Reliability and Validity Evidence of the STarT-Lower Extremity Screening Tool for Patients With Lower Extremity Fracture: A Prospective Study.

To determine whether a modified version of the STarT Back Screening Tool in its current structure has adequate properties for use in patients with lower extremity fracture. Single-center, prospective study. Level I trauma center. Patients with lower extremity fracture without a history of chronic pa...

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Published in:Archives of Physical Medicine & Rehabilitation Vol. 102; no. 2; pp. 261 - 270
Main Authors: Van Wyngaarden, Joshua J., Noehren, Brian, Pennings, Jacquelyn S., Jacobs, Cale, Matuszewski, Paul E., Archer, Kristin R.
Format: research tables/charts Journal Article
Published: W B Saunders Feb2021
Online Access:View this record in EBSCOhost
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      dt: Feb2021
      vid: 102
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      pub: W B Saunders
      place: Philadelphia, Pennsylvania
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        148283434
        148283434
        148283434
        10.1016/j.apmr.2020.08.023
        148283434
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        atl: Reliability and Validity Evidence of the STarT-Lower Extremity Screening Tool for Patients With Lower Extremity Fracture: A Prospective Study.
      aug:
        au:
          Van Wyngaarden, Joshua J.
          Noehren, Brian
          Pennings, Jacquelyn S.
          Jacobs, Cale
          Matuszewski, Paul E.
          Archer, Kristin R.
        affil: Army-Baylor University, Doctoral Program of Physical Therapy, Baylor University, San Antonio, TX
      sug:
        subj:
          Reliability
          Validity
          Lower Extremity Injuries
          Fractures
          Human
          Clinical Assessment Tools
          Prospective Studies
          Questionnaires
      ab: To determine whether a modified version of the STarT Back Screening Tool in its current structure has adequate properties for use in patients with lower extremity fracture. Single-center, prospective study. Level I trauma center. Patients with lower extremity fracture without a history of chronic pain (N=114), with 93% follow-up. Not applicable. Six weeks after surgical fixation, individuals completed the Subgroups for Targeted Treatment of Lower Extremity Screening Tool (STarT-LE). A subsample completed the STarT-LE again 1 week later. The following questionnaires were completed at 6 weeks and 6 months: Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Brief Pain Inventory pain intensity subscale, and PROMIS Depression and Pain Interference computer adaptive testing modules. Reliability was evaluated using intraclass correlation coefficients (ICC) and Cronbach's alpha (α). Convergent validity evidence was measured concurrently using the Spearman ρ correlation between the 6-week STarT-LE and established questionnaires. Predictive validity evidence was evaluated by area under the curve analysis (AUC) using the 6-week STarT-LE total and psychosocial scores and 6-month criterion physical and psychosocial reference standards. The STarT-LE has good test-retest reliability (ICC, 0.85; 95% confidence interval, 0.78-0.91) and acceptable internal consistency (α=0.74). The convergent validity evidence was fair to moderate (ρ, 0.53-0.68; P <.001) and the predictive validity evidence was acceptable to excellent (AUC, 0.73-0.84). The STarT-LE has adequate properties for use in patients with lower extremity fracture. Future larger scale studies are needed to validate risk cutoffs.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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