Flávia Cordeiro Medeiros1, Evelyn Cassia Salomão2, Leonardo Oliveira Pena Costa2, Diego Galace de Freitas3, Thiago Yukio Fukuda4, Renan Lima Monteiro5, Marco Aurélio Nemitalla Added2, Alessandra Narciso Garcia6, Lucíola da Cunha Menezes Costa2. 1. Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil. Electronic address: flaviamedeiros.fisio@gmail.com. 2. Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil. 3. Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil. 4. Instituto Trata - Hip and Knee Rehab, São Paulo, SP, Brazil. 5. Department of Physical Therapy, Speech and Occupational Therapy, Universidade de São Paulo, São Paulo, SP, Brazil. 6. Doctor of Physical Therapy Division, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
Abstract
BACKGROUND: The STarT Back Screening Tool (SBST) is used to stratify care. It is unclear if the SBST approach works as well for patients in low- and medium-income countries as for patients from high-income countries. OBJECTIVES: (1) To investigate whether patients with chronic low back pain (LBP) stratified by the SBST are different at baseline; (2) to describe the clinical course for each SBST subgroup; (3) to investigate the SBST utility to predict clinical outcomes; and (4) to determine which SBST subgroup show greater clinical improvement. DESIGN: This is a secondary analysis of data derived from a previously published clinical trial. METHODS: 148 patients with chronic nonspecific LBP were included. Pain intensity, disability, global perceived effect, and the SBST were assessed at baseline and at 5, 12, and 24 weeks after baseline. Descriptive data were provided and ANOVA, unadjusted and adjusted regression models, and linear mixed models were used for data analysis. RESULTS: Duration of symptoms, use of medication, pain, disability, and global perceived effect were different between SBST subgroups. Clinical improvements over a 6-month period were consistently greater in patients classified as high risk. The SBST was able to predict disability but this predictability decreased when the analysis was adjusted for possible confounders. CONCLUSION: Clinical outcomes were different between SBST subgroups over 6 months. Adjusting for confounders influenced the predictability of SBST. Patients classified as high risk presented higher improvements in terms of disability.
BACKGROUND: The STarT Back Screening Tool (SBST) is used to stratify care. It is unclear if the SBST approach works as well for patients in low- and medium-income countries as for patients from high-income countries. OBJECTIVES: (1) To investigate whether patients with chronic low back pain (LBP) stratified by the SBST are different at baseline; (2) to describe the clinical course for each SBST subgroup; (3) to investigate the SBST utility to predict clinical outcomes; and (4) to determine which SBST subgroup show greater clinical improvement. DESIGN: This is a secondary analysis of data derived from a previously published clinical trial. METHODS: 148 patients with chronic nonspecific LBP were included. Pain intensity, disability, global perceived effect, and the SBST were assessed at baseline and at 5, 12, and 24 weeks after baseline. Descriptive data were provided and ANOVA, unadjusted and adjusted regression models, and linear mixed models were used for data analysis. RESULTS: Duration of symptoms, use of medication, pain, disability, and global perceived effect were different between SBST subgroups. Clinical improvements over a 6-month period were consistently greater in patients classified as high risk. The SBST was able to predict disability but this predictability decreased when the analysis was adjusted for possible confounders. CONCLUSION: Clinical outcomes were different between SBST subgroups over 6 months. Adjusting for confounders influenced the predictability of SBST. Patients classified as high risk presented higher improvements in terms of disability.
Authors: Richard A Deyo; Samuel F Dworkin; Dagmar Amtmann; Gunnar Andersson; David Borenstein; Eugene Carragee; John Carrino; Roger Chou; Karon Cook; Anthony DeLitto; Christine Goertz; Partap Khalsa; John Loeser; Sean Mackey; James Panagis; James Rainville; Tor Tosteson; Dennis Turk; Michael Von Korff; Debra K Weiner Journal: J Pain Date: 2014-04-29 Impact factor: 5.820
Authors: Jan Hartvigsen; Mark J Hancock; Alice Kongsted; Quinette Louw; Manuela L Ferreira; Stéphane Genevay; Damian Hoy; Jaro Karppinen; Glenn Pransky; Joachim Sieper; Rob J Smeets; Martin Underwood Journal: Lancet Date: 2018-03-21 Impact factor: 79.321
Authors: Nicole van der Roer; Raymond W J G Ostelo; Geertruida E Bekkering; Maurits W van Tulder; Henrica C W de Vet Journal: Spine (Phila Pa 1976) Date: 2006-03-01 Impact factor: 3.468
Authors: Nadine E Foster; Johannes R Anema; Dan Cherkin; Roger Chou; Steven P Cohen; Douglas P Gross; Paulo H Ferreira; Julie M Fritz; Bart W Koes; Wilco Peul; Judith A Turner; Chris G Maher Journal: Lancet Date: 2018-03-21 Impact factor: 79.321
Authors: Bruna Pilz; Rodrigo A Vasconcelos; Paulo P Teixeira; Wilson Mello; Freddy B Marcondes; Jonathan C Hill; Débora B Grossi Journal: Braz J Phys Ther Date: 2017-01-14 Impact factor: 3.377