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    The predictive ability of the STarT Back Tool was limited in people with chronic low back pain: a prospective cohort study

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    Authors
    Kendell, M.
    Beales, Darren
    O'Sullivan, Peter
    Rabey, M.
    Hill, J.
    Smith, Anne
    Date
    2018
    Type
    Journal Article
    
    Metadata
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    Citation
    Kendell, M. and Beales, D. and O'Sullivan, P. and Rabey, M. and Hill, J. and 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 (2): pp. 107-113.
    Source Title
    Journal of Physiotherapy
    DOI
    10.1016/j.jphys.2018.02.009
    ISSN
    1836-9553
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/67094
    Collection
    • Curtin Research Publications
    Abstract

    © 2018 Australian Physiotherapy Association Questions: 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? Design: Prospective cohort study. Participants: A total of 290 adults with dominant axial LBP of ≥ 3 months’ duration recruited from the general community, and private physiotherapy, psychology, and pain-management clinics in Western Australia. Outcome measures: The 1-year follow-up measures were pain intensity, LBP-related disability, and global self-perceived change. Results: 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. Conclusion: 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 1 year. [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]

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