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Vengatraman S, Aseer Peter AL, Kannan S. Cross-cultural adaptation, reliability, validity, and psychometric evaluation of the Tamil version STarT back screening tool among low back pain subjects. J Orthop Sci 2023:S0949-2658(23)00192-6. [PMID: 37482443 DOI: 10.1016/j.jos.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/20/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The STarT back screening tool helps primary care workers make the initial clinical decision and classify low back pain subjects into subgroups. Currently, the tool is required for stratification/triaging of low back pain and is commonly used in clinical practice, and requires linguistic validation in Tamil. The study aimed to determine the validity and reliability of the Tamil version of the STarT back screening tool. METHODS The baseline measurements include the Tamil version of the STarT back screening tool-, pain severity using the Numeric pain rating Scale (NPRS), disability status using the Tamil version of the Roland Morris Disability Questionnaire (RMDQ), and fear avoidance beliefs using the fear-avoidance beliefs questionnaire (FABQ) - Tamil were obtained. After five days, the retest measures are done to investigate the test-retest reliability. RESULTS The current study showed excellent test-retest reliability of total score (ICC - 0.80) and psychosocial subscore (ICC-0.82) with excellent internal consistency and moderate to high validity with clinical outcomes. CONCLUSION The study concludes that the Tamil version of the STarT Back Screening Questionnaire is a reliable and valid tool that reported good understanding and easy completion by the subject.
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Affiliation(s)
- Srinithi Vengatraman
- Sri Ramachandra Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Porur, Chennai, India
| | - Antony Leo Aseer Peter
- Sri Ramachandra Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Porur, Chennai, India.
| | - Soundararajan Kannan
- Sri Ramachandra Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Porur, Chennai, India
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Wiangkham T, Phungwattanakul N, Thongbai N, Situy N, Polchaika T, Kongmee I, Thongnoi D, Chaisang R, Suwanmongkhon W. Translation, cross-cultural adaptation and psychometric validation of the Thai version of the STarT Back Screening Tool in patients with non-specific low back pain. BMC Musculoskelet Disord 2021; 22:454. [PMID: 34006259 PMCID: PMC8132393 DOI: 10.1186/s12891-021-04347-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/07/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is a top musculoskeletal problem and a substantial cause of socioeconomic burden internationally. The STarT Back Screening Tool (SBST) is a useful screening tool to manage patients with LBP but it is unavailable in Thai. Therefore, the aims of this study were to translate and cross-culturally adapt the SBST into a Thai version (SBST-TH) and validate its psychometric properties (e.g., factor analysis, internal consistency, test-retest reliability, agreement, convergent validity and discriminative validity). METHODS Translation and cross-cultural adaptation of the SBST into Thai version were conducted according to standard guidelines. A total of 200 participants with non-specific LBP were invited to complete the SBST, visual analogue scale for pain intensity, Roland-Morris disability questionnaire (RMDQ), fear-avoidance beliefs questionnaire, pain catastrophising scale, hospital anxiety and depression scale and the EuroQol five-dimensional questionnaire. Thirty participants completed the SBST-TH twice with an interval of 48 h to evaluate test-retest reliability. RESULTS Factor analysis demonstrated two (physical and psychological) components for the SBST-TH (39.38% of the total variance). The Cronbach's alpha (0.86 for total score and 0.76 for psychosocial subscore) represent satisfactory internal consistency. The acceptability of intraclass correlation coefficient was found in the total (0.73) and subscore (0.79). The areas under the curve (AUC) for the total score ranged 0.67-0.85 and 0.66-0.75 for subscore. The excellent discriminative validity was observed (AUC = 0.85, 95% confidence interval = 0.72, 0.97) between the total score of the SBST-TH and disability (RMDQ). Spearman's correlation coefficients represented moderate to strong correlation (0.32-0.56) between the SBST-TH and all questionnaires. The findings suggest a good relationship between the SBST-TH and disability and quality of life. Owing to the results from the convergent and discriminative validity, construct validity of the SBST-TH can be supported. The minimal detectable changes of the total score and subscore were 2.04 and 1.60, respectively. Significant floor and ceiling effects were not found in the SBST-TH. CONCLUSION The SBST-TH was successfully translated and adapted. It is a valid and reliable tool to classify Thai patients with non-specific LBP into low, moderate and high risks for chronicity. TRIAL REGISTRATION TCTR20191009005 #.
