Cross-cultural adaptation, reliability, validity, and psychometric evaluation of the Tamil version STarT back screening tool among low back pain subjects

The STarT back screening tool helps primary care workers make the initial clinical decision and classify low back pain subjects into subgroups. Currently, the tool is required for stratification/triaging of low back pain and is commonly used in clinical practice, and requires linguistic validation in Tamil. The study aimed to determine the validity and reliability of the Tamil version of the STarT back screening tool. The baseline measurements include the Tamil version of the STarT back screening tool-, pain severity using the Numeric pain rating Scale (NPRS), disability status using the Tamil version of the Roland Morris Disability Questionnaire (RMDQ), and fear avoidance beliefs using the fear-avoidance beliefs questionnaire (FABQ) - Tamil were obtained. After five days, the retest measures are done to investigate the test-retest reliability. The current study showed excellent test-retest reliability of total score (ICC – 0.80) and psychosocial subscore (ICC-0.82) with excellent internal consistency and moderate to high validity with clinical outcomes. The study concludes that the Tamil version of the STarT Back Screening Questionnaire is a reliable and valid tool that reported good understanding and easy completion by the subject.