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. 2021 Oct 20:12:740851.
doi: 10.3389/fpsyg.2021.740851. eCollection 2021.

Factor Structure, Validity, and Reliability of the STarT Back Screening Tool in Italian Obese and Non-obese Patients With Low Back Pain

Emanuele Maria Giusti  1   2 , Giorgia Varallo  1   2 , Alessandra Abenavoli  3 , Gian Mauro Manzoni  4   2 , Luca Aletti  3 , Paolo Capodaglio  5   6 , Gianluca Castelnuovo  1   2 , Alberto Maggiani  3
Affiliations

Factor Structure, Validity, and Reliability of the STarT Back Screening Tool in Italian Obese and Non-obese Patients With Low Back Pain

Emanuele Maria Giusti et al. Front Psychol. .

Abstract

Background: The STarT Back Screening Tool (SBST) is a self-report questionnaire developed for prognostic purposes which evaluates risk factors for disability outcomes in patients with chronic low back pain. Previous studies found that its use enables to provide a cost-effective stratified care. However, its dimensionality has been assessed only using exploratory approaches, and reports on its psychometric properties are conflicting. Objective: The objective of this study was to assess the factorial structure and the psychometric properties of the Italian version of the STarT Back Screening Tool (SBST). Materials and Methods: Patients with medical diagnosis of low back pain were enrolled from a rehabilitation unit of a tertiary care hospital specialized in obesity care (Sample 1) and from a clinical internship center of an osteopathic training institute (Sample 2). At baseline and after 7 days patients were asked to fill a battery of self-report questionnaires. The factorial structure, internal consistency, test-retest reliability, and construct validity of the SBST were assessed. Results: One hundred forty-six patients were enrolled (62 from Sample 1 and 84 from Sample 2). The confirmatory factor analysis showed that the fit of the original two-correlated factors model was adequate (CFI = 0.98, TLI = 0.99, RMSEA = 0.03). Cronbach's α of the total scale (α = 0.64) and of the subscales (physical subscale α = 0.55; psychological subscale α = 0.61) was below the cutoffs, partly because of the low correlation of item 2 with the other items. Test-retest reliability was adequate (ICC = 0.84). The SBST had moderate correlations with comparisons questionnaires, except for the Roland-Morris Disability Questionnaire, which had a high correlation (r = 0.65). Discussion: The SBST has adequate psychometric properties and can be used to assess prognostic factors for disability in low back pain patients.

Keywords: STarT back screening tool; back pain; obesity; prognosis; rehabilitation; reliability; risk factors; validity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Confirmatory factor analysis of the Start Back Screening Tool evaluating a two correlated factors model.
Figure 2
Figure 2
Correlations between the Start Back Screening Tool and the comparator instruments. PCS, Pain Catastrophizing Scale; RMDQ, Roland Morris Disability Questionnaire; TSK, Tampa Scale for Kinesiophobia; NRS, Numeric Rating Scale; SBST-Ph, Start Back Screening Tool—Physical subscale; SBST-Ps, Start Back Screening Tool—Psychological subscale.
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References

    1. Abedi M., Manshadi F. D., Khalkhali M., Mousavi S. J., Baghban A. A., Montazeri A., et al. . (2015). Translation and validation of the Persian version of the STarT Back Screening Tool in patients with nonspecific low back pain. Man. Ther. 20, 850–854. 10.1016/j.math.2015.04.006 - DOI - PubMed
    1. Ami N. B., Weisman A., Yona T., Shashua A., Hill J., Pincus T. (2020). STarT back tool retained its predicting abilities in patients with acute and sub-acute low back pain after a transcultural adaptation and validation to Hebrew. Musculoskelet. Sci. Pract. 46:102134. 10.1016/j.msksp.2020.102134 - DOI - PubMed
    1. Bollen K. A., Diamantopoulos A. (2017). In defense of causal-formative indicators: a minority report. Psychol. Methods 22, 581–596. 10.1037/met0000056 - DOI - PMC - PubMed
    1. Castelnuovo G., Giusti E. M., Manzoni G. M., Saviola D., Gatti A., Gabrielli S., et al. . (2016). Psychological considerations in the assessment and treatment of pain in neurorehabilitation and psychological factors predictive of therapeutic response: evidence and recommendations from the Italian consensus conference on pain in neurorehabilitation. Front. Psychol. 7:468. 10.3389/fpsyg.2016.00468 - DOI - PMC - PubMed
    1. Cecchi F., Negrini S., Pasquini G., Paperini A., Conti A. A., Chiti M., et al. . (2012). Predictors of functional outcome in patients with chronic low back pain undergoing back school, individual physiotherapy or spinal manipulation. Eur. J. Phys. Rehabil. Med. 48, 371–378. - PubMed