The Tampa Scale of Kinesiophobia (TSK) is a self-report measure designed to assess an individual’s fear of movement or (re)injury․ It was created as a 17-item checklist using a 4-point Likert scale, and it is used to identify kinesiophobia․
Definition and Concept of Kinesiophobia
Kinesiophobia, as defined by the creators of the Tampa Scale, is an irrational and debilitating fear of physical movement and activity․ This fear stems from a perceived vulnerability to painful injury or re-injury, which can significantly limit an individual’s physical capabilities․ The concept was introduced in 1990 at the Ninth Annual Scientific Meeting of the American Pain Society, initially focusing on the fear of pain associated with movement․ This fear is not merely a normal apprehension but an excessive and unreasonable response to the idea of engaging in physical activities, causing avoidance behaviors and functional limitations․ It is a psychological barrier that can hinder recovery and rehabilitation, especially in individuals with chronic pain or musculoskeletal issues․ This fear leads to a vicious cycle of inactivity and deconditioning, further exacerbating the original problem․
Development and Versions of the TSK
The TSK has evolved since its original creation, leading to different versions․ These include the original 17-item scale, a revised 11-item version, and other variations like a 13-item version․
Original 17-Item TSK (TSK-17)
The original Tampa Scale of Kinesiophobia, known as the TSK-17, was developed in 1991 by R․ Miller, S․ Kori, and D․ Todd․ It consists of seventeen self-report questions designed to measure an individual’s fear of movement or re-injury․ Each item is rated on a 4-point Likert scale, ranging from ‘strongly disagree’ to ‘strongly agree’․ The TSK-17 was initially designed to assess kinesiophobia, defined as an irrational and debilitating fear of physical activity due to a feeling of vulnerability to painful injury or re-injury, often seen in patients with musculoskeletal pain, particularly lower back pain․ The total score is calculated after reverse-scoring specific items․ The scale is intended to quantify the extent of an individual’s fear of movement, with higher scores indicating greater levels of kinesiophobia․
Revised 11-Item TSK (TSK-11)
The revised 11-item Tampa Scale of Kinesiophobia, or TSK-11, emerged from a need to address some psychometric limitations of the original 17-item version․ Six items from the TSK-17 were removed due to their poor performance․ The TSK-11 retains items 1, 2, 3, 5, 6, 7, 10, 11, 13, 15, and 17 from the original scale and maintains the same 4-point Likert scale for responses․ This shorter version was developed to provide a more concise and efficient tool for assessing kinesiophobia․ The TSK-11 scores range from 11 to 44, where higher scores indicate greater fear of movement-related pain․ Although widely used because of its brevity, the TSK-11 is still undergoing validation to establish clear interpretive thresholds․
Other TSK Versions (e․g․, TSK-13)
Besides the original 17-item TSK and the revised 11-item TSK, other versions of the Tampa Scale of Kinesiophobia have been developed, such as the 13-item version (TSK-13)․ The TSK-13 was introduced as a variant that aimed to improve on the psychometric properties of the original scale․ While the TSK-13 has been studied, it lacks established cut-off scores․ This version is sometimes used in research and clinical settings, but it is important to note that the interpretive context of the TSK-13 is still evolving․ This scale sought to balance the need for brevity while maintaining the integrity of the kinesiophobia construct․ Different versions of TSK exist to meet the specific needs of various research and clinical contexts․
Scoring and Interpretation
The TSK utilizes a Likert scale, with some items requiring reverse scoring․ Total scores are calculated, and higher scores indicate greater kinesiophobia․ Cut-off scores help classify levels of fear of movement․
Likert Scale and Item Scoring
The Tampa Scale of Kinesiophobia (TSK) employs a 4-point Likert scale for each of its items․ Participants respond to each statement indicating their level of agreement, ranging from ‘strongly disagree’ to ‘strongly agree’․ Typically, a score of 1 is assigned to ‘strongly disagree’, 2 to ‘disagree’, 3 to ‘agree’, and 4 to ‘strongly agree’․ This standard scoring method is applied to most items on the scale․ However, it’s crucial to note that certain items on the TSK are reverse-scored․ This process ensures that the scale accurately reflects the level of kinesiophobia․ The specific items requiring reverse scoring are an important aspect of accurately calculating the total TSK score․ The standard Likert scale provides a clear framework for individuals to rate their fear of movement, while the reverse scoring addresses the wording of specific items․ This dual approach is essential for the scale to effectively measure the construct of kinesiophobia․
Reverse Scoring of Specific Items
Within the Tampa Scale of Kinesiophobia (TSK), specific items require reverse scoring to accurately reflect the participant’s level of kinesiophobia․ These items, which are negatively worded, are typically items 4, 8, 12, and 16 in the original 17-item version of the TSK․ Instead of directly using the responses provided, the scoring is inverted for these particular items․ Specifically, a response of ‘strongly disagree,’ which would normally receive a score of 1, is given a score of 4․ Similarly, ‘disagree’ is scored as 3, ‘agree’ as 2, and ‘strongly agree’ as 1 for those items․ This reverse scoring method is essential because these items are phrased in a way that a higher level of agreement indicates a lower level of kinesiophobia, and vice versa․ By inverting the scores, these items contribute to a total score that accurately captures the overall degree of kinesiophobia․
