A self-administered questionnaire was developed based on the NVL “Non-specific LBP” chapters on diagnostics and non-pharmacological therapy (see Additional file 1 on the eAddenda for the complete online survey in German language and Additional file 2 for a translated English language version of the questionnaire). Although in international guidelines a core recommendation is to advice patients to stay active and educate patients to support self-management [19, 20], we did not include this chapter of the NVL in our study. Advice and education should primarily be provided by physicians in Germany since not addressed by the German catalogue of therapies [10], acknowledging that physical therapists might give advice and educate patients within physical therapy sessions in an informal way. This questionnaire served to collect information on (1) participants’ demographics, (2) the physical therapeutic diagnostic process of LBP, (3) the treatment of LBP and (4) the application of clinical practice guidelines (CPG) and perceived barriers. We used a mix of multiple-choice questions and yes/no-questions. For all items, there was a non-response option. To assess the current clinical practice, study participants were asked to rate different treatment modalities for acute and chronic LBP on a 4-point Likert-type scale (where 1 = never, 2 = sometimes, 3 = often, 4 = always). Items were listed alphabetically to avoid any influence of display order. Questions regarding participant’s awareness of the NVL and the application of CPGs in general were developed by the authors. Respondents who denied using guideline recommendations in clinical practice were asked for their perceived barriers based on common barriers described in the literature [21].

For the online questionnaire, SoSci Survey was used, a free of charge online tool for research projects (www.soscisurvey.de). The survey was accessible online without restrictions (password or registration) via an internet link to the SoSci Survey platform. Study participants were estimated to be able to complete the questionnaire within 10–15 min. The sequence of items and thus, the number of pages and items per page, were individually adjusted using filter questions. The maximum number of pages was 27. In case of missing answers, participants were reminded to complete all questions before submission. To ensure an accurate data collection process and to avoid bias, there was no possibility to go back to the previous pages once participants had proceeded to the next page. Technical conditions did not allow determining unique visitors of the survey.

To improve quality and understanding of the questionnaire, a pre-test was conducted with 10 physical therapists. Pre-test participants were asked to point out any difficulties in understanding, semantics, conception or layout. All results obtained in this process were discussed within the study team, resulting in minor adjustments.

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