The relationship between the Tampa Scale of Kinesiophobia and low back pain rehabilitation outcomes.
OBJECTIVE
The Tampa Scale for Kinesiophobia (TSK) is commonly used in clinical practice to quantify levels of pain-related fear of activity or re-injury in patients presenting with back pain. Patients with high levels of kinesiophobia are often considered at greater risk of developing long-term activity limitation and chronicity. There is, however, little evidence to support this assumption.


OBJECTIVE
The purpose of this study was to assess the role of the TSK in determining eventual outcome in a cohort of low back pain patients completing a multidisciplinary rehabilitation program.


METHODS
A prospective cohort study was used.


METHODS
The sample consisted of 313 low back pain patients treated at one of six rehabilitation clinics in New Zealand over a 4-year period.


METHODS
The outcome measures for this study are the TSK, Numeric Pain Scale (NPS), Modified Low Back Outcome Score (m-LBOS), and vocational status (working or not working).


METHODS
TSK questionnaire scores and three additional quality of life (QoL) measures (NPS, m-LBOS, and vocational status) were recorded at the initial assessment and after a 6- to 12-week period of rehabilitation. Statistical analysis was performed to determine the relationships between TSK scores and the QoL values recorded at initial assessment and postrehabilitation checkpoints.


RESULTS
The correlations between initial TSK, NPS, and m-LBOS values recorded at assessment were statistically significant, but the relationships were weak. More importantly, there was no correlation between baseline TSK scores and changes in the numeric pain rating, perceived function, or vocational status after a period of rehabilitation. Correlations between changes in TSK scores and changes in NPS and m-LBOS values after rehabilitation were statistically significant, but the relationships were weak.


CONCLUSIONS
The TSK provides no benefit as a screening tool to predict pain, functional and work outcomes following rehabilitation. Measured changes in TSK scores following rehabilitation do not correlate strongly with similar, concordant changes in pain scores, functional levels, or return-to-work outcomes.
The Back Institute, PO Box 57-105, Mana, Wellington 5247 New Zealand. Electronic address: chris.gregg@tbihealth.co.nz.
Chris D
CD
Gregg
CBI Health Group, Sun Life Financial Centre, West Tower, 3300 Bloor Street West, Suite 900, Toronto, Ontario M8X 2X2 Canada.
Greg
G
McIntosh
CBI Health Group, Sun Life Financial Centre, West Tower, 3300 Bloor Street West, Suite 900, Toronto, Ontario M8X 2X2 Canada.
Hamilton
H
Hall
The Back Institute, PO Box 57-105, Mana, Wellington 5247 New Zealand.
Heather
H
Watson
The Back Institute, PO Box 57-105, Mana, Wellington 5247 New Zealand.
David
D
Williams
The Back Institute, PO Box 57-105, Mana, Wellington 5247 New Zealand.
Chris W
CW
Hoffman
D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010698:Phobic Disorders / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D062707:Return to Work; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
Chronic low back pain; Fear avoidance; Kinesiophobia; Outcomes; Prognosis