was specifically developed for use in patients with spinal cord injuries to assess their ability to complete routine daily tasks and activities of daily living. 1 The SCIM-III is a clinician-rated instrument comprised of 19 items across 3 subscales: (1) self-care, (2) respiration and sphincter management, and (3) mobility, with items being weighted according to assumed clinical importance. The SCIM-III has shown to be a reliable and valid instrument for the functional evaluation of individuals with spinal cord injuries 2-4 and has been endorsed by relevant stakeholders and outcomes assessment experts for use in clinical and research contexts. [5][6][7] This measure has been shown to be responsive to functional change from admission to discharge and has demonstrated excellent concurrent validity with FIM scores. 8 Minimal detectable change and minimal important difference scores for the SCIM-III have been established, 9 and expected scores for various neurologic levels in spinal cord injury have been reported. 10 Floor and ceiling effects have been noted across all 3 subscales; these effects have been shown to vary according to patients' American Spinal Injury Association motor neurologic grade. 11 The SCIM-III has been translated and validated in multiple languages, [12][13][14][15] and self-report 16 and youth 17 versions have been developed.
Low back pain is commonly experienced by people throughout the world, with the 1-year global prevalence rate estimated at 38.1%, and the 1-year global incidence of people who experience a first-ever episode of low back pain ranging from 6.3% to 15.4%. 1 Yet, the perceived burden of low back pain is often considered minimal, despite that low back pain has been associated with significant activity limitations, work interference, and financial burden worldwide. 2 It is important for clinicians to screen for individuals with low back pain in order to identify and prioritize treatment. The Keele STarT Back Screening Tool (SBST) 3,4 is a brief 9-item instrument used to identify prognostic indicators important for clinicians to make treatment-planning decisions. The SBST assesses 8 unique domains and provides 2 scores for interpretation: (1) a total tool score, and (2) a psychosocial distress score. Clinically derived cut-off scores have been established using receiver operating characteristic analyses 3,4 ; the SBST demonstrates adequate convergent and predictive validity with criterion-standard measures of disability and functioning. 3 Adequate to poor ceiling and floor effects have been reported for the SBST. 5 The SBST total score and psychosocial subscale demonstrate adequate test-retest reliability and adequate internal consistency. 3 The SBST is free to use and can be administered in 5 to 10 minutes, making it a feasible screening tool for use in clinical practice.This abbreviated summary provides a review of the psychometric properties of the SBST in people with low back pain. A full review of the SBST and reviews of nearly 350 other instruments for patients with various health conditions can be found at www. rehabilitationmeasures.org.
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