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

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.