A Responsiveness Analysis of the Subgroups for Targeted Treatment (STarT) Back Screening Tool in Patients With Nonspecific Low Back Pain

Autor(es)

Medeiros, Flavia Cordeiro ^[1] ; Pena Costa, Leonardo Oliveira ^[1] ; Oliveira, Indiara Soares ^[1] ; Menezes Costa, Luciola da Cunha ^[1]

Afiliação do(s) autor(es)

^[1] Univ Cidade Sao Paulo, Masters & Doctoral Programs Phys Therapy, Tatuape - Brazil

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF ORTHOPAEDIC & SPORTS PHYSICAL THERAPY; v. 49, n. 10, p. 725+, OCT 2019.
• Citações Web of Science: 0

Resumo

BACKGROUND: The Subgroups for Targeted Treatment (STarT) Back Screening Tool (SBST) screens patients with low back pain and directs them to different levels of physical therapy treatment. The SBST is also used to monitor changes in a range of modifiable prognostic factors. However, the current evidence on the responsiveness of the SBST is limited. OBJECTIVES: To test the responsiveness of the SBST at 6 weeks and 6 months. METHODS: This measurement property study is a secondary analysis of data from 2 previous studies that included 348 participants with nonspecific low back pain. All participants were assessed at baseline, 6 weeks, and 6 months. To detect clinical changes, the SBST was compared to 3 one-dimensional constructs: global perceived effect, disability, and pain intensity. To assess responsiveness. we tested 15 specific predefined hypotheses based on correlation, effect size, and receiver operating characteristic curve analyses. If 75% or more of the hypotheses were accepted, then responsiveness was considered to be high. RESULTS: Most of the hypotheses were accepted. Testing the SBST as a continuous score, 857% and 87.5% of the hypotheses were accepted at 6 weeks and 6 months, respectively. For mediumand high-risk subgroups, 85.7% and 875% of the hypotheses were accepted at 6 weeks and 6 months. The low-risk subgroup had 42.9% of the hypotheses accepted at 6 weeks and 100% of the hypotheses accepted at 6 months. CONCLUSION: The SBST had high responsiveness at 6 weeks in subgroups of patients with a medium and high risk, and poor responsiveness in those with a low risk, of persistent disability. The SBST has high responsiveness in all SBST subgroups at 6 months. Clinicians can confidently use the SBST to measure changes over time in terms of subgroups. (AU)

• Processo FAPESP: 16/18575-8 - O uso do start back screening tool para predizer desfechos clínicos de pacientes com dor lombar inespecífica por meio de avaliações distintas no tempo
• Beneficiário: Flávia Cordeiro de Medeiros
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto
• Processo FAPESP: 13/02075-8 - Eficácia da adição do uso do Kinesio Taping em pacientes com dor lombar crônica inespecífica que recebem tratamento baseado nos princípios da fisioterapia convencional: um estudo controlado aleatorizado
• Beneficiário: Luciola da Cunha Menezes Costa
• Modalidade de apoio: Auxílio à Pesquisa - Regular