STarT Back Tool risk stratification is associated with changes in movement profile and sensory discrimination in low back pain: A study of 290 patients
Background: Investigation of movement and sensory profiles across STarT Back risk subgroups. Methods: A chronic low back pain cohort (n = 290) were classified as low, medium or high risk using the STarT Back Tool, and completed a repeated spinal bending task and quantitative sensory testing. Pain su...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
| Published: |
John Wiley & Sons Ltd.
2019
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| Online Access: | http://hdl.handle.net/20.500.11937/73628 |
| _version_ | 1848763051310841856 |
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| author | Rabey, Martin Kendall, Michelle Godden, Chris Liburd, Jermaine Netley, Hayley O'Shaughnessy, Ciaran O'Sullivan, Peter Smith, Anne Beales, Darren |
| author_facet | Rabey, Martin Kendall, Michelle Godden, Chris Liburd, Jermaine Netley, Hayley O'Shaughnessy, Ciaran O'Sullivan, Peter Smith, Anne Beales, Darren |
| author_sort | Rabey, Martin |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Investigation of movement and sensory profiles across STarT Back risk subgroups. Methods: A chronic low back pain cohort (n = 290) were classified as low, medium or high risk using the STarT Back Tool, and completed a repeated spinal bending task and quantitative sensory testing. Pain summation, time taken and the number of protective behaviours with repeated bending were measured. Sensory tests included two-point discrimination, temporal summation, pressure/thermal pain thresholds and conditioned pain modulation. Subgroups were profiled against movement and sensory variables. Results: The high-risk subgroup demonstrated greater pain summation following repeated forward bending (p < 0.001). The medium-risk subgroup demonstrated greater pain summation following repeated backward bending (p = 0.032). Medium- and high-risk subgroups demonstrated greater forward/backward bend time compared to the low-risk subgroup (p = 0.001, p = 0.005, respectively). Medium- and high-risk subgroups demonstrated a higher number of protective behaviours per forward bend compared to the low-risk subgroup (p = 0.008). For sensory variables, only two-point discrimination differed between subgroups, with medium- and high-risk subgroups demonstrating higher thresholds (p = 0.016). Conclusions: This study showed altered movement characteristics and sensory discrimination across SBT risk subgroups in people with CLBP. Membership of the high SBT risk subgroup was associated with greater pain and disability levels, greater pain summation following repeated bending, slower bending times, a greater number of protective behaviours during forward bending, and a higher TPD threshold. Treatment outcomes for higher risk SBT subgroups may be enhanced by interventions specifically targeting movement and sensory alterations. Significance: In 290 people with chronic low back pain movement profile and two-point discrimination threshold differed across risk subgroups defined by the STarT Back Tool. Conversely, pain sensitivity did not differ across these subgroups. These findings may add further guidance for targeted care in these subgroups. |
| first_indexed | 2025-11-14T10:57:19Z |
| format | Journal Article |
| id | curtin-20.500.11937-73628 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:57:19Z |
| publishDate | 2019 |
| publisher | John Wiley & Sons Ltd. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-736282024-05-22T08:47:53Z STarT Back Tool risk stratification is associated with changes in movement profile and sensory discrimination in low back pain: A study of 290 patients Rabey, Martin Kendall, Michelle Godden, Chris Liburd, Jermaine Netley, Hayley O'Shaughnessy, Ciaran O'Sullivan, Peter Smith, Anne Beales, Darren Background: Investigation of movement and sensory profiles across STarT Back risk subgroups. Methods: A chronic low back pain cohort (n = 290) were classified as low, medium or high risk using the STarT Back Tool, and completed a repeated spinal bending task and quantitative sensory testing. Pain summation, time taken and the number of protective behaviours with repeated bending were measured. Sensory tests included two-point discrimination, temporal summation, pressure/thermal pain thresholds and conditioned pain modulation. Subgroups were profiled against movement and sensory variables. Results: The high-risk subgroup demonstrated greater pain summation following repeated forward bending (p < 0.001). The medium-risk subgroup demonstrated greater pain summation following repeated backward bending (p = 0.032). Medium- and high-risk subgroups demonstrated greater forward/backward bend time compared to the low-risk subgroup (p = 0.001, p = 0.005, respectively). Medium- and high-risk subgroups demonstrated a higher number of protective behaviours per forward bend compared to the low-risk subgroup (p = 0.008). For sensory variables, only two-point discrimination differed between subgroups, with medium- and high-risk subgroups demonstrating higher thresholds (p = 0.016). Conclusions: This study showed altered movement characteristics and sensory discrimination across SBT risk subgroups in people with CLBP. Membership of the high SBT risk subgroup was associated with greater pain and disability levels, greater pain summation following repeated bending, slower bending times, a greater number of protective behaviours during forward bending, and a higher TPD threshold. Treatment outcomes for higher risk SBT subgroups may be enhanced by interventions specifically targeting movement and sensory alterations. Significance: In 290 people with chronic low back pain movement profile and two-point discrimination threshold differed across risk subgroups defined by the STarT Back Tool. Conversely, pain sensitivity did not differ across these subgroups. These findings may add further guidance for targeted care in these subgroups. 2019 Journal Article http://hdl.handle.net/20.500.11937/73628 10.1002/ejp.1351 John Wiley & Sons Ltd. fulltext |
| spellingShingle | Rabey, Martin Kendall, Michelle Godden, Chris Liburd, Jermaine Netley, Hayley O'Shaughnessy, Ciaran O'Sullivan, Peter Smith, Anne Beales, Darren STarT Back Tool risk stratification is associated with changes in movement profile and sensory discrimination in low back pain: A study of 290 patients |
| title | STarT Back Tool risk stratification is associated with changes in movement profile and sensory discrimination in low back pain: A study of 290 patients |
| title_full | STarT Back Tool risk stratification is associated with changes in movement profile and sensory discrimination in low back pain: A study of 290 patients |
| title_fullStr | STarT Back Tool risk stratification is associated with changes in movement profile and sensory discrimination in low back pain: A study of 290 patients |
| title_full_unstemmed | STarT Back Tool risk stratification is associated with changes in movement profile and sensory discrimination in low back pain: A study of 290 patients |
| title_short | STarT Back Tool risk stratification is associated with changes in movement profile and sensory discrimination in low back pain: A study of 290 patients |
| title_sort | start back tool risk stratification is associated with changes in movement profile and sensory discrimination in low back pain: a study of 290 patients |
| url | http://hdl.handle.net/20.500.11937/73628 |