Translation and psychometric evaluation of the Yoruba version of the STarT Back tool among persons with longterm non-specific low-back pain
Keywords:
STarT Back Tool, Low Back Pain, Yoruba LanguageAbstract
Background. Translating questionnaires into local languages is essential as it aids easy accessibility and understanding of such questionnaires by patients and their health caregivers. The STarT Back Tool (SBT), validated tool used to classify subgroups of persons with Low-Back Pain, has few translated versions. We translated the STarT Back Tool into the Yoruba language and established its psychometric properties among patients with long-term non-specific Low-Back Pain.
Methods. Following the Lenz protocol, the SBT was successfully cross-culturally adapted into the Yoruba language. One hundred consenting patients (mean age = 57.0±11.43 years, 55% females) took part in the validation phase, while 53 of them participated in the test-retest phase. Psychometric indices of the Y-SBT assessed showed internal consistency, intraclass correlation coefficient (ICC), ceiling and floor effects and divergent validity.
Results. The sub- and total Cronbach’s α score for Y-SBT was 0.704 and 0.857, respectively. The test-retest reliability of the sub- and total scores of the Y-SBT yielded an ICC of 0.82 (95% CI: 0.74 - 0.87) and 0.89
(95% CI: 0.84 - 0.93), respectively. The divergent validity for sub- and total-scores of the Y-SBT based on Quadruple Visual Analogue Scale score for on-going pain was r = 0.374 (p = 0.001) and r = 0.432 (p = 0.001), respectively. The Y-SBT had no ceiling or floor effects.
Conclusion. The Y-SBT have acceptable psychometric properties. It is recommended for use among Yoruba speaking patients with LBP.
References
1. Murray CJL, Vos T, Lozano R, et al. Disabilityadjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859): 2197-223. doi:10.1016/S0140-6736(12)61689-4.
2. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet 2012; 379(9814): 482-91. doi:10.1016/S0140-6736(11)60610-7.
3. Hurwitz EL, Randhawa K, Yu H, Côté P, Haldeman S. The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. Eur Spine J 2018; 27(Suppl 6): 796-801. doi:10.1007/s00586-017-5432-9.
4. Stanton TR, Henschke N, Maher CG, Refshauge KM, Latimer J, McAuley JH. After an episode of acute low back pain, recurrence is unpredictable and not as common as previously thought. Spine 2008; 33(26): 2923-8. doi:10.1097/ BRS.0b013e31818a3167.
5. Denis A, Zelmar A, Le Pogam M-A, ChaleatValayer E, Bergeret A, Colin C. The PRESLO study: evaluation of a global secondary low back pain prevention program for health care personnel in a hospital setting. Multicenter, randomized intervention trial. BMC Musculoskelet Disord 2012; 13: 234. doi:10.1186/1471-247413-234.
6. Grotle M, Brox JI, Veierød MB, Glomsrød B, Lønn JH, Vøllestad NK. Clinical course and prognostic factors in acute low back pain: patients consulting primary care for the first time.
Spine 2005; 30(8): 976-82. doi:10.1097/01.
brs.0000158972.34102.6f.
7. Melloh M, Elfering A, Egli Presland C, et al. Identification of prognostic factors for chronicity in patients with low back pain: a review of screening instruments. Int Orthop 2009; 33(2): 301-13. doi:10.1007/s00264-008-0707-8.
8. Turk DC, Okifuji A. Psychological factors in chronic pain: evolution and revolution. J Consult Clin Psychol 2002; 70(3): 678-90. doi:10.1037//0022-006x.70.3.678.
9. Mbada CE, Ayanniyi O, Ogunlade SO, Orimolade EA, Oladiran AB, Ogundele AO. Influence of Mckenzie protocol and two modes of endurance exercises on health-related quality of life of patients with long-term mechanical low-back pain. Pan Afr Med J 2014; 17(Suppl 1): 5.
doi:10.11694/pamj.supp.2014.17.1.2950.
10. Meroni R, Piscitelli D, Ravasio C, et al. Evidence for managing chronic low back pain in primary care: a review of recommendations from highquality clinical practice guidelines. Disabil Rehabil Published online August 1, 2019: 1-15. doi:10.1080/09638288.2019.1645888.
11. Oliveira CB, Maher CG, Pinto RZ, et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J 2018; 27(11): 2791-803. doi:10.1007/s00586-018-5673-2.
12. Mills S, Torrance N, Smith BH. Identification and Management of Chronic Pain in Primary Care: a Review. Curr Psychiatry Rep 2016; 18(2): 22. doi:10.1007/s11920-015-0659-9.
13. Hill JC, Fritz JM. Psychosocial influences on low back pain, disability, and response to treatment. Phys Ther 2011; 91(5): 712-21. doi:10.2522/ ptj.20100280.
14. Costa L da C, Koes BW, Pransky G, Borkan J, Maher CG, Smeets RJ. Primary care research priorities in low back pain: an update. Spine 2013; 38(2): 148-56. doi:10.1097/ BRS.0b013e318267a92f.
15. Sheeran L, Coales P, Sparkes V. Clinical challenges of classification based targeted therapies for non-specific low back pain: What do physiotherapy practitioners and managers think?
Man Ther 2015; 20(3): 456-62. doi:10.1016/j. math.2014.11.008.
16. Hill JC, Dunn KM, Lewis M, et al. A primary care back pain screening tool: Identifying patient subgroups for initial treatment. Arthritis Care Res 2008; 59(5): 632-41. doi:10.1002/ art.23563.
