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Preliminary Evaluation of a Modified STarT Back Screening Tool Across Different Musculoskeletal Pain Conditions

Katie A. Butera, Trevor A. Lentz, Jason M. Beneciuk, Steven Z. George
DOI: 10.2522/ptj.20150377 Published 1 August 2016
Katie A. Butera
K.A. Butera, PT, DPT, Department of Physical Therapy, University of Florida, PO Box 100154, Gainesville, FL 32610-0154 (USA), and Brooks–PHHP Research Collaboration, University of Florida, Gainesville, Florida.
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Trevor A. Lentz
T.A. Lentz, PT, SCS, Department of Physical Therapy, University of Florida, and UF Health Shands Rehab Center, University of Florida Orthopaedics and Sports Medicine Institute, Gainesville, Florida.
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Jason M. Beneciuk
J.M. Beneciuk, PT, PhD, MPH, Department of Physical Therapy, University of Florida, and Brooks–PHHP Research Collaboration, University of Florida.
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Steven Z. George
S.Z. George, PT, PhD, Doctor of Physical Therapy Program, Department of Physical Therapy, University of Florida, and Brooks–PHHP Research Collaboration, University of Florida.
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Figure.

Comparison, by anatomical region, of unadjusted association between Modified STarT Back Screening Tool (mSBT) overall score and (A) Medical Outcomes Study 8-item Short-Form Health Survey Physical Component Score (SF-8 PCS), (B) Medical Outcomes Study 8-item Short-Form Health Survey Mental Component Score (SF-8 MCS), (C) pain intensity rating, and (D) disability score. The pain intensity rating was the average of the current pain intensity rating, the worst pain intensity rating in the preceding 24 hours, and the best pain intensity rating in the preceding 24 hours (all rated on a numerical scale from 0 to 10). The disability score was the z-transformed disability score generated from region-specific disability measures (low back [Oswestry Disability Index], neck [Neck Disability Index], shoulder [Disabilities of the Arm, Shoulder and Hand Questionnaire], or knee [International Knee Documentation Committee Subjective Knee Form]). Lines represent best-fitting linear regression lines for each anatomical region.

Tables

Table 1.
Table 1.

Description of Original STarT Back Screening Tool (SBT) Items and Matched Items on the Developed Modified STarT Back Screening Tool (mSBT)a

  • ↵a TSK=Tampa Scale for Kinesiophobia, STAI-T=trait portion of the State-Trait Anxiety Inventory, PHQ-9=Patient Health Questionnaire.

Table 2.
Table 2.

Descriptive Characteristics of the Sample as a Whole and by Anatomical Regiona

  • ↵a Data are reported as mean (standard deviation) unless otherwise indicated. The pain intensity rating was the average of the current pain intensity rating, the worst pain intensity rating in the preceding 24 hours, and the best pain intensity rating in the preceding 24 hours (all rated on a scale from 0 to 10). mSBT=modified STarT Back Screening Tool; SF-8 PCS=Medical Outcomes Study 8-item Short-Form Health Survey Physical Component Score; SF-8 MCS=Medical Outcomes Study 8-item Short-Form Health Survey Mental Component Score; ODI=Oswestry Disability Index; NDI=Neck Disability Index; QuickDASH=Disabilities of the Arm, Shoulder and Hand Questionnaire; IKDC=International Knee Documentation Committee Subjective Knee Form (score reversed to reflect disability); TSK-11=11-item Tampa Scale for Kinesiophobia; mFABQ-PA=Modified Fear-Avoidance Belief Questionnaire Physical Activity subscale; STAI-T=trait portion of the State-Trait Anxiety Inventory; PHQ-9=Patient Health Questionnaire; PSEQ=Pain Self-Efficacy Questionnaire.

Table 3.
Table 3.

Associations Between Modified STarT Back Screening Tool (mSBT) Scores and General Health, Pain, Disability, and Psychological Measure Scoresa

  • ↵a R, 95% confidence interval (CI), and P values were obtained from bootstrap and bivariate correlations. The pain intensity rating was the average of the current pain intensity rating, the worst pain intensity rating in the preceding 24 hours, and the best pain intensity rating in the preceding 24 hours (all rated on a scale from 0 to 10). The disability score was the z-transformed disability score generated from region-specific disability measures (low back [Oswestry Disability Index], neck [Neck Disability Index], shoulder [Disabilities of the Arm, Shoulder and Hand Questionnaire], or knee [International Knee Documentation Committee Subjective Knee Form]). SF-8 PCS=Medical Outcomes Study 8-item Short-Form Health Survey Physical Component Score, SF-8 MCS=Medical Outcomes Study 8-item Short-Form Health Survey Mental Component Score, TSK-11=11-item Tampa Scale for Kinesiophobia, mFABQ-PA=Modified Fear-Avoidance Belief Questionnaire Physical Activity subscale, STAI-T=trait portion of the State-Trait Anxiety Inventory, PHQ-9=Patient Health Questionnaire, PSEQ=Pain Self-Efficacy Questionnaire.

  • b P<.01.

Table 4.
Table 4.

