KNOWLEDGE, ATTITUDES, AND PRACTICES OF PHYSIOTHERAPISTS TOWARD MINDFULNESS-BASED INTERVENTIONS IN PAKISTAN: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.71000/x2tn7x98Keywords:
Attitude, Chronic Diseases, Knowledge, Mental Health, Mindfulness-Based Interventions (MBIs), , Physiotherapy, Rehabilitation, Clinical PracticeAbstract
Background: Patients undergoing rehabilitation following injury or surgery often experience both physical limitations and psychological distress, including anxiety, depression, and reduced motivation. These psychological challenges can impede recovery and functional outcomes. Mindfulness-Based Interventions (MBIs), which emphasize non-judgmental awareness and stress reduction, have been proven effective in improving both mental and physical health. Despite global recognition, the role of MBIs in physiotherapy practice remains underexplored in Pakistan.
Objective: To investigate the knowledge, attitude, and practice (KAP) of physiotherapists in Pakistan regarding the use of mindfulness-based interventions alongside disease-specific rehabilitation strategies.
Methods: A descriptive cross-sectional study was conducted over a three-month period across multiple healthcare settings in Pakistan, including hospitals, clinics, and rehabilitation centers. A self-developed, structured questionnaire comprising three domains—knowledge (8 items), attitude (10 items), and practice (10 items)—was distributed among physiotherapists using a non-probability convenience sampling method. Out of 390 physiotherapists approached, 375 completed the survey (response rate: 96.15%). Descriptive statistics were analyzed using SPSS version 22, and mean scores were interpreted using a cut-off value of 2.2 on a 3-point Likert scale.
Results: Physiotherapists demonstrated a high level of knowledge and a positive attitude toward MBIs, with mean domain scores of 2.57 and 2.70 respectively. However, the mean score for the practice domain was 2.04, indicating low integration of MBIs into clinical settings. Only 30.3% reported regular use of mindfulness techniques, and 36.8% cited time constraints as a major barrier.
Conclusion: Although physiotherapists in Pakistan are knowledgeable and supportive of MBIs conceptually, their actual clinical implementation remains limited. Structured training and resource allocation are essential to bridge this gap in practice.
References
Cornwell L, Doyle H, Stohner M, Hazle C. Work-related musculoskeletal disorders in physical therapists attributable to manual therapy. J Man Manip Ther. 2021;29(2):92-8.
Rios WRC, Almeida Silva HJ, Pontes NS, Pontes-Silva A, Avila MA, Saragiotto BT, et al. Use of cupping therapy in musculoskeletal disorders: A cross-sectional study on the profile, training, and practice of Brazilian physical therapists. Musculoskelet Sci Pract. 2024;71:102943.
Tatta J, Willgens AM, Palombaro KM. Mindfulness and acceptance–based interventions in physical therapist practice: The time is now. Physical therapy. 2022;102(3):pzab293.
de Best RF, Coppieters MW, van Trijffel E, Compter A, Uyttenboogaart M, Bot JC, et al. Risk assessment of vascular complications following manual therapy and exercise for the cervical region: diagnostic accuracy of the International Federation of Orthopaedic Manipulative Physical Therapists framework (The Go4Safe project). J Physiother. 2023;69(4):260-6.
Cornforth E, Schramm K. Physical therapist's beliefs, practice patterns and barriers to the incorporation of mindfulness meditation into management of individuals with chronic dizziness. Complement Ther Clin Pract. 2021;43:101387.
Höder A, Stenbeck J, Fernando M, Lange E. Pelvic floor muscle training with biofeedback or feedback from a physiotherapist for urinary and anal incontinence after childbirth - a systematic review. BMC Womens Health. 2023;23(1):618.
Vibholm AP, Christensen JR, Pallesen H. Occupational therapists and physiotherapists experiences of using nature-based rehabilitation. Physiother Theory Pract. 2023;39(3):529-39.
Tatta J, Willgens AM, Palombaro KM. Mindfulness and Acceptance-Based Interventions in Physical Therapist Practice: The Time Is Now. Phys Ther. 2022;102(3).
Gilliam JR, George SZ, Norman KS, Hendren S, Sahu PK, Silfies SP. Mind-Body Exercise Performed by Physical Therapists for Reducing Pain and Disability in Low Back Pain: A Systematic Review With Meta-analysis. Arch Phys Med Rehabil. 2023;104(5):776-89.
Alghadir AH, Iqbal ZA, Iqbal A. Knowledge and utilization of manual therapy in the management of knee osteoarthritis by physical therapists in Saudi Arabia: a cross-sectional study. BMC Public Health. 2024;24(1):3379.
Sánchez-Infante J, Navarro-Santana MJ, Bravo-Sánchez A, Jiménez-Diaz F, Abián-Vicén J. Is Dry Needling Applied by Physical Therapists Effective for Pain in Musculoskeletal Conditions? A Systematic Review and Meta-Analysis. Phys Ther. 2021;101(3).
de Best RF, Coppieters MW, van Trijffel E, Compter A, Uyttenboogaart M, Bot JC, et al. Interexaminer Agreement and Reliability of an Internationally Endorsed Screening Framework for Cervical Vascular Risks Following Manual Therapy and Exercise: The Go4Safe Project. Phys Ther. 2021;101(10).
Arslan R. Evidence-Based Comparison of Physical Therapists and Traditional Healers: Distinguishing Science from Quackery. J Coll Physicians Surg Pak. 2024;34(8):1006.
Jones RJ. Blind and partially sighted physiotherapy in the United Kingdom. A century of development, success and challenge. Will it still belong? Physiother Theory Pract. 2021;37(3):401-19.
Lee J, Lee KS, Lee JH, Hwang J, Park DJ. Analysis of job stress, depression, and mindfulness among Korean physical therapists during the COVID-19 pandemic. Work. 2025;80(2):741-9.
Ebihara S, Otsubo Y, Miyagi M. Role of physical therapists and aromatherapy for fall prevention in older people: A narrative review. Geriatr Gerontol Int. 2021;21(6):445-50.
Fumero A, Peñate W, Oyanadel C, Porter B. The effectiveness of mindfulness-based interventions on anxiety disorders. a systematic meta-review. European Journal of Investigation in Health, Psychology and Education. 2020;10(3):704-19.
McCartney M, Nevitt S, Lloyd A, Hill R, White R, Duarte R. Mindfulness‐based cognitive therapy for prevention and time to depressive relapse: Systematic review and network meta‐analysis. Acta Psychiatrica Scandinavica. 2021;143(1):6-21.
Yusof N, Mansor M, Hasyim H. Mindfulness Based Stress Reduction (MBSR) and its Affect Reduce Stress and Fatigue among Carrier Woman. Indonesian Journal of Guidance and Counseling Research. 2024;2(1):8-14.
Zhang D, Lee EK, Mak EC, Ho CY, Wong SY. Mindfulness-based interventions: an overall review. British medical bulletin. 2021;138(1):41-57.
Driver C, Lovell GP, Oprescu F. Physiotherapists’ views, perceived knowledge, and reported use of psychosocial strategies in practice. Physiotherapy Theory and Practice. 2021.
Holopainen R, Simpson P, Piirainen A, Karppinen J, Schütze R, Smith A, et al. Physiotherapists' perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions: a systematic review and metasynthesis of qualitative studies. Pain. 2020;161(6):1150-68.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Um-E- Habiba, Laiba Shah, Aqdas Waheed, Hira Hafeez, Shah Faras Khan, Laiba Raza, Hifza Arif (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
