COMPARISON BETWEEN START BACK SCREENING TOOL AND DRAM FOR DETECTION OF PSYCHOSOCIAL FACTORS IN LOW BACK PAIN

Carlos Tucci,Tarcísio Eloy Pessoa De Barros Filho,Raphael Martus Marcon,Alexandre Fogaça Cristante,Alex Oliveira De Araujo

doi:10.1590/s1808-185120212004239030

Abstract

ABSTRACT Objective: To correlate the results of the STarT Back Screening Tool and DRAM questionnaires, applied simultaneously, in a population with low back pain. Methods: Comparative cross-sectional study with 84 participants with low back pain assessed by both STarT Back Screening Tool (SBST) and DRAM questionnaires. The degree of correlation between the two questionnaires was analyzed through the evaluation of individualized data and using the Spearman correlation coefficient. Results: According to the DRAM, 19% of the patients were classified as “normal”, 32.1% as “at risk” and 48.8% as “distressed”. According to SBST, 59.5% of patients were classified as “low risk”, 31% as “medium risk” and 9.5% as “high risk”. Applying the Spearman's coefficient to evaluate the degree of correlation between the two questionnaires, a value of 0.4 was obtained. This shows that there is a positive, but weak, correlation (p <0.001) between the two questionnaires. Conclusion: There is a positive correlation between the two questionnaires, but the DRAM showed a greater tendency to classify patients with some degree of psychological distress when compared to the SBST. Both questionnaires are effective in identifying these factors, but the data suggest that the DRAM may be more effective as a screening tool in patients with low back pain, in view of the higher number of patients identified. Level of evidence III; Diagnostic test study.

Highlights

Low back pain is a universal complaint that affects a considerable proportion of the global population, predominantly women and patients aged 40-80 years
There is a positive correlation between the two questionnaires, but the DRAM showed a greater tendency to classify patients with some degree of psychological distress when compared to the STarT Back Screening Tool (SBST)
Both questionnaires are effective in identifying these factors, but the data suggest that the DRAM may be more effective as a screening tool in patients with low back pain, in view of the higher number of patients identified

Summary

Introduction

Low back pain is a universal complaint that affects a considerable proportion of the global population, predominantly women and patients aged 40-80 years. There is an important relationship between low back pain and psychological abnormalities,[5] with reports of an association of about 53% between chronic low back pain and relevant psychological disorders.[6,7] Patients who suffer from low back pain often exhibit a distinct inability to perform daily or occupational activities, and this interferes in their personal relationships and their behavior. This behavioral change associated with psychosocial factors contributes to treatment failure and the transition from an acute to chronic condition. The identification of these psychosocial factors that influence the prognosis can help to achieve a more specific treatment and improve the patient’s understanding of his or her condition.[8]

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Results

Discussion

Conclusion