Cognitive Assessment of Musculoskeletal Pain: Validity and Reliability of the Greek Version of the Tampa Scale of Kinesiophobia in Patients Suffering from Chronic Low Back Pain.

Abstract

Objectives: The Tampa Scale of Kinesiophobia (TSK) evaluates pain associated fear, which is considered an important factor in the cognitive assessment of musculoskeletal pain according to the biopsychosocial model. The aim of this study was to validate the Greek version of the TSK (TSK-GR) in a population suffering from chronic low back pain. Methods:Following Institutional Review Board's approval (ref.: 6/16-2-2018), 70 consecutive patients with low back pain, lasting more than three months, completed the TSK-GR together with the Greek versions of the Hospital Anxiety & Depression Scale (HADs-GR), Fear Avoidance Beliefs Questionnaire (FABQ-GR), Pain Locus of Control (PLC-GR) and visual analogue scale for pain (VAS). A subgroup of 20 patients completed the TSK-GR (48 hours) twice (test-retest reliability). Construct validity was evaluated through the a priori hypothesis of correlation with the FABQ-GR, HADs-GR and VAS, while discriminant construct validity through the lack of correlation with the PLC-GR. The Cronbach's alpha (a), the Pearson's correlation coefficient (r) and the Intraclass Correlation Coefficient (ICC) statistics were used for analyses. Results:Internal consistency and test-retest reliability were satisfactory (Cronbach's a=0.74 and ICC=0.78). The construct validity of the TSK-GR was shown through its association with both FABQ subscales (FABQ-work: r=0.48, p<0.001, and FABQ-physical: r=0.51, p<0.001), with both HADs subscales (HADs-depression: r=0.45, p<0.001, and HADs-anxiety: r=0.34, p<0.005) and with the VAS (r=0.62, p<0.001). Discriminant construct validity was shown through the lack of association between TSK-GR and the PLC-GR. Conclusion:This study provided evidence for the validity and reliability of the Greek version of TSK in patients with chronic low back pain.