Low Back Pain Belief Orientations Among Undergraduate Physiotherapy Students: A Cross-Sectional Study.

INTRODUCTION

Low back pain (LBP) is a leading cause of disability worldwide, and its effective management requires a shift from a purely biomedical perspective to a biopsychosocial model. Physiotherapists play a crucial role in LBP care, and their belief systems significantly influence clinical decision-making. However, limited evidence exists on how undergraduate physiotherapy students conceptualise pain and whether their beliefs evolve during training. This study aimed to examine the dominant belief orientation (biomedical or biopsychosocial) among undergraduate physiotherapy students and evaluate differences across academic years. Understanding how students conceptualise low back pain (LBP) is essential to inform curriculum design and enhance evidence-based, patient-centred care in physiotherapy education.

DESIGN/METHODOLOGY/APPROACH: A cross-sectional survey was conducted among undergraduate physiotherapy students (1st year: n = 137; 4th year: n = 308) using the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS.PT). Standardized mean scores were computed separately for biomedical and biopsychosocial subscales. Wilcoxon signed-rank and Mann-Whitney U tests were applied to compare within- and between-group differences.

RESULTS

Students demonstrated higher biomedical belief scores (1st year: M = 34.5, SD = 6.05; 4th year: M = 33.5, SD = 7.25) than biopsychosocial scores (both years: M = 23.8). The difference in biomedical scores between 1st- and 4th-year students was statistically significant (U = 18,749, p = 0.006), while biopsychosocial scores showed no significant difference (U = 20,827, p = 0.829). Regression analysis found no association between students' belief orientation and personal experience of LBP.

CONCLUSION

Findings suggest that physiotherapy students maintain predominantly biomedical pain beliefs, underscoring a need for targeted curricular reform. Integrating interprofessional and reflective learning strategies may enhance students' understanding of the biopsychosocial model, improving their readiness for holistic clinical reasoning.