Original Report| Volume 13, ISSUE 10, P970-977, October 2012

Psychometric Properties of the Tampa Scale for Kinesiophobia-11 (TSK-11)


      The aim of this study was to investigate the psychometric properties of an abbreviated version of the Tampa Scale for Kinesiophobia (TSK) in a clinical sample of patients with chronic pain. Chronic pain patients (n = 276) seeking treatment at an interdisciplinary treatment center completed self-report questionnaires including the TSK-13, and 2 tests of physical functioning. Four competing models of the TSK were tested using confirmatory factor analysis. Internal consistency was assessed, as were discriminant evidence of construct validity and concurrent criterion-related validity. Incremental validity was assessed with hierarchical multiple regressions controlling for pain severity. The analyses indicated that an 11-item, 2-factor structure best fit the data. The first factor, somatic focus, consisted of 5 items, while the second factor, activity avoidance, was comprised of 6 items. The TSK-11 scales demonstrated acceptable levels of internal consistency, as well as evidence of discriminant, concurrent criterion-related, and incremental validity. Somatic focus uniquely predicted perceived disability while activity avoidance uniquely predicted actual physical performance, controlling for pain severity. The 2-factor structure of the TSK-11 was found to be a brief, reliable, and valid measure of fear of movement/(re)injury for chronic pain patients. We recommend that the TSK-11 be used in future research and in clinical settings.


      In this study, confirmatory factor analysis identified the 2-factor TSK-11 as the best fitting model of TSK factor structure. The TSK-11 is a brief, reliable, and valid measure of fear of movement/(re)injury for chronic pain patients.

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        • Beck A.T.
        • Steer R.A.
        • Brown G.K.
        Manual for the Beck Depression Inventory-II.
        Psychological Corporation, San Antonio, TX1996
        • Bentler P.M.
        EQS 6.1: Structural Equations Program Manual.
        Multivariate Software Inc., Encino, CA2004
        • Bernstein I.
        • Jaremko M.
        • Hinkley B.
        On the West Haven-Yale Multidimensional Pain Inventory.
        Spine. 1995; 20: 956-963
        • Burwinkle T.
        • Robinson J.P.
        • Turk D.C.
        Fear of movement: Factor structure of the Tampa Scale of Kinesiophobia in patients with fibromyalgia syndrome.
        J Pain. 2005; 6: 384-391
        • Byrne B.M.
        Structural Equation Modeling with EQS: Basic Concepts, Applications, and Programming.
        Psychology Press, New York, NY2006
      1. Clark ME, Kori SH, Broeckel J: Kinesiophobia and chronic pain: Psychometric characteristics and factor analysis of the Tampa Scale. Poster presented at the 15th Annual Scientific Meeting of the American Pain Society, 1996

