The impact of manual handling training on beliefs regarding low back pain

Purpose: Despite widespread use, the impact of manual handling (MH) training on low back pain (LBP) beliefs is unclear, with some data suggesting MH instructors hold outdated beliefs about LBP. This study aimed to examine the effect of MH training on a range of LBP beliefs. Materials and methods: Ethics committee approval (University of Limerick) was obtained prior to the study. A pre-post design study of healthcare workers prior to, and after, MH training. 129 participants completed questionnaires regarding their demographics, their LBP history, as well as a range of LBP beliefs using the Back Beliefs Questionnaire (BBQ), the modified Tampa Scale of Kinesiophobia (TSK) and the modified Photograph Series of Daily Activities (mPHODA) scale. Results: BBQ (mean difference = 3.12 (95% CI: 1.72, 4.52), p <.001) and TSK (mean difference = −1.43 (95% CI: −2.38, −0.49), p =.004) scores were more positive after MH training. In contrast, common daily activities on the mPHODA were considered significantly more harmful after MH training (mean difference = 6.95 (95% CI: 4.62, 9.28), p <.001). Conclusions: A single day of MH training can change LBP beliefs, with improvements exhibited in the BBQ and TSK, whereas scores on the mPHODA were worse after training. While the changes are small, these results confirm that the TSK and BBQ have similarities, and differ from the mPHODA. The content and delivery of MH training courses may need to better align participant learning with evidence regarding the safety of gradual exposure to spinal loading.