17. Maggiani A, Abenavol A. Italian Translation and Cross-Cultural Adaptation of a Back Pain Screening Questionnaire (Start Back Screening Tool). Ann Ig 2019; 31(1): 69-75. doi:10.7416/ ai.2019.2260.
18. Bruyère O, Demoulin M, Beaudart C, et al. Validity and reliability of the French version of the STarT Back screening tool for patients
with low back pain. Spine 2014; 39(2): E123-8.
doi:10.1097/BRS.0000000000000062.
19. Gusi N, del Pozo-Cruz B, Olivares PR, Hernández-Mocholi M, Hill JC. The Spanish version of the “STarT Back Screening Tool” (SBST) in different subgroups. Aten Primaria 2011; 43(7): 356-61. doi:10.1016/j.aprim.2010.05.019.
20. Aebischer B, Hill JC, Hilfiker R, Karstens S. German Translation and Cross-Cultural Adaptation of the STarT Back Screening Tool.
PLoS ONE 2015; 10(7). doi:10.1371/journal.
pone.0132068.
21. Abedi M, Manshadi FD, Khalkhali M, et al. Translation and validation of the Persian version of the STarT Back Screening Tool in patients with nonspecific low back pain. Man Ther 2015; 20(6): 850-4. doi:10.1016/j.math.2015.04.006.
22. Schmidt P-A, Naidoo V. Cross-cultural adaptation and validation of the STarT back screening tool in isiZulu. South Afr J Physiother 2020; 76(1). doi:10.4102/sajp.v76i1.1402.
23. Onuh CN, Uwadiegwu CUI. A Review of the Communicative Roles of English Language in Multilingual/Ethnic Nigeria. J Niger Lang Cult 2014; 15(1): 63-74.
24. Central Intelligence Agency. Africa :: Nigeria — The World Factbook - Central Intelligence Agency. Available on: https://www.cia.gov/library/publications/resources/the-world-factbook/ geos/ni.html [Last accessed: 2020, Sep 12].
25. Akinkurolere SO, Adewumi SI. Translation and Its Linguistic Implications for Yoruba/ English Bilinguals. Res Humanity Soc Sci RHSS 2015; 3: 16-20.
26. Westman A, Linton SJ, Ohrvik J, Wahlén P, Leppert J. Do psychosocial factors predict disability and health at a 3-year follow-up for patients with non-acute musculoskeletal pain? A validation of the Orebro Musculoskeletal Pain Screening Questionnaire. Eur J Pain 2008; 12(5): 641-9. doi:10.1016/j.ejpain.2007.10.007.
27. Hill JC, Dunn KM, Main CJ, Hay EM. Subgrouping low back pain: a comparison of the STarT Back Tool with the Orebro Musculoskeletal Pain Screening Questionnaire. Eur J Pain 2010; 14(1): 83-9. doi:10.1016/j.ejpain.2009.01.003.
28. Al Zoubi FM, Eilayyan O, Mayo NE, Bussières AE. Evaluation of Cross-Cultural Adaptation and Measurement Properties of STarT Back Screening Tool: A Systematic Review. J Manipulative Physiol Ther 2017; 40(8): 558-72. doi:10.1016/j.jmpt.2017.07.005.
29. Boonstra AM, Schiphorst Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res 2008; 31(2): 165-9. doi:10.1097/ MRR.0b013e3282fc0f93.
30. Lenz AS, Soler IG, Dell’Aquilla J, Uribe PM. Translation and Cross-Cultural Adaptation of Assessments for Use in Counseling Research. Meas Eval Couns Dev 2017; 50(4): 224-31. do i:10.1080/07481756.2017.1320947.
31. Terwee CB, Bot SDM, de Boer MR, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007; 60(1): 34-42. doi:10.1016/j. jclinepi.2006.03.012.
32. Huang Y, Ruan T, Yi Q, Wang T, Guo Z. The health literacy questionnaire among the aged in Changsha, China: confirmatory factor analysis. BMC Public Health 2019; 19. doi:10.1186/ s12889-019-7563-x.
33. Azimi P, Shahzadi S, Azhari S, Montazeri A. A validation study of the Iranian version of STarT Back Screening Tool (SBST) in lumbar central canal stenosis patients. J Orthop Sci 2014; 19(2):
213-7. doi:10.1007/s00776-013-0506-y.
34. Streiner DL, Norman GR, Cairney J. Health Measurement Scales: A Practical Guide to Their Development and Use. 5th ed. Oxford University Press, 2014. Available on: https://oxfordmedicine.com/ view/10.1093/med/9780199685219.001.0001/ med-9780199685219 [Last accessed: 2020, Sep 12].
35. Matsudaira K, Kikuchi N, Murakami A, Isomura T. Psychometric properties of the Japanese version of the Fear-Avoidance Beliefs Questionnaire (FABQ). J Orthop Sci 2014; 19(1): 26-32. doi:10.1007/s00776-013-0471-5.
36. Karstens S, Krug K, Hill JC, et al. 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. doi:10.1186/s12891-015-0806-9.
37. Betten C, Sandell C, Hill JC, Gutke A. Crosscultural adaptation and validation of the Swedish STarT Back Screening Tool. Eur J Physiother 2015; 17(1): 29-36. doi:10.3109/21679169.20 14.1003962.
38. Foster NE, Mullis R, Hill JC, et al. Effect of Stratified Care for Low Back Pain in Family Practice (IMPaCT Back): A Prospective PopulationBased Sequential Comparison. Ann Fam Med 2014; 12(2): 102-111. doi:10.1370/afm.1625.
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