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Affiliation(s)
- Taweewat Wiangkham
- grid.412029.c0000 0000 9211 2704Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000 Thailand ,grid.412029.c0000 0000 9211 2704Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000 Thailand
| | - Nattawan Phungwattanakul
- grid.412029.c0000 0000 9211 2704Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000 Thailand
| | - Natthathida Thongbai
- grid.412029.c0000 0000 9211 2704Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000 Thailand
| | - Nisa Situy
- grid.412029.c0000 0000 9211 2704Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000 Thailand
| | - Titipa Polchaika
- grid.412029.c0000 0000 9211 2704Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000 Thailand
| | - Isara Kongmee
- grid.412029.c0000 0000 9211 2704Department of English Language, Faculty of Humanities, Naresuan University, Phitsanulok, 65000 Thailand
| | - Duangporn Thongnoi
- grid.412029.c0000 0000 9211 2704Department of English Language, Faculty of Humanities, Naresuan University, Phitsanulok, 65000 Thailand
| | - Rujirat Chaisang
- grid.412029.c0000 0000 9211 2704Department of English Language, Faculty of Humanities, Naresuan University, Phitsanulok, 65000 Thailand
| | - Wanisara Suwanmongkhon
- grid.7132.70000 0000 9039 7662Department of Accounting, Faculty of Business Administration, Chiang Mai University, Chiang Mai, 50200 Thailand
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Yamashita Y, Nishigami T, Mibu A, Tanaka K, Wand BM, Catley MJ, Higashi T. Development and Psychometric Testing of the Japanese Version of the Fremantle Neck Awareness Questionnaire: A Cross-Sectional Study. J Pain Res 2021; 14:311-324. [PMID: 33568938 PMCID: PMC7870290 DOI: 10.2147/jpr.s267930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose Contemporary theories of pain suggest that how the body is perceived is central to the emergence of pain. The Fremantle Back Awareness Questionnaire (FreBAQ) was developed to assess body-perception specific to the back in people with chronic low back pain. However, there is no comprehensive measure to quantify self-perception of the painful area in Japanese people with neck pain. This study aimed to develop a Japanese version of a self-perception questionnaire specific to the neck and evaluate the validity and reliability of the scale using Rasch analysis. Materials and Methods The Fremantle Neck Awareness Questionnaire (FreNAQ-J) was developed by modifying the FreBAQ-J. One hundred people with chronic neck pain and fifty-six matched healthy controls completed the questionnaire. Rasch analysis was used to evaluate targeting, category order, unidimensionality, person fit, internal consistency, differential item functioning, and differential test functioning in the neck pain population. Validity was investigated by examining the relationship between the FreNAQ-J and clinical status. Results People with chronic neck pain endorsed FreNAQ-J items with greater frequency than healthy controls. FreNAQ-J did not reject the null hypothesis of fitting the Rasch model, had acceptable internal consistency and good test–retest reliability. Summed FreNAQ-J scores were significantly correlated with pain intensity, disability, pain-related catastrophizing and fear of movement. Conclusion The individual items of the FreNAQ-J can be validly summed to provide a score of self-perception. The FreNAQ-J is the first scale developed for comprehensively evaluating disturbed body perception in Japanese patients with chronic neck pain.
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Affiliation(s)
- Yuh Yamashita
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, 852-8520, Japan.,Department of Rehabilitation, Morinaga Orthopedic Clinic, Saga, 849-0934, Japan
| | - Tomohiko Nishigami
- Department of Physical Therapy, Prefectural University of Hiroshima, Mihara, Hiroshima, 723-0053, Japan
| | - Akira Mibu
- Department of Nursing and Physical Therapy, Konan Women's University, Kobe, Hyogo, 658-0001, Japan
| | | | - Benedict M Wand
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, 6959, Australia
| | - Mark J Catley
- School of Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia
| | - Toshio Higashi
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, 852-8520, Japan
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Nishigami T, Watanabe A, Maitani T, Shigetoh H, Mibu A, Wand BM, Catley MJ, Stanton TR, Moseley GL. Development and validation of a shoulder-specific body-perception questionnaire in people with persistent shoulder pain. BMC Musculoskelet Disord 2021; 22:98. [PMID: 33478446 PMCID: PMC7819341 DOI: 10.1186/s12891-021-03944-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 01/02/2021] [Indexed: 12/17/2022] Open
Abstract
Background There is evidence that people with persistent shoulder pain exhibit findings consistent with the presence of sensorimotor dysfunction. Sensorimotor impairments can manifest in a variety of ways, and further developing our understanding of sensorimotor dysfunction in shoulder pain may improve current models of care. The Fremantle Back Awareness Questionnaire (FreBAQ) has been developed to assess disturbed body perception specific to the back. The purpose of the present study was to develop a shoulder-specific self-perception questionnaire and evaluate the questionnaire in people with persistent shoulder pain. Methods The Fremantle Shoulder Awareness Questionnaire (FreSHAQ-J) was developed by modifying the FreBAQ. One hundred and twelve consecutive people with persistent shoulder pain completed the FreSHAQ-J. Thirty participants completed the FreSHAQ-J again two-weeks later to assess test-retest reliability. Rasch analysis was used to assess the psychometric properties of the FreSHAQ-J. Associations between FreSHAQ-J total score and clinical status was explored using correlational analysis. Results The FreSHAQ-J has acceptable category order, unidimensionality, no misfitting items, and excellent test-retest reliability. The FreSHAQ-J was moderately correlated with disability and pain catastrophization. Conclusions The FreSHAQ-J fits the Rasch measurement model well and is suitable for use with people with shoulder pain. Given the relationship between the FreSHAQ-J score and clinical status, change in body perception may be worth assessing when managing patients with shoulder pain.
