School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
Institute of Primary Care and Health Sciences, Keele University, Staffordshire, United Kingdom.
J Physiother. 2018 Apr;64(2):107-113. doi: 10.1016/j.jphys.2018.02.009. Epub 2018 Mar 27.
In people with chronic non-specific low back pain (LBP), what is the predictive and discriminative validity of the STarT Back Tool (SBT) for pain intensity, self-reported LBP-related disability, and global self-perceived change at 1-year follow-up? What is the profile of the SBT risk subgroups with respect to demographic variables, pain intensity, self-reported LBP-related disability, and psychological measures?
Prospective cohort study.
A total of 290 adults with dominant axial LBP of≥3months' duration recruited from the general community, and private physiotherapy, psychology, and pain-management clinics in Western Australia.
The 1-year follow-up measures were pain intensity, LBP-related disability, and global self-perceived change.
Outcomes were collected on 264 participants. The SBT categorised 82 participants (28%) as low risk, 116 (40%) as medium risk, and 92 (32%) as high risk. The risk subgroups differed significantly (p<0.05) on baseline pain, disability, and psychological scores. The SBT's predictive ability was strongest for disability: RR was 2.30 (95% CI 1.28 to 4.10) in the medium-risk group and 2.86 (95% CI 1.60 to 5.11) in the high-risk group. The SBT's predictive ability was weaker for pain: RR was 1.25 (95% CI 1.04 to 1.51) in the medium-risk group and 1.26 (95% CI 1.03 to 1.52) in the high-risk group. For the SBT total score, the AUC was 0.71 (95% CI 0.64 to 0.77) for disability and 0.63 (95% CI 0.55 to 0.71) for pain.
This was the first large study to investigate the SBT in a population exclusively with chronic LBP. The SBT provided an acceptable indication of 1-year disability, had poor predictive and discriminative ability for future pain, and was unable to predict or discriminate global perceived change. In this cohort with chronic non-specific LBP, the SBT's predictive and discriminative abilities were restricted to disability at 1year. [Kendell M, Beales D, O'Sullivan P, Rabey M, Hill J, Smith A (2018) The predictive ability of the STarT Back Tool was limited in people with chronic low back pain: a prospective cohort study. Journal of Physiotherapy 64: 107-113].
在患有慢性非特异性下腰痛（LBP）的人群中，STarT Back Tool（SBT）在预测和区分 1 年随访时疼痛强度、自我报告的与腰痛相关的残疾以及总体自我感知变化方面的预测和区分效度如何？SBT 的风险亚组在人口统计学变量、疼痛强度、与腰痛相关的残疾以及心理测量方面的特征是什么？
前瞻性队列研究。
共有 290 名来自西澳大利亚州普通社区、私人物理治疗、心理和疼痛管理诊所的，以轴向为主的腰痛≥3 个月的成年人参与。
1 年随访的结局测量包括疼痛强度、腰痛相关残疾和总体自我感知变化。
共纳入 264 名参与者。SBT 将 82 名参与者（28%）归类为低风险，116 名（40%）为中风险，92 名（32%）为高风险。风险亚组在基线疼痛、残疾和心理评分上存在显著差异（p<0.05）。SBT 对残疾的预测能力最强：RR 在中风险组为 2.30（95%CI 1.28 至 4.10），在高风险组为 2.86（95%CI 1.60 至 5.11）。SBT 对疼痛的预测能力较弱：RR 在中风险组为 1.25（95%CI 1.04 至 1.51），在高风险组为 1.26（95%CI 1.03 至 1.52）。对于 SBT 总分，残疾的 AUC 为 0.71（95%CI 0.64 至 0.77），疼痛的 AUC 为 0.63（95%CI 0.55 至 0.71）。
这是第一项专门针对慢性腰痛人群的 SBT 大型研究。SBT 对 1 年残疾有较好的提示作用，对未来疼痛的预测和区分能力较差，无法预测或区分整体感知变化。在该慢性非特异性下腰痛队列中，SBT 的预测和区分能力仅限于 1 年时的残疾。
