# Exploring the clinical utility of postural outcome tools for back and neck pain clinical outcomes: a systematic scoping review

## TL;DR

This review explores how well postural outcome tools are used in clinical settings for back and neck pain, finding they are mostly complex and limited in practical use.

## Contribution

The study systematically maps the clinical utility of postural outcome tools for spinal pain using a scoping review approach.

## Key findings

- Most postural tools are complex electronic devices or time-consuming questionnaires with limited non-occupational use.
- Clinical utility domains like construct validity and reliability were most achieved, while sensitivity to change and predictive validity were lacking.
- Tools are primarily based on a biomechanical pain model rather than the biopsychosocial model.

## Abstract

The role of posture in spinal pain is unclear which might be linked to characteristics of postural outcome measures. This systematic scoping review mapped the clinical utility of postural outcome tools for spinal pain. Following Joanna Briggs Institute framework, twelve bibliographic databases were searched until 8
th August 2023. Article selection, characterisation/mapping and synthesis using qualitative content analysis were performed by two independent reviewers. Clinical utility was defined by psychometric and clinimetric criteria. 85 eligible studies were identified from 89 publications. Twenty-eight distinct postural outcome tools plus bespoke measures were identified. Most tools were sophisticated computer-based electronic devices or complex time-consuming questionnaires, with limited applicability in non-occupational settings. Clinical utility domains most achieved were construct validity and inter/intra-rater reliability. Tools being underpinned by the biopsychosocial model of pain, sensitivity to clinical change, and predictive validity were the least achieved. Tools had limited clinical utility and were based on postural-structural-biomechanical pain model.