Cited by 61Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationSpine and Intervertebral Disc Pathology

Relationship between STarT Back Screening Tool and prognosis for low back pain patients receiving spinal manipulative therapy

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Field, Jonathan, Newell, Dave·2012·Chiropractic & Manual Therapies

Abstract

BACKGROUND: Low back pain (LBP) is common and costly and few treatments have been shown to be markedly superior to any other. Effort has been focused on stratifying patients to better target treatment. Recently the STarT Back Screening Tool (SBT) has been developed for use in primary care to enable sub grouping of patients based on modifiable baseline characteristics and has been shown to be associated with differential outcomes. In the UK the SBT is being recommended to assist in care decisions for those presenting to general practitioners with LBP. In the light of growing recommendation for widespread use of this tool, generalisability to other LBP populations is important. However, studies to date have focused only on patients attending physiotherapy whereas LBP patients seeking other treatment have not been investigated. AIMS: This study aims to investigate the utility of the SBT to predict outcomes in LBP patients presenting for chiropractic management. METHODS: A total of 404 patients undergoing chiropractic care were asked to complete the SBT before initial treatment. Clinical outcomes were collected at 14, 30 and 90 days following this initial consultation. The clinical course was described comparing SBT categories and logistic regression analysis performed to examine the tool's prognostic utility. RESULTS: Although the high-risk categories had greater pain at baseline this difference rapidly faded, with both change in composite outcome scores and pain scores being statistically insignificant between the risk groups at 30 and 90 days follow up. In addition, both univariate and adjusted analysis showed no prognostic utility of the SBT categorisations to differentiate clinical outcomes between risk groups. CONCLUSION: Whilst the SBT appears useful in some back pain populations it does not appear to differentiate outcomes in LBP patients seeking chiropractic care.

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  • The items used for impact stratification (pain intensity, pain interference, and functional status) have substantial research support for their discriminatory and prognostic importance.

    “These items have substantial research support to validate their discriminatory and prognostic importance. 13, 19, 31, 38, 39, 43, 47–49, 53, 54, 57–60, 66–68, 73, 76, 80, 82, 85, 86, 97, 106, 108, 110, 112–116, 122”

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Authors
Field, J., & Newell, D.
Corresponding author
Field, Jonathan
Venue
Chiropractic & Manual Therapies
Published
2012-06-12
Volume
20
Issue
1
Pages
17-17
ISSN
  • 1746-1340 (ISSN-L)
  • 2045-709X
OpenAlex
W2136956079
Cited by
61
References
38
Citations by year
2026: 1 · 2025: 1 · 2024: 5 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 3 · 2016: 5 · 2015: 12 · 2014: 10 · 2013: 7
FWCI
6.82
Type
journal article
Language
en
Open access
Locations
  • Chiropractic & Manual Therapies (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Keywords
STarT Back Screening Tool, low back pain, spinal manipulation, chiropractic, prognostic utility, patient stratification, risk classification, clinical outcomes, pain scores, generalizability

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