scholarly journals The STarT Back Screening Tool and Individual Psychological Measures: Evaluation of Prognostic Capabilities for Low Back Pain Clinical Outcomes in Outpatient Physical Therapy Settings

2013 ◽  
Vol 93 (3) ◽  
pp. 321-333 ◽  
Author(s):  
Jason M. Beneciuk ◽  
Mark D. Bishop ◽  
Julie M. Fritz ◽  
Michael E. Robinson ◽  
Nabih R. Asal ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Physical Therapy ◽  
Pain Intensity ◽  
Clinical Outcomes ◽  
Regression Models ◽  
Screening Tool ◽  
Low Back ◽  
Start Back Screening Tool ◽  
Psychological Measures ◽  
Psychological Measure

BackgroundPsychologically informed practice emphasizes routine identification of modifiable psychological risk factors being highlighted.ObjectiveThe purpose of this study was to test the predictive validity of the STarT Back Screening Tool (SBT) in comparison with single-construct psychological measures for 6-month clinical outcomes.DesignThis was an observational, prospective cohort study.MethodsPatients (n=146) receiving physical therapy for low back pain were administered the SBT and a battery of psychological measures (Fear-Avoidance Beliefs Questionnaire physical activity scale and work scale [FABQ-PA and FABQ-W, respectively], Pain Catastrophizing Scale [PCS], 11-item version of the Tampa Scale of Kinesiophobia [TSK-11], and 9-item Patient Health Questionnaire [PHQ-9]) at initial evaluation and 4 weeks later. Treatment was at the physical therapist's discretion. Clinical outcomes consisted of pain intensity and self-reported disability. Prediction of 6-month clinical outcomes was assessed for intake SBT and psychological measure scores using multiple regression models while controlling for other prognostic variables. In addition, the predictive capabilities of intake to 4-week changes in SBT and psychological measure scores for 6-month clinical outcomes were assessed.ResultsIntake pain intensity scores (β=.39 to .45) and disability scores (β=.47 to .60) were the strongest predictors in all final regression models, explaining 22% and 24% and 43% and 48% of the variance for the respective clinical outcome at 6 months. Neither SBT nor psychological measure scores improved prediction of 6-month pain intensity. The SBT overall scores (β=.22) and SBT psychosocial scores (β=.25) added to the prediction of disability at 6 months. Four-week changes in TSK-11 scores (β=−.18) were predictive of pain intensity at 6 months. Four-week changes in FABQ-PA scores (β=−.21), TSK-11 scores (β=−.20) and SBT overall scores (β=−.18) were predictive of disability at 6 months.LimitationsPhysical therapy treatment was not standardized or accounted for in the analysis.ConclusionsPrediction of clinical outcomes by psychology-based measures was dependent upon the clinical outcome domain of interest. Similar to studies from the primary care setting, initial screening with the SBT provided additional prognostic information for 6-month disability and changes in SBT overall scores may provide important clinical decision-making information for treatment monitoring.

scholarly journals Comparison of STarT Back Screening Tool and Simmonds Physical Performance Based Test Battery in Prediction of Disability Risks Among Patients with Chronic Low-Back Pain

2019 ◽  
Vol 22 (4) ◽  
pp. 4-17
Author(s):  
Chidozie Emmanuel Mbada (PhD PT) ◽  
Aanuoluwapo Deborah Afolabi (MSc PT) ◽  
Olubusola Esther Johnson (PhD PT) ◽  
Adesola Christianah Odole (PhD PT) ◽  
Taofik Oluwasegun Afolabi (MSc PT) ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Physical Performance ◽  
Screening Tool ◽  
Low Back ◽  
Performance Tests ◽  
Start Back Screening Tool ◽  
Ceiling Effects ◽  
The Mean

Objectives This study identified disability sub-groups of patients with chronic low back pain (LBP) using the Subgroup for Targeted Treatment (or STarT) Back Screening Tool (SBST) and Simmonds Physical Performance Tests Battery (SPPTB). In addition, the study investigated the divergent validity of SBST, and compared the predictive validity of SBST and SPPTB among the patients with the aim to enhance quick and accurate prediction of disability risks among patients with chronic LBP. Methods This exploratory cross-sectional study involved 70 (52.0% female and 47.1% male) consenting patients with chronic non-specific LBP attending out-patient physiotherapy and Orthopedic Clinics at the Obafemi Awolowo University Teaching Hospitals, Ile-Ife and Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. Disability risk subgrouping and prediction were carried out using the SBST and SPPTB (comprising six functional tasks of repeated trunk flexion, sit-to-stand, 360-degree rollover, Sorenson fatigue test, unloaded reach test, and 50 foot walk test). Pain intensity was assessed using the Quadruple Visual Analogue Scale. Data on age, sex, height, weight and BMI were also collected. Descriptive and inferential statistics were used to analyze data at p<0.05 Alpha level. Results The mean age, weight, height and body mass index of the participants were 51.4 ±8.78 years, 1.61 ±0.76 m and 26.6 ±3.18 kg/m2 respectively. The mean pain intensity and duration were 5.37 ±1.37 and 21.2 ±6.68 respectively. The divergent validity of SBST with percentage overall pain intensity was r = 0.732; p = 0.001. Under SBST sub-grouping the majority of participants were rated as having medium disability risk (76%), whilst SPPTB sub-grouped the majority as having high disability risk (71.4%). There was a significant difference in disability risk subgrouping between SBST and SPPTB (χ²=12.334; p=0.015). SBST had no floor and ceiling effects, as less than 15% of the participants reached the lowest (2.9%) or highest (1.4%) possible score. Conversely, SPPBT showed both floor and ceiling effects, as it was unable to detect ‘1’ and ‘9’, the lowest and highest obtainable scores. The ‘Area Under Curve’ for sensitivity (0.83) and specificity (0.23) of the SBST to predict ‘high-disability risk’ was 0.51. The estimated prevalence for ‘high-disability risk’ prediction of SBST was 0.76. The estimate for true positive, false positive, true negative and false negative for prediction of ‘high-disability risk’ for SBST were 0.77, 0.23, 0.31, and 0.69 respectively. Conclusion The Start Back Screening Tool is able to identify the proportion of patients with low back pain with moderate disability risks, while the Simmonds Physical Performance Tests Battery is better able to identify high disability risks. Thus, SBST as a self-report measure may not adequately substitute physical performance assessment based disability risks prediction. However, SBST has good divergent predictive validity with pain intensity. In contrast to SPBBT, SBST exhibited no floor or ceiling effects in our tests, and demonstrated high sensitivity but low specificity in predicting ‘high-disability risk’.

