Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore.
Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore, Singapore.
Disabil Rehabil. 2022 Aug;44(16):4452-4458. doi: 10.1080/09638288.2021.1883750. Epub 2021 Feb 12.
The association of the modified STarT Back Tool (mSBT) psychosocial measure with gait speed and knee pain in knee osteoarthritis is not well defined. This study aimed to, in patients with knee osteoarthritis, (i) examine the convergent validity of mSBT with the Hospital Anxiety and Depression Scale (HADS) and (ii) compare the predictive validity of mSBT and HADS with gait speed and knee pain.
We performed a retrospective cohort analysis of mSBT, HADS, gait speed, and knee pain outcomes data collected from 119 patients who received outpatient physical therapy. Of these patients who were evaluated at their first (baseline) physical therapy visit, 55 had available data at the Week-16 follow-up visit.
mSBT and HADS showed moderately strong pairwise correlations (Spearman correlation > 0.57; < 0.001). After adjusting for age, sex, body weight, and knee impairment variables in multivariable linear mixed-effects analyses, mSBT was associated with gait speed ( < 0.001) and knee pain intensity ( < 0.001) and it had comparable strength of association as HADS. In within-patient regression analyses, change in mSBT was associated with changes in gait speed ( = 0.04) and knee pain ( = 0.01) over 16 weeks.
The mSBT had convergent validity with HADS and it showed predictive validity with gait speed and knee pain in knee osteoarthritis. Although broader validation is required, the 5-item mSBT psychosocial measure may be applied as part of routine clinical care to assess psychological distress in patients with knee osteoarthritis.IMPLICATIONS FOR REHABILITATIONThe 5-item psychosocial subscale of the modified STarT Back tool (mSBT) showed good convergent validity with the 14-item Hospital Anxiety and Depression Scale in patients with knee osteoarthritis.The mSBT psychosocial subscale showed predictive validity, at both cross-sectional and longitudinal levels, with gait speed and knee pain in patients with knee osteoarthritis.The mSBT can potentially be used in the busy clinical setting to assess psychological distress in patients with knee osteoarthritis.
改良 STarT 后背工具（mSBT）的心理社会测量与膝骨关节炎患者的步态速度和膝关节疼痛之间的关联尚不清楚。本研究旨在：（i）在膝骨关节炎患者中，检查 mSBT 与医院焦虑和抑郁量表（HADS）的收敛效度；（ii）比较 mSBT 和 HADS 与步态速度和膝关节疼痛的预测效度。
我们对接受门诊物理治疗的 119 例患者的 mSBT、HADS、步态速度和膝关节疼痛结局数据进行了回顾性队列分析。在这些接受首次（基线）物理治疗就诊评估的患者中，有 55 例在第 16 周随访时可获得数据。
mSBT 和 HADS 之间呈中度强相关（Spearman 相关系数>0.57；<0.001）。在多变量线性混合效应分析中，调整年龄、性别、体重和膝关节损伤变量后，mSBT 与步态速度（<0.001）和膝关节疼痛强度（<0.001）相关，其关联强度与 HADS 相当。在患者内回归分析中，mSBT 的变化与 16 周内步态速度（=0.04）和膝关节疼痛（=0.01）的变化相关。
mSBT 与 HADS 具有收敛效度，并且在膝骨关节炎患者的步态速度和膝关节疼痛方面具有预测效度。虽然需要更广泛的验证，但 5 项 mSBT 心理社会测量可能会作为常规临床护理的一部分应用，以评估膝骨关节炎患者的心理困扰。
改良 STarT 后背工具（mSBT）的 5 项心理社会分量表在膝骨关节炎患者中与 14 项医院焦虑和抑郁量表具有良好的收敛效度。mSBT 心理社会分量表在横断面和纵向水平上均具有预测效度，与膝骨关节炎患者的步态速度和膝关节疼痛相关。mSBT 可在繁忙的临床环境中用于评估膝骨关节炎患者的心理困扰。
