Transcultural adaption and psychometric properties of the STarT Back Screening Tool among Finnish low back pain patients.

PURPOSE: The STarT Back Screening Tool (SBST) is a 9-item questionnaire designed for screening low back pain (LBP) patients into three prognostic groups for stratified care. The stratified care approach has proven to be clinically more beneficial and cost-effective than the current best physiotherapy practice. The objective of this study was to translate, culturally adapt and study psychometric properties of the SBST among Finnish LBP patients. METHODS: The SBST was translated into Finnish using appropriate translation guidelines. A total of 116 patients were recruited from outpatient clinics. They were asked to fill out two questionnaires within 1-7 days. The first questionnaire set included the SBST, Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) and intensities of back and leg pain (10-cm Visual Analogue Scale). The second questionnaire form included the SBST and a question about persistence of symptoms. RESULTS: Some linguistic and cultural differences emerged during the translation process with item 1 ("spread down my legs"), item 2 ("neck and shoulder pain"), item 6 ("worrying thoughts") and item 9 ("bothersome"). The test-retest reliability of the SBST total score was excellent (intraclass correlation coefficient 0.78) and of the psychosocial subscale good (0.68). Cronbach's alpha for the psychosocial subscale was 0.55. Spearman's correlation coefficient between SBST total score and BDI was 0.38, ODI 0.39, ÖMPSQ 0.45, intensity of leg pain 0.45 and LBP 0.31. Based on analysis of variance, the SBST discriminated low- and medium-risk groups better than medium- and high-risk groups. CONCLUSIONS: The Finnish translation of the SBST is linguistically accurate and has been adapted to the Finnish-speaking population. It showed to be a valid and reliable instrument and comparable with the original English version. Therefore, it may be used in clinical work with Finnish LBP patients.

Placement of forearm surface EMG electrodes in the assessment of hand loading in manual tasks.

Surface electromyography (EMG) is commonly used to study the loading of the forearm. Pro-supination movements cause surface electrodes to move in relation to the underlying muscles. We studied the effects of different electrode locations and forearm postures on the association between the EMG signals and external hand load in a laboratory experiment. Eleven subjects performed simulated work tasks with the forearm in neutral, pronated or supinated postures and with systematic variation of external load. The tasks included isometric gripping, pushing and pulling, and lifting and lowering weights. Surface EMG was recorded by six pairs of electrodes located on the forearm. The associations were studied using multiple regression models. EMG activity varied according to the forearm posture, location of electrodes and type of simulated task. Variation was lowest with a through-forearm setting of electrodes. This setting also showed the highest correlation between external loads and the EMG activity [coefficient of determination (R (2)) = 0.25-0.66]. PRACTITIONER SUMMARY: Moving of surface electrodes in relation to the underlying muscles interferes with the assessment of loading in ergonomic settings. This laboratory experiment showed that a through-forearm location of electrodes seems to be an optimal option in the assessment of forearm loading.

Expert assessment of physical ergonomics at video-display unit workstations: repeatability, validity and responsiveness to changes.

AIMS: Inter-observer repeatability, validity and responsiveness to change were determined for an expert assessment method for video-display unit (VDU) workstation ergonomics. The aim was to determine to what extent the expert assessment of ergonomics is related to the technical measurements, tidiness and space, work chair ergonomics and responds to changes in these characteristics. METHODS: Technical measurements and video-recordings before and 2 months after an ergonomic intervention were made for 109 VDU office workstations. Two experts in ergonomics analysed and rated the ergonomics of the workstations. A researcher analysed tidiness and available space. A physiotherapist classified the work chairs used according to their ergonomic properties. RESULTS: The intra-class correlation coefficient between the workstation ergonomic ratings of the two experts was 0.74 at the baseline and 0.81 at the follow-up. Workstation tidiness and space, and work chair ergonomics, had a strong effect on the assessments of both experts. For both experts a change in the locations of the mouse, the screen and the keyboard and values of tidiness and space and work chair ergonomics during the intervention showed a significant association with the ratings. CONCLUSION: The assessment method studied can be utilized by an expert in a repeatable manner both in cross-sectional and in longitudinal settings.