Department of Physical Therapy, University of Utah, and Clinical Outcomes Research Scientist, Intermountain Healthcare, 520 Wakara Way, Salt Lake City, UT 84108, USA.
Phys Ther. 2011 May;91(5):722-32. doi: 10.2522/ptj.20100109. Epub 2011 Mar 30.
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.
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.
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.
The SBT may provide important prognostic information for physical therapists.
STarT 后背筛查工具（SBT）最近被开发出来，供初级保健提供者在基于可改变的预后因素的基础上，将低背痛（LBP）患者进行分组时使用。SBT 在物理治疗中的应用尚未被描述。
本研究的目的是描述 SBT 在接受 LBP 物理治疗的患者中的使用情况，并描述整个治疗过程中以及 SBT 类别之间临床结果的变化模式。
这是一项前瞻性病例系列研究。
共有 214 名接受 LBP 物理治疗的患者在初始评估时接受了 SBT 测试。治疗由物理治疗师决定。临床结果包括每次就诊时的疼痛强度和残疾评分。计算了描述性统计数据，并比较了 SBT 类别之间的基线特征。使用分层线性混合模型来检查整个治疗过程中预测结果的变化模式。
患者的平均年龄为 44.3 岁（标准差=15.8），56.5%为女性。SBT 将 33.2%的患者归类为低风险，47.7%为中风险，19.2%为高风险。高风险类别对应于最高的初始疼痛强度和残疾评分。低风险类别对应于最低的初始疼痛强度和残疾评分。线性混合模型表明，在 SBT 类别中，疼痛强度（F=3.99）和残疾（F=3.49）的结果评分变化模式不同。与低风险类别相比，高风险类别在预测结果方面有更大的改善，而中风险类别在预测结果方面有相似的改善。局限性：有 24%符合条件的患者未接受 SBT 测试。随访评估的时间不固定。
SBT 可能为物理治疗师提供重要的预后信息。
