Relationship between categorization with the STarT Back Screening Tool and prognosis for people receiving physical therapy for low back pain
Abstract
Background 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. Objective 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. Design 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 ch…
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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”
From Report of the NIH Task Force on research standards for chronic low back pain. (2014) · cites this paper as [49]
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- Authors
- Fritz, J. M., Beneciuk, J. M., & George, S. Z.
- Affiliations
- Intermountain Healthcare (US)
- University of Florida Health (US)
- University of Florida (US)
- Corresponding author
- Fritz, Julie M.
- Venue
- Physical Therapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-05-01
- Volume
- 91
- Issue
- 5
- Pages
- 722-732
- ISSN
- 0031-9023 (ISSN-L)
- 1538-6724
- OpenAlex
- W2160741250
- Cited by
- 128
- References
- 30
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 7 · 2023: 4 · 2022: 9 · 2021: 7 · 2020: 8 · 2019: 13 · 2018: 12 · 2017: 5 · 2016: 7 · 2015: 11 · 2014: 15 · 2013: 14 · 2012: 8
- FWCI
- 9.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Physical Therapy (publishedVersion)
- PubMed (publishedVersion)
- 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, pain intensity, disability, treatment outcomes, risk stratification, primary care screening
- MeSH terms
- Adult, Analysis of Variance, Disability Evaluation, Female, Humans, Male, Middle Aged, Pain Measurement, Prognosis, Prospective Studies, Surveys and Questionnaires, Risk Factors, Utah, Chi-Square Distribution, Linear Models, Treatment Outcome, Episode of Care, Low Back Pain, Risk Assessment, Physical Therapy Modalities
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