Tampa Scale of Kinesiophobia

What is kinesiophobia?

Kinesiophobia, or the fear of movement, is a condition that can severely impact individuals suffering from chronic pain. This fear often stems from the anticipation of pain, particularly in those who have experienced chronic musculoskeletal pain or a painful injury. This term was first introduced by Miller, Kori, and Todd introduced in 1990 at the Ninth Annual Scientific Meeting of the American Pain Society.

According to Lundberg et al.(2006), 51 to 72% of patients with chronic pain, like chronic low back pain or chronic neck pain, are affected by kinesiophobia, limiting their daily activities and overall quality of life. This pain-related fear can lead to chronic pain behavior such as anxiety, attention seeking, and distorted posture and mobility. Individuals with kinesiophobia may also avoid physical activities to prevent perceived pain, which, unfortunately, may exacerbate their condition.

In older adults with chronic pain, kinesiophobia is linked to heightened pain intensity, greater disability, and poor self-perceived health. It can result in avoidance behaviors, physical inactivity, depression, and a vicious cycle of escalating fear, pain, and disability (Larsson et al., 2016).

What is the Tampa Scale of Kinesiophobia?

The Tampa Scale of Kinesiophobia (TSK) is a self-report questionnaire that measures fear of movement and reinjury in individuals with musculoskeletal pain. It was developed by R. Miller, S. Kori, and D. Todd in 1991 to assess the fear-avoidance model of chronic musculoskeletal pain.

The original TSK has 17 items, each scored on a 4-point Likert scale ranging from "strongly disagree" to "strongly agree." The total score ranges from 17 to 68, with higher scores indicating greater kinesiophobia levels.

The TSK also has two subscales: the fear of (re)injury due to movement somatic focus (Physiotutors, 2023). These subscales can provide further insight into an individual's specific fears related to movement and pain.

Additionally, the TSK-11, an 11-item version of the Tampa Scale for Kinesiophobia, was developed to enhance usability while preserving psychometric integrity. By excluding six items from the original 17-item scale due to their poor psychometric properties, the TSK-11 streamlines the assessment process without compromising reliability or validity (Woby et al., 2005).

Scoring and interpretation

Here's how to score and interpret the original TSK and its subscales:

Total score

To score the Tampa Scale of Kinesiophobia accurately, certain items need to be reverse scored. Items 4, 8, 12, and 16 are reversed, where "strongly disagree" is 4 points, "disagree" is 3 points, "agree" is 2 points, and "strongly agree" is 1 point.

For all other items, "strongly disagree" is 1 point, "disagree" is 2 points, "agree" is 3 points, and "strongly agree" is 4 points.

As mentioned, the total score ranges from 17 to 68 points. Higher scores indicate greater kinesiophobia, with 17 showing no or minimal fear of movement and 68 representing maximum kinesiophobia.

Fear of (re) injury subscale score

To calculate the score for the fear of (re)injury due to movement subscale, the scores for items 1, 2, 7, 9, 10, 11, and 12 are added. This subscale specifically focuses on an individual's fear of re-injury through movement.

As with the total score, higher scores on this subscale indicate a greater fear of movement leading to further harm, providing valuable insights into the participant's kinesiophobia.

Somatic focus subscale score

The scores for items 3, 4, 5, 6, 8) are added to obtain the somatic focus subscale score. This subscale delves into the physical symptoms and sensations that an individual associates with movement and pain.

Similar to the fear of (re)injury due to movement subscale, higher scores indicate a more pronounced focus on somatic symptoms, reflecting a heightened awareness and concern about physical sensations related to movement.

How to use our Tampa Scale of Kinesiophobia template

Carepatron has made a user-friendly template featuring the original Tampa Scale of Kinesiophobia to help you assess your patient's level of kinesiophobia. Here's how you can use it:

Step 1: Get a copy of the template

Download the Tampa Scale of Kinesiophobia using the link on this page. You can also find it in the Carepatron app.

Step 2: Give your patient a copy

Explain to your patient the purpose of the TSK and how it can help in their treatment. Provide them with a copy of the template and ensure they understand how to complete it.

Step 3: Assessing scores

Once your patient has completed the TSK, you can calculate their total score using the information provided in the template on how to get the total and subscale scores.

Step 4: Interpret the scores

Using the scoring guidelines in the template, interpret your patient's scores and determine their level of kinesiophobia. This can help in creating a treatment plan that addresses their specific needs and concerns.

Benefits of using this template

Our free Tampa scale for kinesiophobia template makes your clinical documentation easier and assessment more accurate. Here are some benefits of using this template:

• Easy to use: The template is straightforward and easy to understand, making it simple for you and your patient to use.

• Accurate assessment: This template, with detailed guidelines on how to score and interpret, ensures a more accurate assessment of kinesiophobia levels.

• Customizable: The Carepatron app allows you to customize the TSK template according to your needs and preferences. You can also add your own notes and comments for a more personalized approach.

• Time-saving: This template saves time creating and formatting assessments, allowing you to focus more on your patient's treatment.

Treatments for kinesiophobia

Knowing the level of kinesiophobia in your patient can guide you in determining the best treatment approach. Here are some common treatments for kinesiophobia:

• Physical therapy: This involves gradually increasing physical activity and movement in a controlled environment to help reduce fear and improve function.

• Cognitive-behavioral therapy (CBT): CBT focuses on changing negative thoughts and behaviors related to movement and pain and replacing them with more positive and adaptive ones.

• Graded exposure therapy: Similar to physical therapy, graded exposure therapy treatment involves gradually exposing the patient to feared movements or activities in a safe and controlled manner.

• Relaxation techniques: Techniques like deep breathing, progressive muscle relaxation, and meditation can help patients manage their anxiety related to movement.

• Education about pain: Educating patients about how pain works and how it is not always a sign of tissue damage can help reduce fear and improve function.

• Mind-body approaches: Activities like yoga, tai chi, and qi gong can help patients reconnect with their bodies and learn to move in a more relaxed and mindful manner and overcome their debilitating fear of movement.

References

Larsson, C., Ekvall Hansson, E., Sundquist, K., & Jakobsson, U. (2016). Kinesiophobia and its relation to pain characteristics and cognitive affective variables in older adults with chronic pain. BMC Geriatrics, 16(1). https://doi.org/10.1186/s12877-016-0302-6

Lundberg, M., Larsson, M., Östlund, H., & Styf, J. (2006). Kinesiophobia among patients with musculoskeletal pain in primary healthcare. Journal of Rehabilitation Medicine, 38(1), 37–43. https://doi.org/10.1080/16501970510041253

Miller, R. P., Kori, S. H., & Todd, D. D. (1991). The Tampa scale: A measure of kinisophobia. The Clinical Journal of Pain, 7(1), 51.

Physiotutors. (2023, February 17). Tampa scale of kinesiophobia | PDF & online calculator. https://www.physiotutors.com/questionnaires/tampa-scale-kinesiophobia/

Woby, S. R., Roach, N. K., Urmston, M., & Watson, P. J. (2005). Psychometric properties of the TSK-11: A shortened version of the tampa scale for kinesiophobia. Pain, 117(1), 137–144. https://doi.org/10.1016/j.pain.2005.05.029