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Measuring biopsychosocial risk for back pain disability in chiropractic patients using the STarT back screening tool: a cross-sectional survey.

Chiropractic & manual therapies·2019

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The STarT back tool in chiropractic practice: a narrative review.

¹Palmer College of Chiropractic Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803 USA.

Chiropractic & Manual Therapies

|April 26, 2017

Summary

The STarT Back Tool shows promise in chiropractic settings, correlating with some outcomes. However, its prognostic ability for low back pain is limited in patients with shorter episode durations, suggesting further research is needed.

Keywords:

Care setting Chiropractic Prediction Psychosocial STarT back tool Stratified care

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Area of Science:

Chiropractic Care
Low Back Pain Management
Clinical Risk Stratification

Background:

The Keele STarT Back Tool (STarT Back) aids UK primary care physicians in assessing risk for persistent disabling musculoskeletal pain.
Tailored care plans using the STarT Back Tool have improved low back pain outcomes and reduced costs in medical and physical therapy settings.

Purpose of the Study:

To review existing literature on the application of the STarT Back Tool within chiropractic patient populations.
To evaluate the feasibility and prognostic accuracy of the STarT Back Tool in chiropractic care.

Main Methods:

Searched major databases including PubMed, Cochrane Library, Index to Chiropractic Literature, and Science Direct.
Included English-language, peer-reviewed articles focusing on the STarT Back Tool in patients seeking chiropractic care.

Main Results:

Seven articles met inclusion criteria; the STarT Back Tool was feasible in Danish chiropractic clinics.
Moderate correlation found between STarT Back scores and the Bournemouth Questionnaire.
Prognostic ability varied; the tool was less accurate for short low back pain episodes (<2 weeks) but predicted outcomes for longer episodes (≥2 weeks).

Conclusions:

The STarT Back Tool can be integrated into chiropractic settings and shows some correlation with the Bournemouth Questionnaire.
Its prognostic utility for low back pain is constrained by shorter episode durations common in chiropractic patients.
Further research is required to assess the outcomes of stratified care using the STarT Back Tool in chiropractic populations.