ArticlePhysical therapy2013
The STarT back screening tool and individual psychological measures: evaluation of prognostic capabilities for low back pain clinical outcomes in outpatient physical therapy settings.
Article in Physical therapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
87 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Can screening instruments accurately determine poor outcome risk in adults with recent onset low back pain? A systematic review and meta-analysis.BMC medicine · 2017Pooled it
- Immediate effects of two modes of shortwave diathermy in chronic low back pain: randomized controlled clinical trial.Pain management · 2025Trial
- Risk-stratified Care Improves Pain-related Knowledge and Reduces Psychological Distress for Low Back Pain: A Secondary Analysis of a Randomized Trial.Clinical orthopaedics and related research · 2025Trial
- Physiotherapists as first-contact practitioners for patients with low back pain in French primary care: a pragmatic cluster randomised controlled trial.BMC health services research · 2024Trial
- Changes in Pain Catastrophizing and Fear-Avoidance Beliefs as Mediators of Early Physical Therapy on Disability and Pain in Acute Low-Back Pain: A Secondary Analysis of a Clinical Trial.Pain medicine (Malden, Mass.) · 2022Trial
- Development and evaluation of the MAINTAIN instrument, selecting patients suitable for secondary or tertiary preventive manual care: the Nordic maintenance care program.Chiropractic & manual therapies · 2022Trial
- Effectiveness of stratified treatment for back pain in Danish primary care: A randomized controlled trial.European journal of pain (London, England) · 2021Trial
- Research design considerations for chronic pain prevention clinical trials: IMMPACT recommendations.Pain reports · 2021Trial
- Optimizing management of low back pain through the pain and disability drivers management model: A feasibility trial.PloS one · 2021Trial
- Prognostic ability of the German version of the STarT Back tool: analysis of 12-month follow-up data from a randomized controlled trial.BMC musculoskeletal disorders · 2019Trial
- Trial
- Chronic low back pain clinical outcomes present higher associations with the STarT Back Screening Tool than with physiologic measures: a 12-month cohort study.BMC musculoskeletal disorders · 2015Trial
- Pragmatic Implementation of a Stratified Primary Care Model for Low Back Pain Management in Outpatient Physical Therapy Settings: Two-Phase, Sequential Preliminary Study.Physical therapy · 2015Trial
- The Impact of Telehealth Use Experience on Recruitment of Underserved Populations Into a Telehealth-Delivered Mindfulness-Based Trial for Patients With Chronic Low Back Pain: Cross-Sectional Survey.JMIR mHealth and uHealth · 2026Article
- Distribution of prognostic subgroups, assessed by STarT Back Screening Tool, in Veterans with low back pain receiving on-site chiropractic care: a cross-sectional chart review.The Journal of the Canadian Chiropractic Association · 2026Article
- Saudi Clinical Practice Guideline for the Assessment and Management of Low Back Pain and Sciatica in Adults.Journal of clinical medicine · 2026Article
- Efficiency of telephone triage in the assessment of low back pain at a tertiary spine clinic.BMC musculoskeletal disorders · 2025Observational
- Observational
- Article
- Application of Algorithm-Based Treatment Approach to Low Back Pain in the Emergency Department.Physical therapy · 2025Article
27 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors.
Funding
Abstract
backgroundPsychologically informed practice emphasizes routine identification of modifiable psychological risk factors being highlighted.
objectiveThe purpose of this study was to test the predictive validity of the STarT Back Screening Tool (SBT) in comparison with single-construct psychological measures for 6-month clinical outcomes.
designThis was an observational, prospective cohort study.
methodsPatients (n=146) receiving physical therapy for low back pain were administered the SBT and a battery of psychological measures (Fear-Avoidance Beliefs Questionnaire physical activity scale and work scale [FABQ-PA and FABQ-W, respectively], Pain Catastrophizing Scale [PCS], 11-item version of the Tampa Scale of Kinesiophobia [TSK-11], and 9-item Patient Health Questionnaire [PHQ-9]) at initial evaluation and 4 weeks later. Treatment was at the physical therapist's discretion. Clinical outcomes consisted of pain intensity and self-reported disability. Prediction of 6-month clinical outcomes was assessed for intake SBT and psychological measure scores using multiple regression models while controlling for other prognostic variables. In addition, the predictive capabilities of intake to 4-week changes in SBT and psychological measure scores for 6-month clinical outcomes were assessed.
resultsIntake pain intensity scores (β=.39 to .45) and disability scores (β=.47 to .60) were the strongest predictors in all final regression models, explaining 22% and 24% and 43% and 48% of the variance for the respective clinical outcome at 6 months. Neither SBT nor psychological measure scores improved prediction of 6-month pain intensity. The SBT overall scores (β=.22) and SBT psychosocial scores (β=.25) added to the prediction of disability at 6 months. Four-week changes in TSK-11 scores (β=-.18) were predictive of pain intensity at 6 months. Four-week changes in FABQ-PA scores (β=-.21), TSK-11 scores (β=-.20) and SBT overall scores (β=-.18) were predictive of disability at 6 months. LIMITATIONS: Physical therapy treatment was not standardized or accounted for in the analysis.
conclusionsPrediction of clinical outcomes by psychology-based measures was dependent upon the clinical outcome domain of interest. Similar to studies from the primary care setting, initial screening with the SBT provided additional prognostic information for 6-month disability and changes in SBT overall scores may provide important clinical decision-making information for treatment monitoring.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.