Reproducibility, responsiveness and validation of the Tampa Scale for Kinesiophobia in patients with ACL injuries

Abstract

Background and purpose Psychological factors including fear of pain, re-injury during movement (kinesiophbia) affect return-to-sport rates after anterior cruciate ligament (ACL) reconstructive surgery. Clinicians often encounter in the daily practice that athletes explain lack of self-confidence or psychological readiness during the sports activity. The Tampa Scale for Kinesiophobia (TSK) has been used to evaluate psychological outcomes in patients with ACL injuries in many countries and translated into Japanese version in 2013. However, no researchers validated its reliability, validity, and responsiveness of TSK for patients with ACL injury up to now. The purpose of this study was to evaluate the measurement properties of the Japanese version of the TSK (TSK-J) in patients with ACL injuries. Study design Cohort study (Diagnostic); Level of evidence, 2. Methods This prospective study was performed in the department of orthopaedic surgery at the university hospital of Juntendo from Sep 2016 and Apr 2017. Patients who diagnosed with ACL injury with or without reconstruction surgery completed several patient-reported outcome measures (PROMs) were included in this study. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) guidelines were used to evaluate reliability, validity, responsiveness, and interpretability of the TSK-J. Results 222 patients were included in this study. The TSK-J for ACL injured patients showed good internal consistency (Cronbach’s alpha = 0.79) and excellent test-retest reliability (intra-class correlation coefficient, ICC2,1 = 0.90, 95% CI = 0.81 to 0.95). In addtion, the TSK-J was significantly but moderately correlated with the IKDC-SKF (r = − 0.49, P <0.001), VAS-Sports (r = − 0.48, P <0.001), and JACL-25 (r = 0.48, P <0.001). The effect size (ES) was small with the Cohen’s d = − 0.2. The minimal important difference (MID) was − 1.3 points. No significant TSK-J score change was observed over 1-year after ACL reconstruction (r = − 0.12, P <0.001). There were no floor or ceiling effects. Conclusions Our study demonstrated that the Japanese version of TSK has good reliability. However, its low validity and responsiveness indicate that it may not the best way to assess psychological factors for patients with ACL injury.

Association between Kinesiophobia and Gait Asymmetry after ACL Reconstruction: Implications for Prevention of Reinjury

“…Kinesiophobia, which is considered an extreme, irrational, and detrimental fear of physical activity, can occur as a result of sensing susceptibility to injury or reinjury [53]. Fear or anxiety has been documented after ACL injury [21].…”

Kinesiophobia in a Patient With Postoperative Midshaft Fracture: A Case Report of Its Impact on Rehabilitation in a 16-Year-Old Girl

“…Phase III (6)(7)(8)(9)(10)(11)(12) In order to improve mobility, balance, proprioception, and agility training, the focus of the exercises was on increasing the power of the lower limb by partial weight-bearing activities during phase III.…”

“…On palpation, there was a rise in local temperature with non-pitting edema. She also had extreme kinesiophobia with a Tampa Scale score of 67 and a visual analog scale (VAS) score of 10/10 [ 7 ].…”

New Factor Structure of the Tampa Scale for Kinesiophobia in Older Japanese Adults After Lumbar Surgery

“…As such, it has been pointed out that the TSK’s construct validity has not yet been fully tested. 7 In addition, it has been argued that there are cultural differences between Asian and Western populations with regard to kinesiophobia, 17 and a fuller examination of the Japanese population is needed to better understand the factor structure of the TSK. Clarifying the factor structure of TSK in specific populations of Japanese people will help us understand the process by which pain experiences specific to those populations lead to the avoidance of physical activity and further declines in HRQOL, following the so-called fear-avoidance model, which in turn will lead to the practice of effective interventions.…”

“…The use of the TSK has already been analyzed with Western people with LSS; its relationship with pain and HRQOL 20 and the effect of participation in rehabilitation programs on reducing kinesiophobia 21 have also been reported, but there is no report on the use of TSK in older patients with postoperative LSS, and so the nature of their kinesiophobia is not well understood. Moreover, the TSK has already been used in Japanese patients with diseases other than LSS such as knee osteoarthritis, 15 anterior cruciate ligament injuries, 17 and neck and back injuries due to traffic trauma, 22 but, in contrast to when it has been used with a Western population, the factor structure of the TSK in Japanese has not been reported. Therefore, clarification of psychometric structures as well as detailed information on the TSK scores in older Japanese adults with LSS after surgery is expected to lead to the development of research on kinesiophobia in older Japanese adults with LSS after surgery.…”