        • Cohen R.J.
        • Swerdlik M.E.
        Psychological Testing and Assessment: An Introduction to Tests & Measurement.
        McGraw Hill, New York, NY2010
        • Cook A.J.
        • Brawer P.A.
        • Vowles K.E.
        The fear avoidance model of chronic pain: Validation and age analysis using structural equation modeling.
        Pain. 2006; 121: 195-206
        • Crombez G.
        • Vlaeyen J.W.S.
        • Heuts P.H.
        • Lysens R.
        Pain-related fear is more disabling than pain itself: Evidence on the role of pain-related fear in chronic back pain disability.
        Pain. 1999; 80: 329-339
        • French D.J.
        • France C.R.
        • Vigneau F.
        • French J.A.
        • Evans R.T.
        Fear of movement/(re)injury in chronic pain: A psychometric assessment of the original English version of the Tampa Scale for Kinesiophobia (TSK).
        Pain. 2007; 127: 42-51
        • Geisser M.E.
        • Haig A.J.
        • Theisen M.E.
        Activity avoidance and function in persons with chronic back pain.
        J Occup Rehabil. 2000; 10: 215-227
        • Gheldof E.L.M.
        • Vinck J.
        • Van Den Bussche
        • Vlaeyen J.W.S.
        • Hidding A.
        • Crombez G.
        Pain and pain-related fear are associated with functional and social disability in an occupational setting: Evidence of mediation by pain-related fear.
        Eur J Pain. 2006; 10: 513-525
        • Goubert L.
        • Crombez G.
        • Van Damme S.
        • Vlaeyen J.W.S.
        • Bijttebier P.
        • Roelofs J.
        Confirmatory factor analysis of the Tampa Scale for Kinesiophobia.
        Clin J Pain. 2004; 20: 103-110
        • Harding V.R.
        • Williams A.C.
        • Richardson P.H.
        • Nicholas M.K.
        • Jackson J.L.
        • Richardson I.H.
        • Pither C.E.
        The development of a battery of measures for assessing physical functioning of chronic pain patients.
        Pain. 1994; 58: 367-375
        • Harris C.A.
        • D’Eon J.L.
        Psychometric properties of the Beck Depression Inventory-Second Edition (BDI-II) in individuals with chronic pain.
        Pain. 2008; 137: 609-622
        • Heuts P.H.T.G.
        • Vlaeyen J.W.S.
        • Roelofs J.
        • de Bie R.A.
        • Aretz K.
        • van Weel C.
        • van Schayck O.C.
        Pain-related fear and daily functioning in patients with osteoarthritis.
        Pain. 2004; 110: 228-235
        • Hu L.T.
        • Bentler P.M.
        Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives.
        Structural Equation Modeling. 1999; 6: 1-31
        • Kerns R.D.
        • Turk D.C.
        • Rudy T.E.
        The West Haven-Yale Multidimensional Pain Inventory (WHYMPI).
        Pain. 1985; 23: 345-356
        • Kori S.H.
        • Miller R.P.
        • Todd D.D.
        Kinesiophobia: A new view of chronic pain behaviour.
        Pain Manage Jan/Feb. 1990; : 35-43
        • Leeuw M.
        • Goossens M.E.J.B.
        • Linton S.J.
        • Crombez G.
        • Boersma K.
        • Vlaeyen J.W.S.
        The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence.
        J Behav Med. 2007; 30: 77-94
        • Lethem J.
        • Slade P.D.
        • Troup J.D.G.
        • Bentley G.
        Outline of a fear-avoidance model of exaggerated pain perceptions.
        Behav Res Ther. 1983; 21: 401-408
        • McCracken L.M.
        • Vowles K.E.
        • Eccleston C.
        Acceptance of chronic pain: Component analysis and a revised assessment method.
        Pain. 2004; 107: 159-166
        • Roelofs J.
        • Goubert L.
        • Peters M.L.
        • Vlaeyen J.W.S.
        • Crombez G.
        The Tampa Scale for Kinesiophobia: Further examination of psychometric properties in patients with chronic low back pain and fibromyalgia.
        Eur J Pain. 2004; 8: 495-502
        • Roelofs J.
        • Sluiter J.K.
        • Frings-Dresen M.H.W.
        • Goosens M.
        • Thibault P.
        • Boersma K.
        • Vlaeyen J.W.S.
        Fear of movement and (re)injury in chronic musculoskeletal pain: Evidence for an invariant two-factor model of the Tampa Scale for Kinesiophobia across pain diagnoses and Dutch, Swedish, and Canadian samples.
        Pain. 2007; 131: 181-190
        • Swinkels-Meewisse I.E.J.
        • Roelofs J.
        • Schouten E.G.W.
        • Verbeek A.L.M.
        • Oostendorp R.A.B.
        • Vlaeyen J.W.S.
        Fear of movement/(re)injury predicting chronic disabling low back pain: A prospective inception cohort study.
        Spine. 2006; 31: 658-664
        • Vlaeyen J.W.S.
        • Kole-Snijders A.M.J.
        • Boeren R.G.B.
        • van Eek H.
        Fear of movement/(re)injury in chronic low back pain and its relation to behavioural performance.
        Pain. 1995; 62: 363-372
        • Vlaeyen J.W.S.
        • Kole-Snijders A.M.J.
        • Rotteveel A.M.
        • Ruesink R.
        • Heuts P.H.T.G.
        The role of fear of movement/(re)injury in pain disability.
        J Occup Rehabil. 1995; 5: 235-252
        • Vowles K.E.
        • McCracken L.M.
        • McLeod C.
        • Eccleston C.
        The Chronic Pain Acceptance Questionnaire: Confirmatory factor analysis and identification of patient subgroups.
        Pain. 2008; 140: 284-291
        • Woby S.R.
        • Roach N.K.
        • Urmston M.
        • Watson P.J.
        Psychometric properties of the TSK-11: A shortened version of the Tampa Scale for Kinesiophobia.
        Pain. 2005; 17: 137-144