Does the Keele STarT Back Screening Tool Contribute to Effectiveness in Treatment and Cost and Loss of Follow-Up of the Mechanical Diagnosis and Therapy for Patients with Low Back Pain?

Takahiro Tsuge,Hiroshi Takasaki,Michio Toda

doi:10.3390/diagnostics10080536

Takahiro Tsuge, Hiroshi Takasaki + Show 1 more

Open Access

https://doi.org/10.3390/diagnostics10080536

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Abstract

Background: Mechanical diagnosis and therapy (MDT) and the stratified approach using the Keele STarT Back Screening Tool (SBST) are examples of stratified low back pain (LBP) management. We investigated whether the medium–high risk in SBST can contribute to the time and sessions until discharge from MDT (Question 1) and to the loss of follow-up before identifying a promising management strategy (Question 2). Methods: A retrospective chart study was conducted. Multiple regression modeling was constructed using 10 independent variables, including whether the SBST was medium–high risk or not for Question 1, and the 9/10 independent variables for Question 2. Results: The data of 89 participants for Question 1 and 166 participants for Question 2 were analyzed. SBST was not a primary contributing factor for Question 1 (R2 = 0.17–0.19). The model for Question 2 included SBST as a primary contributing factor and the shortest distance from the patient address to the hospital as a secondary contributing factor (93.4% correct classification). Conclusion: SBST status was not a primary contributing factor for time and sessions until discharge from MDT, but was a critical factor for the loss of MDT follow-up before identifying a promising management strategy.

Highlights

A stratified care model is known as a promising management strategy for low back pain (LBP) [1].In this care model, patients are categorized into subgroups, and certain interventions that respond to a specific subgroup are provided
One example of the stratified care model is the McKenzie method of the mechanical diagnosis and therapy (MDT), which has been effective in both treatment and cost for managing LBP [4,5,6,7], and is the most widely used physical therapy management for LBP [8,9,10,11]
The data of 176 participants were initially included, and the data of 89 participants who days in the subgroup of non-derangement syndrome, 101.9 (62.6) days in the low-risk group on STarT Back Screening Tool (SBST), completed the Mechanical diagnosis and therapy (MDT) until discharge were analyzed for Question 1, and the data of 166 participants andwere

Summary

Introduction

A stratified care model is known as a promising management strategy for low back pain (LBP) [1]. In this care model, patients are categorized into subgroups, and certain interventions that respond to a specific subgroup are provided. One example of the stratified care model is the McKenzie method of the mechanical diagnosis and therapy (MDT), which has been effective in both treatment and cost for managing LBP [4,5,6,7], and is the most widely used physical therapy management for LBP [8,9,10,11]. We investigated whether the medium–high risk in SBST can contribute to the time and sessions until discharge from MDT (Question 1) and to the loss of follow-up before identifying a promising management strategy (Question 2). Multiple regression modeling was constructed using 10 independent variables, including whether the SBST was medium–high risk or not for Question 1, and the 9/10 independent variables for Question 2

Results

Discussion

Conclusion