Khan Yasmeen, Lawrence Dana, Vining Robert, Derby Dustin
1Parker University, 2500 Walnut Hill Lane, Dallas, TX 75229 USA.
2Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803 USA.
Chiropr Man Therap. 2019 Jan 15;27:2. doi: 10.1186/s12998-018-0228-5. eCollection 2019.
The Keele STarT Back Screening Tool (SBT), a 9-item questionnaire, screens for pain, physical functioning, fear-avoidance beliefs, catastrophizing, anxious thoughts, low mood, and bothersomeness in persons with back pain. SBT scores designate low, medium, or high risk for developing persistent disabling back pain. The primary study aim was to report the prevalence of SBT-calculated risk for back pain disability in US patients seeking chiropractic care.
The SBT questionnaire was administered to patients ≥18 years in 3 Chiropractic College outpatient teaching clinics in Iowa and Illinois (May 2017). Descriptive statistics were used to analyze respondent characteristics and prevalence of SBT-calculated risk subgroups. Binary logistic regression analysis was used to examine the relationship between respondent characteristics and SBT scores (including psychological subscores).
Of 550 respondents, 496 completed the SBT; 392 (79%) scored low-risk, 81 (16%) medium-risk, and 23 (5%) high-risk. Mean (SD) age was 44.8 (15.9), 56.9% were female, 88.2% white, 62.6% employed, mean current pain was 2.9 (2.1) out of 10, and 62% reported symptom duration > 3 months. Eighteen percent of respondents reported anxious thoughts, 32% low mood, 41% ≥ 1 and 21% ≥ 3 SBT psychological risk factors. Respondents reporting higher average pain (OR = 1.8 [1.4, 2.3]) and pain severity (OR = 1.3 [1.0 to 1.6]) were more likely to score with medium or high risk. Respondents reporting mid back versus low back pain (OR = 0.2 [0.1, 0.7]), and those employed less than full-time versus full-time (0.2 [01, 0.5]) were less likely to score with medium or high risk. Respondents reporting higher average pain were more likely to report ≥1 psychological factor (OR = 1.8 [1.5, 2.0]). Respondents employed part-time were less likely to report ≥1 psychological factor than those employed full-time (OR = 0.4 [0.2, 0.7]).
The sample surveyed was less likely to score with medium or high risk for back pain disability than previous samples studied, perhaps due to differences in study design and sample characteristics. Rates of low mood and anxious thoughts indicate a need for future research to explore psychological factors among persons seeking chiropractic care.
基尔启动背部筛查工具（SBT）是一份包含9个条目的问卷，用于筛查背痛患者的疼痛情况、身体功能、恐惧回避信念、灾难化思维、焦虑想法、情绪低落和困扰程度。SBT评分可确定发展为持续性致残性背痛的低、中或高风险。本研究的主要目的是报告在美国寻求脊椎按摩治疗的患者中，经SBT计算得出的背痛残疾风险的患病率。
2017年5月，在爱荷华州和伊利诺伊州的3家脊椎按摩学院门诊教学诊所，对18岁及以上的患者进行了SBT问卷调查。采用描述性统计分析受访者特征和经SBT计算得出的风险亚组的患病率。采用二元逻辑回归分析来检验受访者特征与SBT评分（包括心理子评分）之间的关系。
在550名受访者中，496人完成了SBT问卷；392人（79%）为低风险评分，81人（16%）为中风险评分，23人（5%）为高风险评分。平均（标准差）年龄为44.8（15.9）岁，56.9%为女性，88.2%为白人，62.6%有工作，目前平均疼痛程度为10分中的2.9（2.1）分，62%的人报告症状持续时间>3个月。18%的受访者报告有焦虑想法，32%有情绪低落，41%有≥1个且21%有≥3个SBT心理风险因素。报告平均疼痛程度较高（比值比[OR]=1.8[1.4,2.3]）和疼痛严重程度较高（OR=1.3[1.0至1.6]）的受访者更有可能获得中或高风险评分。报告中背部疼痛而非下背部疼痛的受访者（OR=0.2[0.1,0.7]），以及非全职工作与全职工作的受访者（0.2[0.1,0.5]）获得中或高风险评分的可能性较小。报告平均疼痛程度较高的受访者更有可能报告≥1个心理因素（OR=1.8[1.5,2.0]）。兼职工作的受访者比全职工作的受访者报告≥1个心理因素的可能性更小（OR=o.4[0.2,0.7]）。
与之前研究的样本相比，本调查样本获得背痛残疾中或高风险评分的可能性较小，这可能是由于研究设计和样本特征的差异。情绪低落和焦虑想法的发生率表明，未来需要开展研究，以探索寻求脊椎按摩治疗的人群中的心理因素。
