Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .
The STarT Back Screening Tool and Individual Psychological Measures: Evaluation of Prognostic Capabilities for Low Back Pain Clinical Outcomes in Outpatient Physical Therapy Settings
Background Psychologically informed practice emphasizes routine identification of modifiable psychological risk factors being highlighted . Objective The purpose of this study was to test the predictive validity of the STarT Back Screening Tool ( SBT ) in comparison with single-construct psychological measures for 6-month clinical outcomes . Design This was an observational , prospect i ve cohort study . Methods Patients ( n=146 ) receiving physical therapy for low back pain were administered the SBT and a battery of psychological measures ( Fear-Avoidance Beliefs Question naire physical activity scale and work scale [ FABQ-PA and FABQ-W , respectively ] , Pain Catastrophizing Scale [ PCS ] , 11-item version of the Tampa Scale of Kinesiophobia [ TSK-11 ] , and 9-item Patient Health Question naire [ PHQ-9 ] ) at initial evaluation and 4 weeks later . Treatment was at the physical therapist 's discretion . Clinical outcomes consisted of pain intensity and self-reported disability . Prediction of 6-month clinical outcomes was assessed for intake SBT and psychological measure scores using multiple regression models while controlling for other prognostic variables . In addition , the predictive capabilities of intake to 4-week changes in SBT and psychological measure scores for 6-month clinical outcomes were assessed . Results Intake pain intensity scores ( β=.39 to .45 ) and disability scores ( β=.47 to .60 ) were the strongest predictors in all final regression models , explaining 22 % and 24 % and 43 % and 48 % of the variance for the respective clinical outcome at 6 months . Neither SBT nor psychological measure scores improved prediction of 6-month pain intensity . The SBT overall scores ( β=.22 ) and SBT psychosocial scores ( β=.25 ) added to the prediction of disability at 6 months . Four-week changes in TSK-11 scores ( β=−.18 ) were predictive of pain intensity at 6 months . Four-week changes in FABQ-PA scores ( β=−.21 ) , TSK-11 scores ( β=−.20 ) and SBT overall scores ( β=−.18 ) were predictive of disability at 6 months . Limitations Physical therapy treatment was not st and ardized or accounted for in the analysis . Conclusions Prediction of clinical outcomes by psychology-based measures was dependent upon the clinical outcome domain of interest . Similar to studies from the primary care setting , initial screening with the SBT provided additional prognostic information for 6-month disability and changes in SBT overall scores may provide important clinical decision-making information for treatment monitoring
Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .