowledge, attitudes and clinical decision-making regarding LBP.
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Fourré, A., Michielsen, J., Ris, L., Darlow, B., Vanderstraeten, R., Bastiaens, H., Demoulin, C., & Roussel, N. (2025). Comparing the impact of interactive versus traditional e-learning on physiotherapists’ knowledge, attitudes, and clinical decision-making in low back pain management: a randomized controlled trial. Journal of Manual & Manipulative Therapy, 33(6), 505-518. https://doi.org/10.1080/10669817.2025.2476670 (Original work published 2025)