The Brazilian version of STarT Back Screening Tool - translation, cross-cultural adaptation and reliability

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.

Validity And Reliablity Of Turkish Version of STarT Back Screening Tool

“…ICC values for SBST ranged from 0.67 (Finnish version) to 0.93 (Mandarin version). [24][25][26][27][28][29][30] Smilarly, in our study, the ICC scores for test-retest reliability were excellent for both the overall scale and psychosocial subscale (0.90 and 0.93, respectively).…”

Cross-cultural adaptation and validation to Brazil of the Medication Counseling Behavior Guidelines

“…As proposed by Borsa et al (2012), the cross-cultural adaptation of the instrument was carried out not only through a literal translation but also through the careful evaluation of its measures, considering the context and specific cultural aspects. For Brazil, in particular, this task is critical due to regional, social, and cultural differences which makes this task relevant (Pilz et al, 2014). In addition, grammar and vocabulary aspects were evaluated, and pronouns and verbal tenses were standardized to solve discrepancies in meaning and content between versions.…”

Classification of Low Back Pain Into Subgroups for Diagnostic and Therapeutic Clarity

“…Prior to the commencement of the evaluations, all participants provided the written Informed Consent Form (ICF) to participate in the study and they completed an identification questionnaire. They also completed three questionnaires: the STarT Back Screening Tool (SBST), consisting of nine items, four of which are related to pain, dysfunction, and comorbidities and five of which are related to the psychosocial part, such as discomfort, fear, anxiety, and depression; 8 the Oswestry Disability Index 2.0 (ODI), composed of ten questions, the first assessing pain and the other nine, the result of pain on daily living activities (DLAs); 9 and the Fear Avoidance Beliefs questionnaire in the version validated for Brazil (FABQ-Brasil), consisting of sixteen questions, the first five of which referring to beliefs about physical activity and the other 11 questions related to occupational beliefs. 10 The physical therapy assessment consisted of evaluating the ability or inability to perform spinal movements using the following techniques: the de Sèze test, performed standing; the Lasègue test, applied with the volunteer in the supine position on a stretcher; the Slump test, conducted with the individual sitting on a stretcher; the Valsalva Maneuver, sitting in a chair; the Visual Analog Scale (VAS) for pain, using a horizontal line to visualize and indicate the score on the scale; and the Pressure Pain Threshold (PPT) to evaluate the lumbar iliocostalis muscle using a Kratos model DDK electronic dynamometer-type pressure algometer with measurements up to 100 kgf, applied with the individual in the prone position and instructed to push a button that blocks the algometer screen when the sensation of pressure turns into pain.…”