Objective: Low back pain (LBP) is a leading cause of disability worldwide, affecting over 500 million people and imposing significant healthcare costs. The Keele STarT Back Screening Tool (SBT) has shown promise in stratifying LBP patients for targeted treatment in primary care settings, but its application in chiropractic teaching clinics remains unexplored. This study investigates the implementation of the SBT in a United States chiropractic academic setting, addressing a critical gap in current practice.
Methods: New patients in two academic chiropractic clinics in Dallas, TX were screened for study inclusion. Patients between 18-70 years old and with LBP were asked to complete the SBT. Interns and providers were not given any training over the tool. A chart review of the first 4 weeks of care was conducted for all respondents to track treatments and group parameters, as well as follow-up.
Results: Of 163 screened patients, 76 were excluded for not meeting study criteria and 87 were stratified into low-risk(n=57), medium-risk(n=24), and high-risk(n=6) groups. The percentage of participants in each group returning for evaluation was 10%, 20%, and 0%, respectively.
Conclusion: The SBT was easy to administer without training and provided important clinical information. The lack of patients returning for 4-week evaluation highlights the importance of tracking LBP patients, especially those in the high-risk category, where there is increased likelihood for developing ongoing disability and psychosocial barriers to recovery.
Author keywords: STarT Back Screening Tool; Psychosocial Factors; Low Back Pain; Chiropractic; Risk Stratification; Prognostic Indicators; Education
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