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Affiliation(s)
- Tomohiko Nishigami
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1, Gakuen-chou, Mihara, Hiroshima, 723-0053, Japan.
| | - Akihisa Watanabe
- Department of Rehabilitation, Machida Orthopaedics, Kochi, Japan
| | - Toshiki Maitani
- Department of Rehabilitation, Utsumi Orthopaedics Clinic, Kagawa, Japan
| | - Hayato Shigetoh
- Department of Rehabilitation, Miura internal Medicine Michiko Pediatrics Clinic, Kagawa, Japan
| | - Akira Mibu
- Department of Nursing and Physical Therapy, Konan Woman's University, Kobe, Hyogo, Japan
| | - Benedict Martin Wand
- The School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Mark J Catley
- Innovation, Implementation and Clinical Translation in Health (IIMPACT in Health), University of South Australia, Adelaide, SA, Australia
| | - Tasha R Stanton
- Innovation, Implementation and Clinical Translation in Health (IIMPACT in Health), University of South Australia, Adelaide, SA, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - G Lorimer Moseley
- Innovation, Implementation and Clinical Translation in Health (IIMPACT in Health), University of South Australia, Adelaide, SA, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
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Yadollahpour N, Zahednejad S, Yazdi MJS, Esfandiarpour F. Clustering of patients with chronic low back pain in terms of physical and psychological factors: A cross-sectional study based on the STarT Back Screening Tool. J Back Musculoskelet Rehabil 2020; 33:581-587. [PMID: 31658040 DOI: 10.3233/bmr-181484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The STarT Back Screening Tool (SBT) is a multidimensional questionnaire consisting of physical and psychological factors which categorizes the patients in the low, medium or high risk subgroups. OBJECTIVE To investigate the relationship between SBT-based subgrouping and clustering of patients with LBP using uni-dimensional psychological, clinical and physical examination measures. METHODS One hundred and fifty-seven patients with chronic LBP completed the SBT and uni-dimensional psychological, disability and pain questionnaires. Physical impairments were evaluated through the Physical Impairment Index (PII). Hierarchical and K-means methods were used for cluster analysis. Between-clusters differences and the association between the clusters and SBT-based subgrouping were investigated. RESULTS Three clusters were identified. The derived clusters were labeled severe, moderate and mild physical-psychological-distress clusters, because pain intensity, disability, psychological and physical factors were relatively high, moderate or low, respectively. Most of the patients in moderate and mild physical-psychological distress clusters were categorized as medium risk based on SBT. The mean difference for the PII was higher than that of psychological factors between moderate and mild physical-psychological-distress clusters. CONCLUSIONS Patients in low and high risk subgroups of SBT were sufficiently differentiated, but patients in a medium risk subgroup had a different profile based on PII. Including additional physical factors in the SBT may be required to better differentiate among patients.
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Szita J, Kiss L, Biczo A, Feher K, Varga PP, Lazary A. Outcome of group physical therapy treatment for non-specific low back pain patients can be predicted with the cross-culturally adapted and validated Hungarian version STarT back screening tool. Disabil Rehabil 2020; 44:1427-1435. [PMID: 32735178 DOI: 10.1080/09638288.2020.1799248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The STarT Back Tool was developed to identify the specific modifiable prognostic factors for non-specific low back pain and to classify the patients into risk groups; low, medium and high risk of chronicity. Applied therapeutic approaches often involve group physical therapy. The aim of this study was the cross-cultural adaptation and validation of the Hungarian version of the STarT Back Tool and to investigate the predictive ability for global treatment outcome. MATERIALS AND METHODS A prospective cohort study (N = 133) was carried out involving non-specific low back pain patients. Internal consistency, construct validity, reliability and prognostic discriminative ability have been investigated. After 3 months of treatment global outcome was evaluated. RESULTS A 2-factor structure was found, with moderate internal consistency (Cronbach α = 0.89 for the total and psychosocial subscale 0.62). Between the Hungarian STarT Back Tool, the Oswestry Disability Index, leg pain, low back pain, Tampa Scale for Kinesiophobia, Fear Avoidance Beliefs Questionnaire and the physical subscale of the quality of life questionnaire, significant good to excellent- correlation was found (r > 0.41). The test-retest analysis showed excellent reliability (Intraclass Correlation Coefficient = 0.93) with standard error measurement being 0.49 (minimal detectable change = 1.37). The Area Under the Curve for baseline STarT Back Tool scores was 0.7 and 0.8 for global treatment outcome and distress, respectively. The Area Under the Curve for global treatment outcome versus STarT risk groups proved to be 0.76 representing adequate discriminative ability. CONCLUSION The successful cross-cultural adaptation was followed by the validity analysis and as a result the Hungarian version of the STarT Back Tool proved to be a reliable and valid tool in the identification of risk groups of chronicity for patients with low back pain. Patients allocated to the high-risk group were more likely experiencing poor outcome at 3 months follow up, thus it can be used to predict outcome if treated with group physical therapy.Implication for rehabilitationLow back pain is a multifactorial disease where physical and psychosocial risk factors play a role in the development and prognosis of the disease.The STarT-H can be considered as a reliable, valid measurement tool in the identification of risk groups of chronicity for patients with low back pain.Clinical relevance of the STarT-H is that it can be used to stratify patients into risk groups of chronicity in different Hungarian speaking healthcare settings.According to our findings the STarT-H can also be applied to predict global treatment outcome in low back pain patients if treated with group physical therapy.
