Relationship between STarT Back Screening Tool and prognosis for low back pain patients receiving spinal manipulative therapy 英文参考文献.docVIP

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Relationship between STarT Back Screening Tool and prognosis for low back pain patients receiving spinal manipulative therapy 英文参考文献.doc

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Relationship between STarT Back Screening Tool and prognosis for low back pain patients receiving spinal manipulative therapy 英文参考文献

FieldandNewellChiropracticManualTherapies2012,20:17 /content/20/1/17 CHIROPRACTIC MANUAL THERAPIES RESEARCH OpenAccess RelationshipbetweenSTarTBackScreeningTool andprognosisforlowbackpainpatients receivingspinalmanipulativetherapy JonathanField1*andDaveNewell2 Abstract Background:Lowbackpain(LBP)iscommonandcostlyandfewtreatmentshavebeenshowntobemarkedly superiortoanyother.Efforthasbeenfocusedonstratifyingpatientstobettertargettreatment.RecentlytheSTarT BackScreeningTool(SBT)hasbeendevelopedforuseinprimarycaretoenablesubgroupingofpatientsbasedon modifiablebaselinecharacteristicsandhasbeenshowntobeassociatedwithdifferentialoutcomes.IntheUKthe SBTisbeingrecommendedtoassistincaredecisionsforthosepresentingtogeneralpractitionerswithLBP.Inthe lightofgrowingrecommendationforwidespreaduseofthistool,generalisabilitytootherLBPpopulationsis important.However,studiestodatehavefocusedonlyonpatientsattendingphysiotherapywhereasLBPpatients seekingothertreatmenthavenotbeeninvestigated. Aims:ThisstudyaimstoinvestigatetheutilityoftheSBTtopredictoutcomesinLBPpatientspresentingfor chiropracticmanagement. Methods:Atotalof404patientsundergoingchiropracticcarewereaskedtocompletetheSBTbeforeinitialtreatment. Clinicaloutcomeswerecollectedat14,30and90daysfollowingthisinitialconsultation.Theclinicalcoursewas describedcomparingSBTcategoriesandlogisticregressionanalysisperformedtoexaminethetool’sprognosticutility. Results:Althoughthehigh-riskcategorieshadgreaterpainatbaselinethisdifferencerapidlyfaded,withbothchangein compositeoutcomescoresandpainscoresbeingstatisticallyinsignificantbetweentheriskgroupsat30and90days followup.Inaddition,bothunivariateandadjustedanalysisshowednoprognosticutilityoftheSBTcategorisationsto differentiateclinicaloutcomesbetweenriskgroups. Conclusion:WhilsttheSBTappearsusefulinsomebackpainpopulationsitdoesnotappeartodifferentiateoutcomes inLBPpatientsseekingchiropracticcare. Keywords:Startbacktool,Lowbackpain,Prognosis,Spinalmanipulativetherapy Introduction foramin