Translation, cross-cultural adaptation, and psychometric testing of the STarT musculoskeletal tool into Yoruba language among persons with low back pain

Abstract Background The STarT Musculoskeletal (MSK) tool is a validated tool used to stratify patients with musculoskeletal disorder, as a guide to applying intervention and prognosticating outcomes. Only few translations and cultural adaptations of it exist. The availability of the tool in local and indigenous languages may help improve comprehensibility and usage among patients. This study was aimed to translate and cross-culturally adapt the STarT MSK tool into the Yoruba language, and to determine its psychometric properties. Methods The first stage of this study involved translation of the English STarT MSK into the the Yoruba language following the Beaton criteria. A total of 55 respondents with low- back pain attending a University Teaching Hospital participated in the validity testing, while 25 patients responded in the reliability test of the tool. The Quadruple Visual Analogue Scale (QVAS) and the Fear Avoidance Belief Questionnaire (FABQ) were used for the convergent and the discriminant validity of the tool. Results The mean age of the respondents was 52.13 ± 13.21 years. The Yoruba version of the STarT MSK (STarT MSK–Y) had an acceptable concurrent validity (r = 0.993; p = 0.001). The discriminant validity of STarT MSK–Y with FABQ yielded correlation co-efficient scores of r = 0.287; p = 0.034 and r = 0.033; p = 0.810 for FABQ-Work and FABQ-physical activities. The result indicated that STarT MSK–Y had fair discriminant validity with FABQ-work and a weak correlation with the FABQ-physical activities. The convergent validity of STarT MSK–Y indicated significant correlations with all domains and global score of the QVAS (r = 0.727; p = 0.001). The test- retest reliability and internal consistency (Cronbach’s alpha = α) of the STarT MSK–Y yielded ICC = 1.00 and α = 0.97 for the global score of the items, respectively. The factor loading for five items were satisfactory ranging from 0.46 to 0.83. Conclusion The STarT MSK–Y has acceptable validity and reliability and can be used as a valid assessment tool among Yoruba- speaking patients with low back pain.