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Affiliation(s)
- Julia Szita
- Department of Research and Development, National Center for Spinal Disorders, Budapest, Hungary.,Doctoral School of Clinical Medicine, Semmelweis University School of Ph.D. Studies, Budapest, Hungary
| | - Laszlo Kiss
- Department of Research and Development, National Center for Spinal Disorders, Budapest, Hungary.,Doctoral School of Clinical Medicine, Semmelweis University School of Ph.D. Studies, Budapest, Hungary
| | - Adam Biczo
- Department of Research and Development, National Center for Spinal Disorders, Budapest, Hungary.,Doctoral School of Clinical Medicine, Semmelweis University School of Ph.D. Studies, Budapest, Hungary
| | - Katalin Feher
- Department of Spinal Surgery, National Center for Spinal Disorders, Budapest, Hungary
| | - Peter P Varga
- Department of Spinal Surgery, National Center for Spinal Disorders, Budapest, Hungary
| | - Aron Lazary
- Department of Research and Development, National Center for Spinal Disorders, Budapest, Hungary.,Department of Spine Surgery, Semmelweis University, Budapest, Hungary
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Association of STarT Back Tool and the short form of the Örebro Musculoskeletal Pain Screening Questionnaire with multidimensional risk factors. Sci Rep 2020; 10:290. [PMID: 31937867 PMCID: PMC6959304 DOI: 10.1038/s41598-019-57105-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 12/23/2019] [Indexed: 11/13/2022] Open
Abstract
The Short form of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-short) and the STarT Back Tool (SBT) have been developed to screen for risk factors for future low back pain (LBP) -related disability and work loss respectively. The aim of this study was to investigate the accordance of the two questionnaires and to evaluate the accumulation of risk factors in the risk groups of both screening tools in a large population-based sample. The study population consisted of 3079 participants of the Northern Finland Birth Cohort 1966 who had reported LBP over the previous 12 months and had SBT and ÖMPSQ-short data. We evaluated the association of depressive and anxiety symptoms (Hopkins symptom check list-25, Generalized anxiety disorder 7 questionnaire, and Beck’s Depression Inventory 21), psychological features (Fear-Avoidance Beliefs Questionnaire), lifestyle characteristics (BMI, smoking, alcohol abuse, physical inactivity) and social factors (education level) with the SBT and ÖMPSQ-short risk groups. The high-risk groups of both questionnaires were associated (p < 0.001) with depressive and anxiety symptoms and fear-avoidance beliefs. In addition, adverse lifestyle factors accumulated in the higher risk groups, especially from the ÖMPSQ-short. Agreement between the two questionnaires was moderate for men and fair for women.
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A Responsiveness Analysis of the Subgroups for Targeted Treatment (STarT) Back Screening Tool in Patients With Nonspecific Low Back Pain. J Orthop Sports Phys Ther 2019; 49:725-735. [PMID: 31443624 DOI: 10.2519/jospt.2019.8776] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Subgroups for Targeted Treatment (STarT) Back Screening Tool (SBST) screens patients with low back pain and directs them to different levels of physical therapy treatment. The SBST is also used to monitor changes in a range of modifiable prognostic factors. However, the current evidence on the responsiveness of the SBST is limited. OBJECTIVES To test the responsiveness of the SBST at 6 weeks and 6 months. METHODS This measurement property study is a secondary analysis of data from 2 previous studies that included 348 participants with nonspecific low back pain. All participants were assessed at baseline, 6 weeks, and 6 months. To detect clinical changes, the SBST was compared to 3 one-dimensional constructs: global perceived effect, disability, and pain intensity. To assess responsiveness, we tested 15 specific predefined hypotheses based on correlation, effect size, and receiver operating characteristic curve analyses. If 75% or more of the hypotheses were accepted, then responsiveness was considered to be high. RESULTS Most of the hypotheses were accepted. Testing the SBST as a continuous score, 85.7% and 87.5% of the hypotheses were accepted at 6 weeks and 6 months, respectively. For medium- and high-risk subgroups, 85.7% and 87.5% of the hypotheses were accepted at 6 weeks and 6 months. The low-risk subgroup had 42.9% of the hypotheses accepted at 6 weeks and 100% of the hypotheses accepted at 6 months. CONCLUSION The SBST had high responsiveness at 6 weeks in subgroups of patients with a medium and high risk, and poor responsiveness in those with a low risk, of persistent disability. The SBST has high responsiveness in all SBST subgroups at 6 months. Clinicians can confidently use the SBST to measure changes over time in terms of subgroups. LEVEL OF EVIDENCE Longitudinal clinical measurement, level 1b. J Orthop Sports Phys Ther 2019;49(10):725-735. Epub 23 Aug 2019. doi:10.2519/jospt.2019.8776.
