Physiotherapists' beliefs about whiplash-associated disorder: a comparison between Singapore and Queensland, Australia

Ng, Tze Siong, Pedler, Ashely, Vicenzino, Bill and Sterling, Michele (2014) Physiotherapists' beliefs about whiplash-associated disorder: a comparison between Singapore and Queensland, Australia. Physiotherapy Research International, 20 2: 77-86. doi:10.1002/pri.1598

Author Ng, Tze Siong
Pedler, Ashely
Vicenzino, Bill
Sterling, Michele
Title Physiotherapists' beliefs about whiplash-associated disorder: a comparison between Singapore and Queensland, Australia
Journal name Physiotherapy Research International   Check publisher's open access policy
ISSN 1358-2267
Publication date 2014-07-23
Sub-type Article (original research)
DOI 10.1002/pri.1598
Open Access Status
Volume 20
Issue 2
Start page 77
End page 86
Total pages 10
Place of publication Chichester, West Sussex, United Kingdom
Publisher John Wiley & Sons
Collection year 2015
Language eng
Formatted abstract
Background and purpose: Healthcare providers' beliefs may play a role in the outcome of whiplash-associated disorders (WAD), a condition which is proposed to be culturally dependent. Clinical practice guidelines recommend an active approach for the management of WAD, which is often delivered by physiotherapists. However, there is no data on physiotherapists' whiplash beliefs. Our primary objective was to determine physiotherapists' beliefs from Queensland (Australia) and Singapore, two cultures with differing prevalence of chronic musculoskeletal pain and chronic WAD.

Methods: A pen and paper survey of musculoskeletal physiotherapists practicing in Queensland and Singapore was conducted. Participants completed questionnaires consisting of patient vignettes and statements inquiring knowledge and attitudes towards WAD. Chi-square tests of significance were used to compare the responses of physiotherapists from both samples.

Results: Ninety-one (response rate 45%) Queensland-based and 94 (response rate 98%) Singapore-based physiotherapists participated in the study. The beliefs in the management strategies for the patient vignettes were generally consistent with practice guidelines. A higher proportion of Queensland-based physiotherapists expected permanent disabilities for the patient vignette depicting chronic WAD (Queensland: 55% Singapore: 28% Pearson chi-sq 18.76, p<0.005).Up to 99% of the physiotherapists from both samples believed in encouragement of physical activity, the effectiveness of exercise and multimodal physiotherapy for WAD. Significantly higher proportions of Singapore-based physiotherapists believed in ordering radiographs for acute WAD (Pearson chi-sq 41.98, p<0.001) and also believed in a psychogenic origin of chronic WAD (Pearson chi-sq 22.57, p<0.001).

Conclusion: The majority of beliefs between physiotherapists in Queensland and Singapore were similar but there were specific differences. Physiotherapists' whiplash beliefs in Queensland and Singapore did not clearly reflect the difference in prevalence of chronic musculoskeletal pain or chronic WAD in Queensland and Singapore.
Keyword Pain
Practice/service settings
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 23 July 2014.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Health and Rehabilitation Sciences Publications
School of Medicine Publications
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