Low Back Pain Clinical Trial
Official title:
Validation of the STarT Back Screening Tool in the Primary Care Management of Low Back Pain in the Military Health System: A Randomized Trial of Risk-stratified vs. Usual Care
NCT number | NCT03127826 |
Other study ID # | C.2016.047d |
Secondary ID | |
Status | Completed |
Phase | N/A |
First received | |
Last updated | |
Start date | April 7, 2017 |
Est. completion date | July 1, 2021 |
Verified date | May 2022 |
Source | Brooke Army Medical Center |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This is a trial to validate the use of the STarT Back Screening Tool (SBST) in the Military Health System for patients with low back pain presenting to primary care.
Status | Completed |
Enrollment | 290 |
Est. completion date | July 1, 2021 |
Est. primary completion date | February 26, 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 50 Years |
Eligibility | Inclusion Criteria: 1. Males and females who are between the ages of 18-50 years old 2. Primary complaint of LBP for any duration, with or without associated radiculopathy 3. Can speak and understand English 4. Be willing and able to give full, informed written consent Exclusion Criteria: 1. Red Flags: Any potentially serious or systemic disorders (e.g., cauda equina compression, inflammatory arthritis, compression fracture, malignancy, infection, severe neurological progression), serious illness or comorbidity 2. Spinal surgery in the past 24 months 3. Current pregnancy (or within the last 6 months) 4. Already receiving treatment (other than primary care) for this episode of LBP 5. Inability to attend regular treatment sessions 6. Pending litigation or a medical evaluation board |
Country | Name | City | State |
---|---|---|---|
United States | Brooke Army Medical Center | San Antonio | Texas |
Lead Sponsor | Collaborator |
---|---|
Brooke Army Medical Center |
United States,
Beneciuk JM, Fritz JM, George SZ. The STarT Back Screening Tool for prediction of 6-month clinical outcomes: relevance of change patterns in outpatient physical therapy settings. J Orthop Sports Phys Ther. 2014 Sep;44(9):656-64. doi: 10.2519/jospt.2014.5178. Epub 2014 Aug 6. — View Citation
Beneciuk JM, George SZ. Pragmatic Implementation of a Stratified Primary Care Model for Low Back Pain Management in Outpatient Physical Therapy Settings: Two-Phase, Sequential Preliminary Study. Phys Ther. 2015 Aug;95(8):1120-34. doi: 10.2522/ptj.20140418. Epub 2015 Apr 9. — View Citation
Hill JC, Whitehurst DG, Lewis M, Bryan S, Dunn KM, Foster NE, Konstantinou K, Main CJ, Mason E, Somerville S, Sowden G, Vohora K, Hay EM. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. Lancet. 2011 Oct 29;378(9802):1560-71. doi: 10.1016/S0140-6736(11)60937-9. Epub 2011 Sep 28. — View Citation
Main CJ, Sowden G, Hill JC, Watson PJ, Hay EM. Integrating physical and psychological approaches to treatment in low back pain: the development and content of the STarT Back trial's 'high-risk' intervention (StarT Back; ISRCTN 37113406). Physiotherapy. 2012 Jun;98(2):110-6. doi: 10.1016/j.physio.2011.03.003. Epub 2011 Jun 12. — View Citation
Saunders B, Bartlam B, Foster NE, Hill JC, Cooper V, Protheroe J. General Practitioners' and patients' perceptions towards stratified care: a theory informed investigation. BMC Fam Pract. 2016 Aug 31;17(1):125. doi: 10.1186/s12875-016-0511-2. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Roland-Morris Disability Questionnaire (RMDQ) | The focus of the interventions is directed towards the secondary prevention of disabling back pain. The RMDQ will be used to assess physical disability. The RMDQ is a recommended disability measure that it is widely used in LBP studies in primary care and was the primary outcome used in the STarT Back trial by Hill et al. (2011). The form provides 24 statements and prompts the participant by stating "When your back hurts, you may find it difficult to do some of the things you normally do." Then it states, "Mark only the sentences that describe you today." Examples include "I avoid heavy jobs around the house because of my back" and "I find it difficult to turn over in bed because of my back". Scores are calculated by percent improvement from baseline to post-intervention [(points of improvement made/total items checked at baseline) x 100] | 1 year | |
Secondary | Patient Acceptable Symptom Scale (PASS) | Often defined as "the highest level of symptoms beyond which patients consider themselves well." This outcome measure has been used in previous studies looking at the effects of cervical thoracic thrust manipulation on shoulder pain. The question that will be asked to assess this level is, "Taking into account all the activities you have during your daily life, your level of pain, and also your functional impairment, do you consider that your current state is satisfactory?" Individuals who respond "yes" will be categorized as a success." | 1 year | |
