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A validation study of the Iranian version of STarT Back Screening Tool (SBST) in lumbar central canal stenosis patients



This study aimed to translate and validate the STarT Back Screening Tool (SBST) in Iran.


This was a prospective clinical validation study. The translation and cross-cultural adaptation of the original questionnaire was performed, and a total of 269 patients with lumbar central canal stenosis were asked to respond to the questionnaire at their first visits. Patients also were asked to complete the Oswestry Disability Index (ODI). Reliability was assessed by internal consistency using the Cronbach’s alpha coefficient. Validity was evaluated by performing convergent validity and responsiveness to change.


Mean patient age was 58.6 [standard deviation (SD) = 10.9] years; 56.5 % were women. According to patients’ imaging, they were diagnosed as grade 1 (n = 86), grade 2 (n = 107), and grade 3 (n = 76). In general, the SBST showed good psychometric properties. Cronbach’s alpha coefficient for overall scale (Q1–Q9) and psychosocial subscale (Q5–Q9) was 0.82 and 0.79, respectively. The ODI correlated strongly with overall SBST scores, lending support to its good convergent validity (r = 0.81; P < 0.001). Responsiveness to change also indicated desirable results.


In general, the Iranian version of the SBST performed well, and findings suggest that it is a reliable and valid measure for screening low back pain in patients with lumbar central canal stenosis in primary care settings.

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The authors thank the staff of the Neurosurgery Unit at Imam-Hossain Hospital, Tehran, Iran.

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The authors declare that they have no competing interests.

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Correspondence to Parisa Azimi.

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Azimi, P., Shahzadi, S., Azhari, S. et al. A validation study of the Iranian version of STarT Back Screening Tool (SBST) in lumbar central canal stenosis patients. J Orthop Sci 19, 213–217 (2014).

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  • Oswestry Disability Index
  • Pain Catastrophizing Scale
  • Iranian Version
  • Persian Version
  • Good Convergent Validity