Background

The STarT Back Screening Tool (SBST) is used to stratify care. It is unclear if the SBST approach works as well for patients in low- and medium-income countries as for patients from high-income countries.

Objectives

(1) To investigate whether patients with chronic low back pain (LBP) stratified by the SBST are different at baseline; (2) to describe the clinical course for each SBST subgroup; (3) to investigate the SBST utility to predict clinical outcomes; and (4) to determine which SBST subgroup show greater clinical improvement.

Design

This is a secondary analysis of data derived from a previously published clinical trial.

Methods

148 patients with chronic nonspecific LBP were included. Pain intensity, disability, global perceived effect, and the SBST were assessed at baseline and at 5, 12, and 24 weeks after baseline. Descriptive data were provided and ANOVA, unadjusted and adjusted regression models, and linear mixed models were used for data analysis.

Results

Duration of symptoms, use of medication, pain, disability, and global perceived effect were different between SBST subgroups. Clinical improvements over a 6-month period were consistently greater in patients classified as high risk. The SBST was able to predict disability but this predictability decreased when the analysis was adjusted for possible confounders.

Conclusion

Clinical outcomes were different between SBST subgroups over 6 months. Adjusting for confounders influenced the predictability of SBST. Patients classified as high risk presented higher improvements in terms of disability.

中文翻译：

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在接受物理治疗干预的慢性腰痛患者中使用 START 背部筛查工具

背景

START 回溯筛查工具 (SBST) 用于对护理进行分层。目前尚不清楚 SBST 方法对中低收入国家的患者和高收入国家的患者是否同样有效。

目标

(1)调查SBST分层的慢性腰痛(LBP)患者在基线时是否不同；(2) 描述每个 SBST 亚组的临床过程；(3) 研究 SBST 效用来预测临床结果；(4) 确定哪个 SBST 亚组显示出更大的临床改善。

设计

这是对先前发表的临床试验数据的二次分析。

方法

包括 148 名慢性非特异性 LBP 患者。在基线和基线后 5、12 和 24 周评估疼痛强度、残疾、整体感知效果和 SBST。提供了描述性数据，并使用方差分析、未调整和调整的回归模型以及线性混合模型进行数据分析。

结果

SBST 亚组之间的症状持续时间、药物使用、疼痛、残疾和整体感知效果不同。在被归类为高风险的患者中，6 个月内的临床改善始终更大。SBST 能够预测残疾，但是当针对可能的混杂因素调整分析时，这种可预测性会降低。

结论

6 个月内 SBST 亚组之间的临床结果不同。调整混杂因素会影响 SBST 的可预测性。被归类为高风险的患者在残疾方面表现出更高的改善。