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Elsabbagh L, Al-Atwi T, Aldossary D, Alshami AM, Hill JC, Abu-Ras W, Huijer HAS, Brooks D. Cross-cultural adaptation and validation of the STarT Back Tool for Arabic speaking adults with low back pain in Saudi Arabia. J Orthop Sci 2019; 24:200-206. [PMID: 30528225 DOI: 10.1016/j.jos.2018.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/24/2018] [Accepted: 09/04/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND The STarT Back Tool (Subgrouping for Targeted Treatment; SBT) was developed and validated in the United Kingdom for adults with non-specific low back pain (LBP) to provide risk stratification groups. An Arabic version has not yet been developed. Consequently, our objectives were: First, to cross-culturally adapt the SBT for use in Arabic speaking adults (SBT-Ar) with LBP. Second, to assess the face, content and construct validity of SBT-Ar against relevant reference standards. METHODS This was a prospective, cross-sectional study carried out in the outpatient department in a tertiary care hospital. A total of 59 participants (aged 18-60) with LBP able to read Arabic completed the questionnaire. SBT cross-cultural adaptation was performed according to published guidelines. Face and content validity were explored by individual interviews. Construct validity was assessed using pre-hypothesized correlations with relevant reference standards. RESULTS Following 48 individual interviews the SBT final version was reached and demonstrated face and content validity. The SBT-Ar total score and psychosocial sub-scale had acceptable internal consistency and no redundancy (Cronbach α = 0.7). Moderate Spearman's correlations were found between the SBT-Ar total score and reference standards (Arabic Pain Numeric Rating Scale NRS-Ar r = 0.50 and Arabic Oswestry Disability Index ODI-ar r = 0.51). As expected the SBT-Ar psychosocial subscale had medium to high correlations with the psychosocial reference measures (Arabic Fear-Avoidance Beliefs Questionnaire Physical Activity FABQPA-Ar r = 0.41, Arabic Hospital Anxiety and Depression Scale-Anxiety HADSA-Ar r = 0.58, Arabic Hospital Anxiety and Depression Scale-Depression HADSD-Ar r = 0.45 and Arabic Pain Catastrophizing Scale PCSAr r = 0.69).The SBT-Ar showed no significant floor or ceiling effects. CONCLUSION This study culturally adapted and preliminary validated SBT into Arabic. STUDY DESIGN Prospective, Cross-sectional.
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Affiliation(s)
- Lina Elsabbagh
- Physical Therapy Department, Faculty of Medicine, University of Toronto, Toronto, Canada; Physical Therapy Department, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia.
| | - Tasneem Al-Atwi
- Physical Therapy Department, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Dhai Aldossary
- Physical Therapy Department, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Ali M Alshami
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jonathan C Hill
- Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - Wahiba Abu-Ras
- School of Social Work, Adelphi University, Garden City, NY, USA; Doha Institute for Graduate Studies, School of Psychology and Social Work, Al-Daayen, Qatar
| | | | - Dina Brooks
- Physical Therapy Department, Faculty of Medicine, University of Toronto, Toronto, Canada
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Validity and reproducibility of the modified STarT Back Tool (Dutch version) for patients with neck pain in primary care. Musculoskelet Sci Pract 2017. [PMID: 28644962 DOI: 10.1016/j.msksp.2017.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the reliability and validity of the Dutch version of the STarT Back screening Tool (SBT), for patients with neck pain. METHODS We modified the SBT to fit patients with neck pain. General practitioners and physiotherapists included patients who completed both a baseline and a follow-up questionnaire at 3 days and 3 months, respectively. The construct validity was assessed using Pearson's correlation between the SBT and the reference questionnaires. The reproducibility was assessed in the first week using the quadratic weighted kappa and the specific agreement. Predictive validity was assessed using a relative-risk ratio (RR) for, amongst others, persisting disability at 3 months. Content validity was analysed using both floor and ceiling effects. RESULTS In total, 100 patients were included; 58% were categorised as being at "low risk" for persisting disability, 37% at "medium risk" and 5% at "high risk". As expected for the construct validity, we found a moderate to high correlation for all questions except for activity question 3. The reproducibility had a quadratic-weighted kappa of 0.58, and a specific agreement of 90.9% for "low-risk" and 66.7% for "medium-risk" patients. The RRs for persisting disability for "medium-risk" against "low-risk" patients were 1.5 (95% C.I. 0.9-2.4) and 1.5 (95% C.I. 0.5-4.1) for pain. The sample size for high-risk patients was low. CONCLUSION The original SBT is modified to fit patients with neck pain in Dutch primary care. The psychometric analysis indicates sufficiently reliable outcomes, although the predictive validity showed statistically insignificant results.
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Evaluation of Cross-Cultural Adaptation and Measurement Properties of STarT Back Screening Tool: A Systematic Review. J Manipulative Physiol Ther 2017; 40:558-572. [DOI: 10.1016/j.jmpt.2017.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/11/2017] [Accepted: 07/21/2017] [Indexed: 11/20/2022]
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Longitudinal Monitoring of Patients With Chronic Low Back Pain During Physical Therapy Treatment Using the STarT Back Screening Tool. J Orthop Sports Phys Ther 2017; 47:314-323. [PMID: 28355979 DOI: 10.2519/jospt.2017.7199] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Preplanned secondary analysis of a randomized clinical trial. Background The STarT Back Screening Tool (SBST) was developed to screen and to classify patients with low back pain into subgroups for the risk of having a poor prognosis. However, this classification at baseline does not take into account variables that can influence the prognosis during treatment or over time. Objectives (1) To investigate the changes in risk subgroup measured by the SBST over a period of 6 months, and (2) to assess the long-term predictive ability of the SBST when administered at different time points. Methods Patients with chronic nonspecific low back pain (n = 148) receiving physical therapy care as part of a randomized trial were analyzed. Pain intensity, disability, global perceived effect, and the SBST were collected at baseline, 5 weeks, 3 months, and 6 months. Changes in SBST risk classification were calculated. Hierarchical linear regression models adjusted for potential confounders were built to analyze the predictive capabilities of the SBST when administered at different time points. Results A large proportion of patients (60.8%) changed their risk subgroup after receiving physical therapy care. The SBST improved the prediction for all 6-month outcomes when using the 5-week risk subgroup and the difference between baseline and 5-week subgroup, after controlling for potential confounders. The SBST at baseline did not improve the predictive ability of the models after adjusting for confounders. Conclusion This study shows that many patients change SBST risk subgroup after receiving physical therapy care, and that the predictive ability of the SBST in patients with chronic low back pain increases when administered at different time points. Level of Evidence Prognosis, 2b. J Orthop Sports Phys Ther 2017;47(5):314-323. Epub 29 Mar 2017. doi:10.2519/jospt.2017.7199.
