The relationship between the Tampa Scale of Kinesiophobia and low back pain rehabilitation outcomes

Abstract

BackgroundContextThe 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. PurposeThe 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. Study Design/SettingA prospective cohort study was used. Patient SampleThe sample consisted of 313 low back pain patients treated at one of six rehabilitation clinics in New Zealand over a 4-year period. Outcome MeasuresThe 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). MethodsTSK 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. ResultsThe 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. ConclusionsThe 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.