scholarly journals The use of STarT back screening tool to predict functional disability outcomes in patients receiving physical therapy for low back pain

2019 ◽  
Vol 19 (4) ◽  
pp. 645-654 ◽  
Author(s):  
Irene L. Katzan ◽  
Nicolas R. Thompson ◽  
Steven Z. George ◽  
Sandi Passek ◽  
Frederick Frost ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Functional Disability ◽  
Screening Tool ◽  
Low Back ◽  
Start Back Screening Tool

Longitudinal Monitoring of Patients With Chronic Low Back Pain During Physical Therapy Treatment Using the STarT Back Screening Tool

2017 ◽  
Vol 47 (5) ◽  
pp. 314-323 ◽  
Author(s):  
Flávia Cordeiro Medeiros ◽  
Leonardo Oliveira Pena Costa ◽  
Marco Aurélio Nemitalla Added ◽  
Evelyn Cassia Salomão ◽  
Lucíola da Cunha Menezes Costa
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Chronic Low Back Pain ◽  
Screening Tool ◽  
Low Back ◽  
Start Back Screening Tool ◽  
Physical Therapy Treatment ◽  
Therapy Treatment

scholarly journals Use of the STarT Back Screening Tool in patients with chronic low back pain receiving physical therapy interventions

2020 ◽  
Author(s):  
Flávia Cordeiro Medeiros ◽  
Evelyn Cassia Salomão ◽  
Leonardo Oliveira Pena Costa ◽  
Diego Galace de Freitas ◽  
Thiago Yukio Fukuda ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Chronic Low Back Pain ◽  
Screening Tool ◽  
Low Back ◽  
Start Back Screening Tool ◽  
Therapy Interventions

Cross-cultural validation of the Start Back Screening Tool in a Greek low back pain sample

2021 ◽  
pp. 102352
Author(s):  
Evdokia Billis ◽  
Fousekis Konstantinos ◽  
Tsekoura Maria ◽  
Lampropoulou Sofia ◽  
Matzaroglou Charalampos ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Screening Tool ◽  
Cross Cultural ◽  
Low Back ◽  
Start Back Screening Tool ◽  
Cultural Validation

scholarly journals Low Back Pain in Adolescents: A Comparison of Clinical Outcomes in Sports Participants and Nonparticipants

2010 ◽  
Vol 45 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Julie M. Fritz ◽  
Shannon N. Clifford
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Treatment Outcomes ◽  
Clinical Outcomes ◽  
Sports Participation ◽  
Mean Difference ◽  
Analysis Of Covariance ◽  
Low Back ◽  
Baseline Characteristics

Abstract Context: Back pain is common in adolescents. Participation in sports has been identified as a risk factor for the development of back pain in adolescents, but the influence of sports participation on treatment outcomes in adolescents has not been adequately examined. Objective: To examine the clinical outcomes of rehabilitation for adolescents with low back pain (LBP) and to evaluate the influence of sports participation on outcomes. Design: Observational study. Setting: Outpatient physical therapy clinics. Patients or Other Participants: Fifty-eight adolescents (age  =  15.40 ± 1.44 years; 56.90% female) with LBP referred for treatment. Twenty-three patients (39.66%) had developed back pain from sports participation. Intervention(s): Patients completed the Modified Oswestry Disability Questionnaire and numeric pain rating before and after treatment. Treatment duration and content were at the clinician's discretion. Adolescents were categorized as sports participants if the onset of back pain was linked to organized sports. Additional data collected included diagnostic imaging before referral, clinical characteristics, and medical diagnosis. Main Outcome Measure(s): Baseline characteristics were compared based on sports participation. The influence of sports participation on outcomes was examined using a repeated-measures analysis of covariance with the Oswestry and pain scores as dependent variables. The number of sessions and duration of care were compared using t tests. Results: Many adolescents with LBP receiving outpatient physical therapy treatment were involved in sports and cited sports participation as a causative factor for their LBP. Some differences in baseline characteristics and clinical treatment outcomes were noted between sports participants and nonparticipants. Sports participants were more likely to undergo magnetic resonance imaging before referral (P  =  .013), attended more sessions (mean difference  =  1.40, 95% confidence interval [CI]  =  0.21, 2.59, P  =  .022) over a longer duration (mean difference  =  12.44 days, 95% CI  =  1.28, 23.10, P  =  .024), and experienced less improvement in disability (mean Oswestry difference  =  6.66, 95% CI  =  0.53, 12.78, P  =  .048) than nonparticipants. Overall, the pattern of clinical outcomes in this sample of adolescents with LBP was similar to that of adults with LBP. Conclusions: Adolescents with LBP due to sports participation received more treatment but experienced less improvement in disability than nonparticipants. This may indicate a worse prognosis for sports participants. Further research is required.

Sign in / Sign up

Export Citation Format

Share Document