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The Japanese version of the STarT Back Tool predicts 6-month clinical outcomes of low back pain. J Orthop Sci 2017; 22:224-229. [PMID: 28025022 DOI: 10.1016/j.jos.2016.11.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/11/2016] [Accepted: 12/02/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND The STarT Back Tool classifies patients into low-, medium-, or high-risk groups according to risk for chronic low back pain. The Japanese version of the STarT Back Tool (STarT-J) has been translated and psychometrically validated. The present analysis investigated the predictive ability of the STarT-J. METHODS Baseline data were collected through an online survey conducted with Japanese patients with low back pain. Long-term outcomes were assessed in a 6-month follow-up survey. Clinical outcomes at 6 months were evaluated with a pain numerical rating scale, the Roland-Morris Disability Questionnaire, and the EuroQol 5 Dimension. Differences in these scores among the three STarT-J risk groups were analyzed. Participants' perceived changes in low back pain and overall health status were examined to determine associations between the chronicity of low back pain at 6 months and STarT-J risk groups. RESULTS Data of 1228 volunteers who responded to the baseline and follow-up surveys were included in this analysis. Mean ± standard deviation (SD) scores for the pain numerical rating scale and the Roland-Morris Disability Questionnaire were highest in the high-risk group (5.6 ± 1.9 and 9.6 ± 7.5) and lowest in the low-risk group (3.9 ± 1.6 and 2.1 ± 3.5). Mean ± SD EuroQol 5 Dimension index scores were lowest in the high-risk group (0.66 ± 0.20) and highest in the low-risk group (0.86 ± 0.14). A small percentage of high-risk patients (5.3%) perceived improvement in low back pain at the 6-month follow-up. CONCLUSIONS The STarT-J predicted 6-month pain and disability outcomes. The STarT-J is an easy-to-use tool to screen for patients who are more likely to have chronic low back pain, and may be useful to initiate stratified care in primary care settings.
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Pilz B, Vasconcelos RA, Teixeira PP, Mello W, Marcondes FB, Hill JC, Grossi DB. Construct and discriminant validity of STarT Back Screening Tool - Brazilian version. Braz J Phys Ther 2017; 21:69-73. [PMID: 28442077 PMCID: PMC5537440 DOI: 10.1016/j.bjpt.2016.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/29/2016] [Accepted: 05/04/2016] [Indexed: 11/29/2022] Open
Abstract
SBST-Brazil showed a moderate to good correlation with disability tools. SBST-Brazil demonstrated weak correlations with fear-avoidance beliefs. SBST-Brazil discriminates LBP patients with disability and fear-avoidance beliefs.
Background The STarT Back Screening Tool (SBST) was developed to stratify low back pain patients according to their risk of future physical disability so that prognostic subgroups can receive matched treatments in primary care. Objective To measure the construct and discriminative validity of the SBST-Brazil questionnaire. Method A hundred and fifty one patients were recruited to test the construct and discriminative validity comparing the SBST-Brazil to the Brazilian Version of the Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMDQ) and Fear-Avoidance Beliefs Questionnaire-Work (FABQ-W) and Physical Activity (FABQ-PA) subscales at baseline. Spearman's rank-order correlation and area under the curve (AUC) derived from receiver operating curves (ROC) for total scores and psychosocial subscale score of the SBST-Brazil were used for construct and discriminant validity analysis, respectively. Results The SBST-Brazil total and psychosocial subscale scores had good and moderate correlation with ODI (r = 0.61; r = 0.56, respectively) and good with RMDQ (r = 0.70; r = 0.64, respectively). Both scores of the SBST-Brazil total and psychosocial subscale correlated weakly and moderately with the FABQ-PA (r = 0.28; r = 0.34, respectively) and weakly with the FABQ-W (r = 0.18; r = 0.20, respectively). The discriminant validity with AUCs for the total and psychosocial subscale scores against reference standard ranged from 0.66 for kinesiophobia to 0.88 for disability. Conclusion The SBST-Brazil showed a moderate to good correlation with the disability tools, but a weak correlation with fear-avoidance beliefs. The results of discriminant validity suggest that SBST-Brazil is able to discriminate low back pain patients with disability and fear-avoidance beliefs.
