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2017 ; 97
(3
): 330-337
Nephropedia Template TP
gab.com Text
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English Wikipedia
Outcomes of Patients With Acute Low Back Pain Stratified by the STarT Back
Screening Tool: Secondary Analysis of a Randomized Trial
#MMPMID28204740
Magel J
; Fritz JM
; Greene T
; Kjaer P
; Marcus RL
; Brennan GP
Phys Ther
2017[Mar]; 97
(3
): 330-337
PMID28204740
show ga
BACKGROUND: The impact of physical therapy on the outcomes of patients with acute
low back pain (LBP) stratified by the STart Back Screening Tool (SBST) is
unclear. OBJECTIVE: The purpose of this study was to compare the outcomes of
patients with acute LBP who were stratified as medium or high risk. DESIGN: This
was a secondary analysis of a randomized trial. SETTING: Patients were recruited
between March 2011 and November 2013 from primary care clinics in Salt Lake City,
Utah. PARTICIPANTS: One hundred eighty-one participants with acute LBP who were
stratified as medium risk (n = 120) or high risk (n = 61) by the SBST were
included. They were aged 18 through 60 years, with duration of symptoms less than
16 days, no symptoms below the knee, no treatment for LBP in the past 6 months,
and an Oswestry Disability Index (ODI) score of 20% or greater. INTERVENTION:
After participants received education on how to manage their LBP, they were
randomized to receive usual care (n = 97) by their primary care provider or early
intervention (n = 84) by a physical therapist. MEASUREMENTS: The primary (3-month
ODI score) outcome measure was obtained at baseline and at 4 weeks, 3 months, and
1 year. RESULTS: No differences were detected in the effect of intervention
between participants stratified as medium or high risk. For the high-risk
subgroup, there was a significant difference between the early intervention and
usual care groups for the 3-month ODI (mean difference = -5.87 [95% CI = -11.24,
-0.50]) favoring early intervention. LIMITATIONS: The primary study was not
designed to examine the SBST. CONCLUSIONS: Patients with acute LBP stratified as
high risk seem likely to respond well to one session of education. They may
experience additional benefit by 3 months from evidence-based physical therapy
treatments. These effects disappear at 1 year.