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The STarT back tool in chiropractic practice: a narrative review

Overview of attention for article published in Chiropractic & Manual Therapies, April 2017
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Title
The STarT back tool in chiropractic practice: a narrative review
Published in
Chiropractic & Manual Therapies, April 2017
DOI 10.1186/s12998-017-0142-2
Pubmed ID
Authors

Yasmeen Khan

Abstract

The Keele STarT Back Tool was designed for primary care medical physicians in the UK to determine the risk for persistent disabling pain in patients with musculoskeletal pain and to tailor treatments accordingly. In medical and physical therapy settings, STarT Back Tool's tailored care plans improved patients' low back pain outcomes and lowered costs. Review studies using the STarT Back Tool in chiropractic patient populations. PubMed, The Cochrane Library, Index to Chiropractic Literature, and Science Direct databases were searched. Articles written in English, published in peer-reviewed journals, that studied the STarT Back Tool in patients seeking chiropractic care were included. Seven articles were selected based on inclusion and exclusion criteria. The STarT Back Tool was feasibly incorporated into 19 chiropractic clinics in Denmark. Total STarT Back 5-item score correlated moderately with total Bournemouth Questionnaire score. Two studies reported that the STarT Back Tool's predictive ability was poor, while another reported that the tool predicted outcomes in patients scoring in the medium and high risk categories who completed the STarT Back 2 days after their initial visit. A study examining Danish chiropractic, medical and physical therapy settings revealed that only baseline episode duration affected STarT Back's prognostic ability across all care settings. The tool predicted pain and disability in chiropractic patients whose episode duration was at least 2 weeks, but not in patients with an episode duration <2 weeks. While the STarT Back Tool can be incorporated into chiropractic settings and correlates with some elements of the Bournemouth Questionnaire, its prognostic ability is sometimes limited by the shorter low back pain episodes with which chiropractic patients often present. It may be a better predictor in patients whose episode duration is at least 2 weeks. Studies examining outcomes of stratified care in chiropractic patients are needed.

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Geographical breakdown

Country Count As %
Unknown 55 100%

Demographic breakdown

Readers by professional status Count As %
Other 11 20%
Student > Master 7 13%
Student > Ph. D. Student 5 9%
Researcher 4 7%
Student > Doctoral Student 3 5%
Other 10 18%
Unknown 15 27%
Readers by discipline Count As %
Medicine and Dentistry 14 25%
Nursing and Health Professions 13 24%
Sports and Recreations 3 5%
Psychology 3 5%
Neuroscience 2 4%
Other 2 4%
Unknown 18 33%