Contribution of Anatomical Region (AR) and Modified STarT Back Screening Tool (mSBT) Overall Score to General Health, Pain, and Disability Measure Scoresa

  • ↵a R2, β, 95% confidence interval (CI; of nonstandardized coefficient), and P values were obtained from final regression models. Age and pain duration were entered as continuous variables: sex was coded as follows—1=male, 2=female; work-related pain was coded as follows—1=painful symptoms work related, 2=painful symptoms not work related; and surgery for pain was coded as follows—1=surgery for primary complaint, 2=no surgery for primary complaint. The AR was entered as 4 categorical variables: low back AR (reference category), neck AR, shoulder AR, and knee AR. The mSBT overall score was entered as a continuous variable (0–9). The AR × mSBT overall score interaction terms were centered and entered as 4 categorical interactions (low back AR × mSBT overall score was used as the reference category). The pain intensity rating was the average of the current pain intensity rating, the worst pain intensity rating in the preceding 24 hours, and the best pain intensity rating in the preceding 24 hours (all rated on a scale from 0 to 10). The disability score was the z-transformed disability score generated from region-specific disability measures (low back [Oswestry Disability Index], neck [Neck Disability Index], shoulder [Disabilities of the Arm, Shoulder and Hand Questionnaire], or knee [International Knee Documentation Committee Subjective Knee Form]). SF-8 PCS=Medical Outcomes Study 8-item Short-Form Health Survey Physical Component Score (a general health measure), SF-8 MCS=Medical Outcomes Study 8-item Short-Form Health Survey Mental Component Score (a general health measure).

  • b P<.01.

Table 5.
Table 5.

Contribution of Anatomical Region (AR) and Modified STarT Back Screening Tool (mSBT) Psychosocial Subscore to Psychological Measure Scoresa

  • ↵a R2, β, 95% confidence interval (CI; of nonstandardized coefficient), and P values were obtained from final regression models. Age and pain duration were entered as continuous variables: sex was coded as follows—1=male, 2=female; work-related pain was coded as follows—1=painful symptoms work related, 2=painful symptoms not work related; and surgery for pain was coded as follows—1=surgery for primary complaint, 2=no surgery for primary complaint. The AR was entered as 4 categorical variables: low back AR (reference category), neck AR, shoulder AR, and knee AR. The mSBT psychosocial subscore was entered as a continuous variable (0–5). The AR × mSBT psychosocial subscore interaction terms were centered and entered as 4 categorical interactions (low back AR × mSBT psychosocial subscore was used as the reference category). TSK-11=11-item Tampa-Scale for Kinesiophobia, mFABQ-PA=Modified Fear-Avoidance Belief Questionnaire Physical Activity subscale, STAI-T=trait portion of the State-Trait Anxiety Inventory, PHQ-9=Patient Health Questionnaire, PSEQ=Pain Self-Efficacy Questionnaire.

  • b P<.01.

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Vol 96 Issue 8 Table of Contents
Physical Therapy: 96 (8)

Issue highlights

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  • Obstacle Crossing During Gait in Children With Cerebral Palsy: Cross-Sectional Study With Kinematic Analysis of Dynamic Balance and Trunk Control
  • Medial Longitudinal Arch Development of Children Aged 7 to 9 Years: Longitudinal Investigation
  • Limitations in the Activity of Mobility at Age 6 Years After Difficult Birth at Term: Prospective Cohort Study
  • From Persuasion to Coercion: Responding to the Reluctant Patient in Rehabilitation
  • “Crawling Out of the Cocoon”: Patients' Experiences of a Physical Therapy Exercise Intervention in the Treatment of Major Depression
  • Preliminary Evaluation of a Modified STarT Back Screening Tool Across Different Musculoskeletal Pain Conditions
  • Validation of the Comprehensive ICF Core Set for Vocational Rehabilitation From the Perspective of Physical Therapists: International Delphi Survey
  • Test-Retest Reliability of Dual-Task Outcome Measures in People With Parkinson Disease
  • Development of a Feasible Implementation Fidelity Protocol Within a Complex Physical Therapy–Led Self-Management Intervention
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Preliminary Evaluation of a Modified STarT Back Screening Tool Across Different Musculoskeletal Pain Conditions
Katie A. Butera, Trevor A. Lentz, Jason M. Beneciuk, Steven Z. George
Physical Therapy Aug 2016, 96 (8) 1251-1261; DOI: 10.2522/ptj.20150377

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Preliminary Evaluation of a Modified STarT Back Screening Tool Across Different Musculoskeletal Pain Conditions
Katie A. Butera, Trevor A. Lentz, Jason M. Beneciuk, Steven Z. George
Physical Therapy Aug 2016, 96 (8) 1251-1261; DOI: 10.2522/ptj.20150377
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  • Reliability and Validity of Force Platform Measures of Balance Impairment in Individuals With Parkinson Disease
  • Predictors of Reduced Frequency of Physical Activity 3 Months After Injury: Findings From the Prospective Outcomes of Injury Study
  • Effects of Locomotor Exercise Intensity on Gait Performance in Individuals With Incomplete Spinal Cord Injury
Show more Measurement

Subjects

  • Psychosocial
    • Psychosocial: Other
  • Examination/Evaluation
    • Tests and Measurements
  • Musculoskeletal System/Orthopedic
    • Injuries and Conditions: Shoulder
    • Injuries and Conditions: Neck
    • Injuries and Conditions: Low Back
    • Injuries and Conditions: Knee
    • Injuries and Conditions: Back

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