Knowledge, Attitude and Practice of Italian Physiotherapists When Prescribing Exercise for People With Non-Specific Neck Pain: A National Survey

Background and objective: Exercise is a crucial component of a multimodal treatment for improving function and reducing pain in patients with non-specific neck pain. This study aims to investigate the knowledge, attitudes, practices and the influence of professional characteristics of Italian specialised musculoskeletal physiotherapists compared with non-specialised physiotherapists. The influence of professional characteristics on exercise prescription for individuals with non-specific neck pain was also investigated. Materials and methods: This observational study was reported according to the CHERRIES checklist. A 30-question survey was conducted from August 2023 until January 2024. Results: A total of 446 Italian physiotherapists participated; 57.3% were Orthopaedic Manipulative Physical Therapists (OMPTs). Most (84%) reported being trained in exercise prescription for neck pain, but many were unfamiliar with certain muscular assessment tests which have been described in the literature (e.g., cervical extensor endurance test [35%], scapular holding test [41%]). 79% of the OMPTs and 56% of non-specialised physiotherapists (non-OMPTs) prescribed exercise for patients with neck pain, with 84% of the OMPTs and 68% of non-OMPTs agreeing that exercise should be part of neck pain management. 81% of the OMPTs and 63% of non-OMPTs reported being trained in the prescription of resistance training for patients with neck pain. However, OMPTs prescribed it less frequently. Conclusions: Italian physiotherapists are trained in exercise prescription for neck pain but lack familiarity with key muscle assessment tests. There is a need for enhanced training in aerobic and resistance exercise prescription to align with international guidelines and ultimately improve patient outcomes.