Robinson Hilde Stendal, Dagfinrud Hanne
Department of Health Sciences, Institute of Health and Society, University of Oslo, P.O. Box 1089, Blindern, 0317, Oslo, Norway.
BMC Musculoskelet Disord. 2017 May 31;18(1):232. doi: 10.1186/s12891-017-1553-x.
Low back pain (LBP) is the most common reported musculoskeletal disorder, with large prevalence numbers and high costs. Focus on early identification of patients at risk of developing chronic LBP has increased. The Keele Start Back Tool (SBT) is a questionnaire aiming at screening prognostic indicators in LBP patients, categorizing patients into risk-groups and guide treatment. The aim of this study was to explore the Norwegian version of the SBT with regard to reliability of the SBT-scoring and the screening ability in LBP patients in primary care physiotherapy.
LBP patients answered a package of questionnaires twice, with 1-3 days in between, containing SBT, Hannover functional ability questionnaire, pain intensity questions and demographics. The relative and absolute reliability of SBT was calculated using intraclass correlation coefficient (ICC) and the smallest detectable change respectively. Independent sample t-tests were used for group comparisons.
Fifty-two patients with LBP. Mean age (SD) was 45 (12) years and 62% were female. The ICC (95% CI) for SBT total score and psychosocial subscore was 0.89 (0.82, 0.94) and 0.82 (0.70, 0.90) respectively. None of the participants were allocated to the high risk group. The medium risk group reported significantly more pain last week and more activity limitations than the low risk group at both test and retest (0.001 ≤ p ≤ 0.003), whereas no significant difference between the groups was found on pain now (0.05 ≤ p ≤ 0.16).
The Norwegian version of the SBT was reliable and the screening ability was good as the subgrouping of patients into risk-groups reflected the severity of their back problems. The SBT may be an applicable and useful tool in physiotherapy practice.
腰痛（LBP）是报告中最常见的肌肉骨骼疾病，患病率高且成本高昂。对慢性腰痛高危患者进行早期识别的关注度日益增加。基尔启动背部工具（SBT）是一份问卷，旨在筛查腰痛患者的预后指标，将患者分为风险组并指导治疗。本研究的目的是探讨挪威版SBT在初级保健物理治疗中腰痛患者的SBT评分可靠性和筛查能力。
腰痛患者两次回答一组问卷，间隔1 - 3天，问卷包括SBT、汉诺威功能能力问卷、疼痛强度问题和人口统计学信息。分别使用组内相关系数（ICC）和最小可检测变化计算SBT的相对和绝对可靠性。采用独立样本t检验进行组间比较。
52例腰痛患者。平均年龄（标准差）为45（12）岁，62%为女性。SBT总分和心理社会子评分的ICC（95%可信区间）分别为0.89（0.82，0.94）和0.82（0.70，0.90）。没有参与者被分配到高风险组。在测试和复测时，中风险组上周报告的疼痛明显多于低风险组，活动受限也更多（0.001≤p≤0.003），而两组目前的疼痛无显著差异（0.05≤p≤0.16）。
挪威版SBT可靠，筛查能力良好，因为将患者分为风险组反映了他们背部问题的严重程度。SBT可能是物理治疗实践中一种适用且有用的工具。
