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STarT MSK tool: Translation, adaptation and validation in Hebrew

Ben Ami, Noa; Hill, Jonathan; Pincus, Tamar

STarT MSK tool: Translation, adaptation and validation in Hebrew Thumbnail


Noa Ben Ami

Tamar Pincus


Abstract Background The Keele STarT MSK Tool divides musculoskeletal patients into three prognostic groups for risk‐stratified care. It has shown good predictive and discriminative ability in development and validation samples. Objectives This study aimed to translate and validate the STarT MSK in a Hebrew version, among Israeli people living with musculoskeletal (MSK) pain. Method A cross‐sectional study, with nested prospective sub‐sample. The STarT MSK was translated into Hebrew using published guidelines. A total of 153 adults (18+) who reported living with MSK pain were administered the STarT MSK. Clinical measures included for validity testing included the 12‐Item Short‐Form Health Survey (SF‐12), the Hospital Anxiety and Depression Scale (HADS), the Fear‐Avoidance Beliefs Questionnaire (FABQ) and a numerical pain rating scale (NPRS). Results The STarT MSK was forward and backward translated, with minor changes to ensure cultural adaptation. The test‐retest reliability of the STarT MSK total score was excellent (intraclass correlation coefficient 0.92). Internal consistency for the MSK scale was (α = 0.612). The Spearman's correlation coefficients between STarT MSK total score and the validation measures confirmed the hypotheses and were significant. Conclusion The Israeli translation and validation of the STarT MSK suggest that it is a valid and reliable instrument. The STarT MSK discriminated low‐, medium‐ and high‐risk groups.


Ben Ami, N., Hill, J., & Pincus, T. (2021). STarT MSK tool: Translation, adaptation and validation in Hebrew. Musculoskeletal Care, 20(3), 541-546.

Journal Article Type Article
Acceptance Date Nov 21, 2021
Online Publication Date Dec 3, 2021
Publication Date Dec 3, 2021
Journal Musculoskeletal Care
Print ISSN 1478-2189
Publisher Wiley
Volume 20
Issue 3
Pages 541-546
Keywords Keele STarT MSK screening tool; musculoskeletal pain; translation; validation
Publisher URL


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