Article

The STarT Back Screening Tool (SBT) was recently developed for
primary care providers to use as a screening tool for subgrouping people with low
back pain (LBP) on the basis of modifiable prognostic factors. The use of the SBT
in physical therapy has not been described. The aims of this study
were to describe the use of the SBT in people receiving physical therapy for LBP
and to describe patterns of change in clinical outcomes across the episode of
care and among SBT categories. This study was a prospective case series.
METHODS: A total of 214 patients receiving physical therapy for LBP were
administered the SBT at the initial evaluation. Treatment was at the physical
therapist's discretion. Clinical outcomes included pain intensity and disability
scores collected at each session. Descriptive statistics were calculated, and
baseline characteristics among SBT categories were compared. Hierarchical linear
mixed models were used to examine patterns of change in predicted outcomes across
the episode of care. RESULTS: The patients' mean age was 44.3 years (SD=15.8),
and 56.5% were women. The SBT categorized 33.2% of the patients as being at low
risk, 47.7% as being at medium risk, and 19.2% as being at high risk. The
high-risk category corresponded to the highest initial pain intensity and
disability scores. The low-risk category corresponded to the lowest initial pain
intensity and disability scores. Linear mixed models indicated different patterns
of change in outcome scores for pain intensity (F=3.99) and disability (F=3.49)
among SBT categories. Relative to the low-risk category, the high-risk category
had larger improvements in predicted outcomes and the medium-risk category had
similar improvements in predicted outcomes. Limitations The SBT was not
administered to 24% of eligible patients. The timing of follow-up assessments was
variable. CONCLUSIONS:
The SBT may provide important prognostic information for
physical therapists.

Langue : ANGLAIS