Total Score Calculation and Range
The total score for the Tampa Scale of Kinesiophobia (TSK) is calculated by summing the scores of all individual items, following the necessary reverse scoring of specific items․ In the original 17-item TSK (TSK-17), the total score can range from 17 to 68․ A score of 17 indicates no kinesiophobia or a negligible fear of movement, while a score of 68 represents the highest possible level of kinesiophobia․ For the 11-item TSK (TSK-11), the total score ranges from 11 to 44․ The lowest possible score of 11 indicates minimal or nonexistent kinesiophobia, and a score of 44 reflects a severe fear of experiencing pain with movement․ Higher scores on both the TSK-17 and TSK-11 indicate an increasing degree of kinesiophobia, suggesting a greater fear of movement or reinjury․
Interpretation of TSK Scores (Cut-off Scores)
Interpreting Tampa Scale of Kinesiophobia (TSK) scores involves understanding the cut-off points that indicate the presence of clinically significant kinesiophobia․ For the original 17-item TSK (TSK-17), a cut-off score of 37 or over is generally considered to signify a high level of kinesiophobia, as established by Vlaeyen in 1995․ Scores below 37 are often interpreted as low levels of kinesiophobia․ It’s important to note that these cut-off scores are not absolute, and individual differences should be considered․ While the 11-item TSK (TSK-11) is widely used, it doesn’t have well-established thresholds to guide interpretation, and the TSK-11 scores need further validation to ensure accurate clinical use․ Therefore, clinicians should use these scores as part of a broader assessment that takes individual context into account․ Factors like pain diagnosis and gender may also impact the interpretation of TSK scores․
Psychometric Properties and Validation
The Tampa Scale of Kinesiophobia has been extensively studied for its reliability and validity․ Research has also explored the factor structure of the TSK․ Validation studies support its use in various populations․
Reliability and Validity Studies
Numerous studies have investigated the reliability and validity of the Tampa Scale of Kinesiophobia (TSK), demonstrating its robustness as a measurement tool․ Test-retest reliability has been shown to be moderate to high, indicating that the TSK provides consistent results over time․ Convergent validity is supported by significant correlations between TSK scores and other measures of pain-related fear and disability․ Researchers have examined the TSK across diverse populations, including those with chronic low back pain, neck pain, and other musculoskeletal conditions․ These studies consistently show that the TSK is a reliable and valid tool for assessing fear of movement․ Furthermore, the TSK’s ability to predict outcomes related to pain and function has also been confirmed through various investigations․ These findings underscore the TSK’s value in clinical and research settings․
Factor Structure of the TSK
The factor structure of the Tampa Scale of Kinesiophobia (TSK) has been a subject of investigation, with studies exploring the underlying dimensions of this fear of movement measure․ While the original TSK was designed as a unidimensional scale, some research suggests a two-factor model․ These factors often reflect activity avoidance and somatic focus․ Activity avoidance captures the tendency to avoid physical activities due to fear of pain, while somatic focus refers to heightened awareness of bodily sensations and their interpretation as threatening․ Confirmatory factor analyses have supported the existence of these two factors in various populations․ However, the precise factor structure may vary across different samples and cultural contexts․ Exploring the factor structure of the TSK is crucial for understanding the nuanced aspects of kinesiophobia․
Clinical Applications and Use
The Tampa Scale of Kinesiophobia (TSK) is used to assess kinesiophobia in various populations, including those with musculoskeletal pain, like neck or lower back pain․ It helps clinicians identify fear of movement․
Assessment of Kinesiophobia in Various Populations
The Tampa Scale of Kinesiophobia (TSK) is a versatile tool used across diverse populations to assess the fear of movement or (re)injury․ Its applications span various conditions, with a prominent focus on individuals experiencing musculoskeletal pain, such as chronic lower back pain and neck pain․ The TSK aids in understanding the psychological aspects of pain, particularly how fear of movement contributes to disability and activity avoidance․ Furthermore, the scale has been utilized in research settings to explore the relationship between kinesiophobia and other factors, like perceived disability and quality of life․ It helps identify those with heightened fear, guiding interventions and treatment strategies․ The TSK is beneficial in clinical practice, enabling healthcare professionals to tailor care plans for those who have kinesiophobia․ The TSK is not limited to pain, as it can be used to identify fear of movement in other groups too․