Validity of the STarT Back Tool in Patients with Low-Back Pain Using Spinal Flexibility Measures

Background: Correlation between prediction tools of disability and traditional physical performance tests in ascertaining disability risks remains unexplored. Objectives: The present study aimed to assess the convergent validity of the STarT back tool (SBT) for predicting disability risk using the spinal range of motion (ROM). Methods: Thirty patients with low-back pain (LBP) volunteered for this study. We used the SBT and Dual inclinometers to assess the future risk for disability and spinal ROM, as well as Anthropometric factors and pain intensity. Results: Poor and moderate spinal ROM for forward (93.3%, 6.7%), left lateral (63.30%, 36.70%) and right lateral (80.00%, 20.00%) flexion respectively were common among the participants. Backward extension ROM (36.70%, 46.70%) was mostly good and very good. There was a 60% medium risk for future physical disability based on SBT. There was no significant association between spinal ROM and SBT future disability prediction (χ^2 = 3.367, P 0.05). Conclusions: The SBT and spinal ROM assessment are independent measures of functional disability. They should complement one another in clinical assessment procedures for effective outcomes in the treatment of LBP.