Secondary | Credibility Expectancy Questionnaire (CEQ) | The CEQ is a 6-item self-report measure evaluating treatment credibility and expectations for improvement. This will be assessed at baseline after treatment group assignment is revealed to provide descriptive information about participants' perceptions of their treatment assignment and optimism for improvement. The CEQ may be used as a covariate if perceptions differ meaningfully between groups as participants' initial perceptions of treatment credibility can impact outcomes. | 1 year | |
Secondary | Patient Reported Outcomes Measurement Information System 57-Item Profile v 2.0 (PROMIS-57) | The PROMIS 57 efficiently assesses several outcomes important to patients including pain intensity and interference, sleep disturbance, anxiety, depression, fatigue, and social role participation using items developed with rigorous methodology and patient input. This is a 57-item questionnaire with 8 questions per domain. | 1 year | |
Secondary | EuroQoL (EQ-5D) | The EQ-5D is a generic quality of life questionnaire that will assess quality of life on a scale that can be referenced to other disease conditions. The EQ-5D covers 5 domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each domain has 3 response categories: level 1, "no problems"; level 2, "some problems"; and level 3, "inability or extreme problems." Responses are combined to give a 5-digit descriptive health state classification (e.g., 11222). The EQ-5D yields a total of 243 possible health states. Valuations for each health state are available. The EQ-5D is commonly used in economic evaluation of interventions and cost-effectiveness analysis. | 1 year | |
Secondary | Healthcare Utilization | Low back pain related healthcare costs | 2 years |
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT03916705 -
Thoraco-Lumbar Fascia Mobility
|
N/A | |
Completed |
NCT04007302 -
Modification of the Activity of the Prefrontal Cortex by Virtual Distraction in the Lumbago
|
N/A | |
Completed |
NCT03273114 -
Cognitive Functional Therapy (CFT) Compared With Core Training Exercise and Manual Therapy (CORE-MT) in Patients With Chronic Low Back Pain
|
N/A | |
Recruiting |
NCT03600207 -
The Effect of Diaphragm Muscle Training on Chronic Low Back Pain
|
N/A | |
Completed |
NCT04284982 -
Periodized Resistance Training for Persistent Non-specific Low Back Pain
|
N/A | |
Recruiting |
NCT05600543 -
Evaluation of the Effect of Lumbar Belt on Spinal Mobility in Subjects With and Without Low Back Pain
|
N/A | |
Withdrawn |
NCT05410366 -
Safe Harbors in Emergency Medicine, Specific Aim 3
|
||
Completed |
NCT03673436 -
Effect of Lumbar Spinal Fusion Predicted by Physiotherapists
|
||
Completed |
NCT02546466 -
Effects of Functional Taping on Static Postural Control in Patients With Non-specific Chronic Low Back Pain
|
N/A | |
Completed |
NCT00983385 -
Evaluation of Effectiveness and Tolerability of Tapentadol Hydrochloride in Subjects With Severe Chronic Low Back Pain Taking Either WHO Step I or Step II Analgesics or no Regular Analgesics
|
Phase 3 | |
Recruiting |
NCT05156242 -
Corticospinal and Motor Behavior Responses After Physical Therapy Intervention in Patients With Chronic Low Back Pain.
|
N/A | |
Recruiting |
NCT04673773 -
MY RELIEF- Evidence Based Information to Support People Aged 55+ Years Living and Working With Persistent Low-back Pain.
|
N/A | |
Completed |
NCT06049277 -
Mulligan Technique Versus McKenzie Extension Exercise Chronic Unilateral Radicular Low Back Pain
|
N/A | |
Completed |
NCT06049251 -
ELDOA Technique Versus Lumbar SNAGS With Motor Control Exercises
|
N/A | |
Completed |
NCT04980469 -
A Study to Explore the Effect of Vitex Negundo and Zingiber Officinale on Non-specific Chronic Low Back Pain Due to Sedentary Lifestyle
|
N/A | |
Completed |
NCT04055545 -
High Intensity Interval Training VS Moderate Intensity Continuous Training in Chronic Low Back Pain Subjects
|
N/A | |
Recruiting |
NCT05552248 -
Assessment of the Safety and Performance of a Lumbar Belt
|
||
Recruiting |
NCT05944354 -
Wearable Spine Health System for Military Readiness
|
||
Completed |
NCT05801588 -
Participating in T'ai Chi to Reduce Back Pain and Improve Quality of Life
|
N/A | |
Completed |
NCT05811143 -
Examining the Effects of Dorsal Column Stimulation on Pain From Lumbar Spinal Stenosis Related to Epidural Lipomatosis.
|