Predictive ability of the STarT Back Tool
A new study has looked at the predictive ability of the STarT Back Tool in people with chronic low back pain (CLBP).
The cohort study enrolled 290 people who already had CLBP. They were all assessed with the STarT Back Tool at enrolment into the study and followed for one year, at which time disability, pain and global perceived change were assessed to see if the STarT Back Tool was predictive of any of those outcomes.
A few caveats need to be mentioned at the outset. The STarT Back Tool was developed for use in people attending primary care (e.g., their GP or physiotherapist) for treatment. The people in this study, instead, most were not actively seeking treatment at the time of enrolment (although lots had sought treatment or went on to seek treatment during the year of followup). Also, the participants already had CLBP so the duration of time they'd had the pain was quite variable.
The STarT Back Tool categorised the participants into low-, medium- and high-risk subgroups at baseline. Those with higher STarT Back Tool risk categorisation had significantly greater pain intensity, greater disability, higher scores on negative psychological constructs, and lower scores on positive psychological constructs at baseline. This is probably not surprising, given that these constructs are what the tool measures.
The study also looked at the STarT Back Tool's ability to predict pain, disability and perceived change at 1 year. While the Tool provided an acceptable indication of future disability in this population, it performed poorly with respect to pain and global perceived change at the 1-year follow-up.
This study adds to the literature on STarT Back Tool’s generalisability across populations.
While the STarT Back Tool provided an acceptable indication of future disability in this population, it performed poorly with respect to pain and global perceived change at the 1-year follow-up. Reliance on the SBT as the sole indicator of prognosis in CLBP is not recommended.
Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!
> From: Kendell et al., J Physiother 64 (2018) 107-113. All rights reserved to the Australian Physiotherapy Association. Click here for the online summary.