Relationship between STarT Back Screening Tool and prognosis for low back pain patients receiving spinal manipulative therapy
Relationship between STarT Back Screening Tool and prognosis for low back pain patients receiving spinal manipulative therapy
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DOI：
10.1186/2045-709x-20-17
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发表时间：
2012-06-12
影响因子：
1.9
通讯作者：
Newell, Dave
中科院分区：
文献类型：
--
作者：
Field, Jonathan;Newell, Dave
背景：腰痛 (LBP) 很常见，而且费用昂贵，很少有治疗方法被证明明显优于其他治疗方法。我们的工作重点是对患者进行分层，以便更好地进行有针对性的治疗。最近，STarT 反向筛查工具 (SBT) 已被开发用于初级保健，以便能够根据可修改的基线特征对患者进行分组，并且已被证明与不同的结果相关。在英国，建议 SBT 协助那些向全科医生就诊的 LBP 患者做出护理决定。鉴于越来越多的人建议广泛使用该工具，对其他 LBP 人群的普遍适用性非常重要。然而，迄今为止的研究仅关注接受物理治疗的患者，而尚未对寻求其他治疗的 LBP 患者进行调查。目的：本研究旨在调查 SBT 在预测接受脊椎按摩治疗的 LBP 患者结果方面的效用。方法：总共 404 名接受脊椎按摩治疗的患者被要求在初始治疗前完成 SBT。在初次咨询后 14、30 和 90 天收集临床结果。通过比较 SBT 类别和逻辑回归分析来描述临床过程，以检查该工具的预后效用。 结果：尽管高风险类别在基线时疼痛更大，但这种差异很快消失，在 30 天和 90 天的随访中，风险组之间的综合结果评分和疼痛评分的变化在统计上均不显着。此外，单变量和调整分析均显示 SBT 分类对于区分不同风险组之间的临床结果没有预后效用。结论：虽然 SBT 在某些背痛人群中似乎有用，但它似乎无法区分寻求脊椎按摩治疗的 LBP 患者的结果。
Background: Low back pain (LBP) is common and costly and few treatments have been shown to be markedly superior to any other. Effort has been focused on stratifying patients to better target treatment. Recently the STarT Back Screening Tool (SBT) has been developed for use in primary care to enable sub grouping of patients based on modifiable baseline characteristics and has been shown to be associated with differential outcomes. In the UK the SBT is being recommended to assist in care decisions for those presenting to general practitioners with LBP. In the light of growing recommendation for widespread use of this tool, generalisability to other LBP populations is important. However, studies to date have focused only on patients attending physiotherapy whereas LBP patients seeking other treatment have not been investigated.Aims: This study aims to investigate the utility of the SBT to predict outcomes in LBP patients presenting for chiropractic management.Methods: A total of 404 patients undergoing chiropractic care were asked to complete the SBT before initial treatment. Clinical outcomes were collected at 14, 30 and 90 days following this initial consultation. The clinical course was described comparing SBT categories and logistic regression analysis performed to examine the tool's prognostic utility.Results: Although the high-risk categories had greater pain at baseline this difference rapidly faded, with both change in composite outcome scores and pain scores being statistically insignificant between the risk groups at 30 and 90 days follow up. In addition, both univariate and adjusted analysis showed no prognostic utility of the SBT categorisations to differentiate clinical outcomes between risk groups.Conclusion: Whilst the SBT appears useful in some back pain populations it does not appear to differentiate outcomes in LBP patients seeking chiropractic care.