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

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 including construct validity, predictive validity, intra and inter rater reliability, sensitivity to change, ease of use, sensibility, format, and alignment with the biopsychosocial pain model. 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. Alignment with the biopsychosocial pain model, 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.