Start back and Örebro as predictors of pain and disability in patients with nonspecific chronic low back pain undergoing physiotherapy

Abstract

Introduction: Screening questionnaires were developed to assist physiotherapists in assessing the risk of a patient with acute low back pain develop chronic pain and disability. However, there are few studies evaluating the scores of these questionnaires as predictors of unsuccessful physical therapy. Objective: The aim of this study is to evaluate whether both scores and categorizations obtained by the STarT (Subgroups Target Treatment) Back Screening Tool and Örebro Musculoskeletal Pain Screening Questionnaire are predictors of pain and disability in patients with nonspecific chronic back pain underwent physiotherapy. Methods: This study has a longitudinal observational design through a pre-planned secondary analysis of one randomized controlled trial that is in the final phase of data collection in the city of Rio de Janeiro. For the prediction of pain and disability outcomes, 4 multiple linear regression models will be used to analyse the association between scores and categorization of STarT Back and Örebro (indepentend variables) and change (pre-post) in pain and disability (dependent variables). Results: There was an association between STarTBack score and pain improvement (beta 0,33, [95% CI 0,08–0,58]) and also between high risk on STarTBack and pain improvement (beta 2,82, [95% CI 0,57–5,08]). There was no association between STarTBack score and disability improvement (beta 1,29, [95% CI -0,01–1,61]), as well as STarTBack categorization and disability improvement (beta 9,31, [95% CI -2,44–21,08]). There was no association between Örebro score and pain improvement (beta 0,01, [95% IC -0,04–0,06]) as well as between Örebro categorization and pain improvement (beta 0,6, [95% IC -1,85– 3,05]). There was no association between Örebro score and disability improvement (beta - 0,04, [95% CI -0,33–0,23]), as well as Örebro categories and disability improvement (beta 1,13 [95% CI -11,5–13,76]). Conclusion: Participants with higher scores on STarTBack presented higher improvement on pain intensity, as well as participants with high risk on STarTBack predicted a greater improvement in the same outcome. However, STartBack was not able to predict disability improvement. Regarding Örebro, the analysis showed that this tool was not able to predict pain or disability improvement in patients witn non-specific chronic low back pain who underwent physiotherapy.