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Affiliation(s)
- Bruna Pilz
- Núcleo de Estudos e pesquisa, Instituto Wilson Mello, Campinas, São Paulo, Brazil; Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.
| | - Rodrigo A Vasconcelos
- Núcleo de Estudos e pesquisa, Instituto Wilson Mello, Campinas, São Paulo, Brazil; Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Paulo P Teixeira
- Núcleo de Estudos e pesquisa, Instituto Wilson Mello, Campinas, São Paulo, Brazil; Departamento de Ortopedia, Grupo do Joelho de Campinas (GJC), Campinas, SP, Brazil
| | - Wilson Mello
- Núcleo de Estudos e pesquisa, Instituto Wilson Mello, Campinas, São Paulo, Brazil; Departamento de Ortopedia, Grupo do Joelho de Campinas (GJC), Campinas, SP, Brazil
| | - Freddy B Marcondes
- Núcleo de Estudos e pesquisa, Instituto Wilson Mello, Campinas, São Paulo, Brazil; Departamento de Ciências da Cirurgia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Jonathan C Hill
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, United Kingdom
| | - Débora B Grossi
- Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
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An Outcome Measure of Functionality and Pain in Patients with Low Back Disorder: A Validation Study of the Iranian version of Low Back Outcome Score. Asian Spine J 2016; 10:719-27. [PMID: 27559453 PMCID: PMC4995256 DOI: 10.4184/asj.2016.10.4.719] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 01/17/2016] [Accepted: 01/19/2016] [Indexed: 12/01/2022] Open
Abstract
Study Design Cross-sectional study. Purpose This study aimed to cross-culturally translate and validate the low back outcome score (LBOS) in Iran. Overview of Literature Lumbar disc hernia (LDH) is the most common diagnoses of low back pain and imposes a heavy burden on both individual and society. Instruments measuring patient reported outcomes should satisfy cetain psychometric properties. Methods The translation and cross-cultural adaptation of the original questionnaire was performed using Beaton's guideline. A total of 163 patients with LDH were asked to respond to the questionnaire at three points in time: preoperative and twice within 1-week interval after surgery assessments. The Oswestry disabilty index (ODI) was also completed. The internal consistency, test-retest, convergent validity, and responsiveness to change were assessed. Responsiveness to change also was assessed comparing patients' pre- and postoperative scores. Results The mean age of the cohort was 49.8 years (standard deviation=10.1). The Cronbach's alpha coefficients for the LBOS at preoperative and postoperative assessments ranged from 0.77 to 0.79, indicating good internal consistency. Test-retest reliability as performed by intraclass correlation coefficient was found to be 0.82 (0.62–0.91). The instrument discriminated well between sub-groups of patients who differed in the Finneson-Cooper score. The ODI correlated strongly with the LBOS score, lending support to its good convergent validity (r=––0.83; p<0.001). Further analysis also indicated that the questionnaire was responsive to change (p<0.001). Conclusions The Iranian version of LBOS performed well and the findings suggest that it is a valid measure of back pain treatment evaluation among LDH patients.
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Matsudaira K, Oka H, Kikuchi N, Haga Y, Sawada T, Tanaka S. Psychometric Properties of the Japanese Version of the STarT Back Tool in Patients with Low Back Pain. PLoS One 2016; 11:e0152019. [PMID: 27002823 PMCID: PMC4803233 DOI: 10.1371/journal.pone.0152019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/08/2016] [Indexed: 12/19/2022] Open
Abstract
Background and Objective The STarT Back Tool uses prognostic indicators to classify patients with low back pain into three risk groups to guide early secondary prevention in primary care. The present study aimed to evaluate the psychometric properties of the Japanese version of the tool (STarT-J). Methods An online survey was conducted among Japanese patients with low back pain aged 20–64 years. Reliability was assessed by examining the internal consistency of the overall and psychosocial subscales using Cronbach’s alpha coefficients. Spearman’s correlation coefficients were used to evaluate the concurrent validity between the STarT-J total score/psychosocial subscore and standard reference questionnaires. Discriminant validity was evaluated by calculating the area under the curves (AUCs) for the total and psychosocial subscale scores against standard reference cases. Known-groups validity was assessed by examining the relationship between low back pain-related disability and STarT-J scores. Results The analysis included data for 2000 Japanese patients with low back pain; the mean (standard deviation [SD]) age was 47.7 (9.3) years, and 54.1% were male. The mean (SD) STarT-J score was 2.2 (2.1). The Cronbach’s alpha coefficient was 0.75 for the overall scale and 0.66 for the psychosocial subscale. Spearman’s correlation coefficients ranged from 0.30 to 0.59, demonstrating moderate to strong concurrent validity. The AUCs for the total score ranged from 0.65 to 0.83, mostly demonstrating acceptable discriminative ability. For known-groups validity, participants with more somatic symptoms had higher total scores. Those in higher STarT-J risk groups had experienced more low back pain-related absences. Conclusions The overall STarT-J scale was internally consistent and had acceptable concurrent, discriminant, and known-groups validity. The STarT-J can be used with Japanese patients with low back pain.
