Beliefs and use of contextual factors in musculoskeletal pain among Argentine physiotherapists: a nationwide cross-sectional study.

BACKGROUND

Contextual factors (CFs), such as clinician's words and patient's expectation, influence musculoskeletal pain outcomes through biopsychosocial processes. While physiotherapists' views on CFs have been studied elsewhere, no such research exists in Argentina.

OBJECTIVE

This study examines Argentine physiotherapists' perspectives and their link to professional characteristics.

METHODS

A cross-sectional online survey was distributed to 512 Argentine physiotherapists, members of a scientific society specializing in musculoskeletal care. It gathered demographic, professional data, two clinical vignettes on decision-making, and closed-ended questions on CF use, ethical and communication aspects, beliefs, use frequency, mechanisms of action, and perceived benefits. Associations between professional factors and both CF beliefs and use were analyzed using univariate and multivariate regression models.

RESULTS

Response rate was 45.5%. The most influential CFs were therapeutic alliance, verbal communication, and positive attitudes and behavior; in contrast, professional reputation, patient's previous experience, and a patient-centered approach were rated less influential. While frequently used CFs generally matched perceived influence, some discrepancies emerged. Reading more than five scientific articles in the past three months was significantly associated with stronger CF beliefs (B = 0.178, 95% CI [0.055-0.301], p < .01) and higher CF use (B = 0.181, 95% CI [0.053-0.309], p < .01). Teaching activities were also linked to greater CF use (B = 0.178, 95% CI [0.027-0.329], p = .021).

CONCLUSION

Argentine physiotherapists recognize the importance of CFs, especially therapeutic alliance and communication. Discrepancies between beliefs and use, along with regression results, suggest that academic exposure and teaching play a key role in CF integration, underscoring the need to strengthen education and training in clinical practice.