Educational interventions on attitudes and beliefs about low back pain treatment in physical therapy students and physical therapists: a systematic review and meta-analysis.

Abstract

To determine the effectiveness of educational interventions on attitudes and beliefs about low back pain (LBP) treatment in physical therapy students and physical therapists. Electronic searches were conducted on January 14, 2026, in the PubMed, EMBASE, CINAHL, SPORTDiscus, Web of Science, Scopus, Epistemonikos, and LILACS databases. Randomised controlled trials involving physical therapy students or physical therapists that investigated the effectiveness of educational interventions to improve attitudes and beliefs about LBP were included. Of the 1,924 records screened, nine trials were included. The meta-analysis (<i>n</i> = 717) revealed a statistically significant difference in attitudes and beliefs about LBP measured with the HC-PAIRS in favour of biopsychosocial versus biomedical educational interventions (MD = -10.7 points; <i>p</i> < 0.001; 95% CI: -15.80 to -5.66; I² = 89.48%). A subgroup analysis of students also showed a significant difference favouring biopsychosocial educational interventions (MD = -14.11 points; <i>p</i> < 0.001; 95% CI: -17.07 to -8.85; I² = 44.41%). Low-to-moderate certainty evidence suggests that biopsychosocial educational interventions improve LBP-related attitudes and beliefs among physical therapy students, though this effect is notably attenuated in practicing therapists. Further research should evaluate these interventions in practising physical therapists and their subsequent impact on patient-level LBP outcomes.