Translation and validation of the Persian version of the STarT Back Screening Tool in patients with nonspecific low back pain

Objective: To translate the STarT Back Screening Tool (SBT) into Persian and to investigate the psychometric properties of the new version in a group of patients with Non-Specific Low Back Pain (NSLBP). Background: The STarT is a validated questionnaire used for subgrouping LBP patients at three levels of low-, medium-, and high-risk, based on the risk of chronicity. It has previously been translated and validated in different languages. Methods: The translation and validation of the original questionnaire were carried out in accordance with the standard guidelines. To approve the construct validity, 295 patients with NSLBP completed a questionnaire package. The package comprised of the STarT, Roland-Morris Disability questionnaire (RMDQ), Tampa Scale for Kinesiophobia (TSK), Coping Strategies Questionnaire (CSQ), and Hospital Anxiety and Depression Scale (HADS). To evaluate test-retest reliability, 35 randomly selected NSLBP patients completed the STarT questionnaire within min. 24-hour interval. Results: Factor analysis confirmed two subscales of the STarT. The Cronbach α was .83 and .81 for the STarT and the subscale, respectively. This questionnaire showed excellent test-retest reliability (ICC = .85) (p < 0.01). The correlations between the STarT and RMDQ, CSQ, TSK, and the two subscales of HADS were estimated to be .81, .70, .71, .74, and .71, respectively. The Area under the Curve was also calculated for 6 items and the range was between .734 and .860. Conclusions: The Persian version of the STarT is reliable and valid, and consistent with the original questionaire. Therefore, clinicians to subgroup Persian-speaking NSLBP patients can use it.