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Affiliation(s)
- Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- * E-mail:
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Norimasa Kikuchi
- Clinical Study Support, Inc., Nagoya, Aichi, Japan
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Yuri Haga
- Clinical Study Support, Inc., Nagoya, Aichi, Japan
| | - Takayuki Sawada
- Clinical Study Support, Inc., Nagoya, Aichi, Japan
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Abedi M, Manshadi FD, Khalkhali M, Mousavi SJ, Baghban AA, Montazeri A, Parnianpour M. Translation and validation of the Persian version of the STarT Back Screening Tool in patients with nonspecific low back pain. ACTA ACUST UNITED AC 2015; 20:850-4. [DOI: 10.1016/j.math.2015.04.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/30/2015] [Accepted: 04/07/2015] [Indexed: 11/25/2022]
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Karstens S, Krug K, Hill JC, Stock C, Steinhaeuser J, Szecsenyi J, Joos S. Validation of the German version of the STarT-Back Tool (STarT-G): a cohort study with patients from primary care practices. BMC Musculoskelet Disord 2015; 16:346. [PMID: 26559635 PMCID: PMC4642614 DOI: 10.1186/s12891-015-0806-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/05/2015] [Indexed: 12/19/2022] Open
Abstract
Background Current research emphasizes the high prevalence and costs of low back pain (LBP). The STarT Back Tool was designed to support primary care decision making for treatment by helping to determine the treatment prognosis of patients with non-specific low back pain. The German version is the STarT-G. The cross-cultural translation of the tool followed a structured and widely accepted process but to date it was only partially validated with a small sample. The aim of the study was to test the psychometric properties construct validity, discriminative ability, internal consistency and test-retest-reliability of the STarT-G and to compare them with values given for the original English version. Methods A consecutive cohort study with a two-week retest was conducted among patients with non-specific LBP, aged 18 to 60 years, from primary care practices. Questionnaires were collected before the first consultation, and two weeks later by post, using the following reference standards: the Roland and Morris disability questionnaire, the Tampa Scale of Kinesiophobia, the Pain Catastrophizing Scale and the Hospital Anxiety and Depression Scale. Psychometric properties examined included the tool’s discriminative abilities, whether the psychosocial subscale was one factor, internal consistency, item redundancy, test-retest reliability and floor and ceiling effects. Results There were 228 patients recruited with a mean age of 42.2 (SD 11.0) years, and 53 % were female. The areas under the curve (AUC) for discriminative ability ranged from 0.70 (STarT-G Subscale - Pain Catastrophizing Scale; CI95 0.63, 0.78) to 0.77 (STarT-G Total - Composite reference standard, CI95 0.60, 0.94). Factor loadings ranged from 0.49 to 0.74. Cronbach’s alpha testing the internal consistency and redundancy for the total/subscale scores were α = 0.52/0.55 respectively. The STarT-G test-retest reliability Kappa values for the total/subscale scores were 0.67/0.68 respectively. No floor or ceiling effects were present. Conclusions The STarT-G shows acceptable psychometric properties although not in exact agreement with the original English version. The items previously regarded as a psychosocial subscale may be better seen as an index of different individual psychosocial constructs. The relevance of using the tool at the point of consultation should be further examined.
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Affiliation(s)
- Sven Karstens
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
| | - Katja Krug
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Jonathan C Hill
- Institute of Primary Care and Health Sciences, Keele University, Keele/Stoke-on-Trent, United Kingdom
| | - Christian Stock
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Jost Steinhaeuser
- Institute of Family Medicine, University Hospital Schleswig-Holstein Campus Luebeck, Luebeck, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefanie Joos
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.,Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
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Transcultural adaption and psychometric properties of the STarT Back Screening Tool among Finnish low back pain patients. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:287-295. [DOI: 10.1007/s00586-015-3804-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/26/2022]
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Pilz B, Vasconcelos RA, Marcondes FB, Lodovichi SS, Mello W, Grossi DB. The Brazilian version of STarT Back Screening Tool - translation, cross-cultural adaptation and reliability. Braz J Phys Ther 2014; 18:453-61. [PMID: 25372008 PMCID: PMC4228631 DOI: 10.1590/bjpt-rbf.2014.0028] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 03/31/2014] [Indexed: 11/22/2022] Open
Abstract
Background: Psychosocial factors are not routinely identified in physical therapy
assessments, although they can influence the prognosis of patients with low back
pain. The "STarT Back Screening Tool" (SBST) questionnaire aids in screening such
patients for poor prognosis in the primary care setting and classifies them as
high, medium, or low risk based on physical and psychosocial factors. Objectives: This study sought to translate and cross-culturally adapt the SBST to the
Brazilian Portuguese language and test the reliability of the Brazilian version.
Method: The first stage of the study consisted of the translation, synthesis, and
back-translation of the original version of the STSB, including revision by the
Translation Group, pretest of the translated version, and assessment by an expert
panel. The pre-final Brazilian version was applied to 2 samples comprising 52
patients with low back pain; these patients were of both genders and older than 18
years of age. To assess the instrument's reliability, an additional sample
comprising 50 patients was subjected to 2 interviews, and the results were
assessed using the quadratic weighted kappa value. The instrument's internal
consistency was assessed using Cronbach's alpha (n=105), and the standard error of
measurement was also calculated (n=50). Results: Translation and back-translation attained consensus, and only item 6 required
changes; the reformulated version was applied to an additional sample comprising
52 individuals who did not report any doubts related to this item. The reliability
of the SBST-Brazil was 0.79 (95% confidence interval: 0.63-0.95), the internal
consistency was 0.74 for the total score and 0.72 for the psychosocial subscale,
and the standard error of measurement was 1.9%. Conclusion: The translated and cross-culturally adapted SBST-Brazil proved to be reliable for
screening patients according to their risk of poor prognosis and the presence of
psychosocial factors.
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Affiliation(s)
- Bruna Pilz
- Instituto Wilson Mello, Campinas, SP, Brazil
| | | | | | - Samuel S Lodovichi
- Centro Universitário da Fundação Educacional de Guaxupé, Guaxupé, MG, Brazil
| | | | - Débora B Grossi
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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