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Transcultural adaption and psychometric properties of the STarT Back Screening Tool among Finnish low back pain patients

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Abstract

Purpose

The STarT Back Screening Tool (SBST) is a 9-item questionnaire designed for screening low back pain (LBP) patients into three prognostic groups for stratified care. The stratified care approach has proven to be clinically more beneficial and cost-effective than the current best physiotherapy practice. The objective of this study was to translate, culturally adapt and study psychometric properties of the SBST among Finnish LBP patients.

Methods

The SBST was translated into Finnish using appropriate translation guidelines. A total of 116 patients were recruited from outpatient clinics. They were asked to fill out two questionnaires within 1–7 days. The first questionnaire set included the SBST, Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) and intensities of back and leg pain (10-cm Visual Analogue Scale). The second questionnaire form included the SBST and a question about persistence of symptoms.

Results

Some linguistic and cultural differences emerged during the translation process with item 1 (“spread down my legs”), item 2 (“neck and shoulder pain”), item 6 (“worrying thoughts”) and item 9 (“bothersome”). The test–retest reliability of the SBST total score was excellent (intraclass correlation coefficient 0.78) and of the psychosocial subscale good (0.68). Cronbach’s alpha for the psychosocial subscale was 0.55. Spearman’s correlation coefficient between SBST total score and BDI was 0.38, ODI 0.39, ÖMPSQ 0.45, intensity of leg pain 0.45 and LBP 0.31. Based on analysis of variance, the SBST discriminated low- and medium-risk groups better than medium- and high-risk groups.

Conclusions

The Finnish translation of the SBST is linguistically accurate and has been adapted to the Finnish-speaking population. It showed to be a valid and reliable instrument and comparable with the original English version. Therefore, it may be used in clinical work with Finnish LBP patients.

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Authors and Affiliations

  1. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland

    Susanna Piironen, Markus Paananen, Katja Ryynänen & Jaro Karppinen

  2. Department of Psychiatry, Oulu University Hospital, Oulu, Finland

    Marianne Haapea

  3. Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland

    Marianne Haapea

  4. Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland

    Markku Hupli

  5. Department of Physical and Rehabilitation Medicine, Lapland Central Hospital, Rovaniemi, Finland

    Paavo Zitting

  6. Rokua Rehabilitation Ltd and Attendo Occupational Health Oulu, Oulu, Finland

    Katja Ryynänen

  7. Finnish Institute of Occupational Health, Health and Work Ability, and Disability Prevention Centre, Oulu and Helsinki, Finland

    Esa-Pekka Takala & Jaro Karppinen

  8. Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland

    Katariina Korniloff & Arja Häkkinen

  9. Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK

    Jonathan C. Hill

  10. Department of Physical Medicine and Rehabilitation and Medicine, Jyväskylä Central Hospital, Jyväskylä, Finland

    Arja Häkkinen

  11. Center for Life Course Epidemiology, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland

    Jaro Karppinen

Authors
  1. Susanna Piironen
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  2. Markus Paananen
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  8. Katariina Korniloff
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  9. Jonathan C. Hill
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  11. Jaro Karppinen
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Correspondence to Jaro Karppinen.

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Piironen, S., Paananen, M., Haapea, M. et al. Transcultural adaption and psychometric properties of the STarT Back Screening Tool among Finnish low back pain patients. Eur Spine J 25, 287–295 (2016). https://doi.org/10.1007/s00586-015-3804-6

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  • DOI: https://doi.org/10.1007/s00586-015-3804-6

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