Tampa Scale For Kinesiophobia Research Articles

Current status and influencing factors of kinesiophobia in patients with peritoneal dialysis: a multicenter cross-sectional study.

Kinesiophobia, an irrational fear-avoidance behaviour, can significantly impact the quality of life and prognosis of peritoneal dialysis patients. This study aimed to assess the prevalence of kinesiophobia in patients undergoing peritoneal dialysis and to analyse its influencing factors. A total of 291 patients who visited the outpatient and ward of peritoneal dialysis in 7 tertiary hospitals in Jiangsu Province from December 2023 to March 2024 were selected as research subjects via the convenience sampling method. A cross-sectional survey was conducted using a general data questionnaire, the Tampa Kinesiophobia-11 Scale, the Chinese Version of the Multidimensional Fatigue Symptom Scale, and the Simplified Coping Style Questionnaire. The score obtained using the Tampa Scale for kinesiophobia in patients with peritoneal dialysis was 22.44 ± 7.46, with a prevalence rate of 69.1%. Binary logistic regression analysis revealed that no complications, daily exercise before illness, and positive coping styles were protective factors (p < 0.05), whereas fatigue and negative coping styles were risk factors for kinesiophobia in patients receiving peritoneal dialysis (p < 0.05). The prevalence of kinesiophobia in patients receiving peritoneal dialysis was high but at a mild level. Medical staff should combine influencing factors to identify high-risk groups as early as possible, formulate targeted interventions to reduce the occurrence of kinesiophobia and mitigate adverse effects on peritoneal dialysis patients.

EFFECTIVENESS OF EPLEY MANEUVER AND GANS REPOSITIONING MANEUVER ON DIZZINESS, BALANCE AND KINESIOPHOBIA IN PATIENTS WITH POSTERIOR CANAL BENIGN PAROXYSMAL POSITIONAL VERTIGO

Background: Benign paroxysmal positional vertigo (BPPV) is the most prevalent type of peripheral vestibular vertigo, typically affecting the posterior semi-circular canal. Objective: The objective of study was to compare the effectiveness of Epley maneuver and Gans repositioning maneuver on dizziness, balance and kinesiophobia in patients with posterior canal BPPV. Methods: 30 BPPV patients were selected and assigned into two groups based on the selection criteria. Group-A (N=15), received Epley maneuver and 15 were assigned to Group-B, undergone Gans repositioning maneuver, for 20 minutes per session, 3 session (alternate days) per week for 3 weeks. Cawthorne and Cooksey Exercises were given to both the group as common intervention. Dizziness, balance and kinesiophobia were assessed both before and after the 3-week intervention program using Dizziness Handicap Inventory (DHI) scale, Timed-Up and Go (TUG) test and Tampa Scale of Kinesiophobia (TSK), respectively. The collected data were subsequently tabulated and analyzed using appropriate statistical tools. Results: The unpaired ‘t’ test analysis of dizziness and balance revealed statistically significant scores in DHI(t=2.2259) and TUG(t=2.2547), respectively, at a 95% confidence interval. Consequently, Group A demonstrated significant reduction in dizziness and balance improvement in patients with posterior canal BPPV. The scores of Kinesiophobia for both the groups were (A, Mean=31.6; B, Mean= 32.2), which showed no significant difference(t=1.074), that means the group showed the improvement from baseline. Conclusion: The study concluded that a 3-week intervention combining the Epley maneuver with Cawthorne-Cooksey exercises was effective in treating dizziness, balance and kinesiophobia in patients with posterior canal BPPV. Implication: The Epley and Gans maneuvers effectively reduce dizziness and improve balance in patients with posterior canal BPPV. They also may alleviate kinesiophobia, enhancing patient confidence in movement. These interventions highlight the importance of targeted therapy in managing vestibular disorders, promoting functional recovery and quality of life.

Translation, reliability, and validity of the German version of the Activity Patterns Scale (APS) in musculoskeletal pain: a methodological study

In musculoskeletal pain (MSP), pain duration, disability, and mental health relate to how a person engages in daily activities. The self-reporting questionnaire Activity Patterns Scale (APS) assesses these activity patterns and their subscales: Pacing (Pacing to increase activity levels,Pacing to conserve energy for valued activities,Pacing to reduce pain); Avoidance (Pain avoidance,Activity avoidance); Pacing (Excessive persistence, Task-contingent persistence, Pain-contingent persistence). This investigation translated the APS into German and estimated its internal consistency, test-retest reliability, and construct validity. The APS translation was conducted following international guidelines for the transcultural adaptation of self-reported measures. For the construct validity, the Avoidance Endurance Fast-Screening (AE-FS), Tampa Scale of Kinesiophobia (TSK), and Coping Strategies Questionnaires (CSQ) scales were employed. Sixty-five participants with MSP contributed to a baseline survey with a follow-up at two weeks. The German version of the APS subscales demonstrated good internal consistency (Cronbach’s alpha = 0.670-0.89) and satisfactory test-retest reliability (intraclass correlation coefficient = 0.72-0.82); only Task-contingent persistence revealed a poor result. Construct validity was supported by significant correlations between APS subscales (pacing, avoidance, persistence) with related measures, including the Coping Strategies Questionnaire (0.27 to 0.40; -0.50 to 0.55; 0.27 to 0.50), the Tampa Scale for Kinesiophobia (0.28 to 0.47; 0.36 to 0.37; 0.38), and Avoidance-Endurance Fast Screening Pain Persistence Scale (none; none; 0.40). The findings demonstrate high construct validity by the substantial correlations in the predicted directions for the APS subscales and their corresponding questionnaires. The German version of the APS is a reliable and valid tool for assessing activity pattern subscales in individuals with MSP. This distinction could refine research and customize treatment instructions to regulate people’s activity in clinical practice.

Effect of cervical traction on cervicogenic headache in patients with cervical radiculopathy: a preliminary randomized controlled trial

BackgroundCervical radiculopathy (CR) is a common condition, often associated with cervicogenic headache (CGH), a secondary headache arising from cervical spine disorders. Mechanical intermittent cervical traction (MICT) is frequently prescribed to treat CR symptoms. The purpose of the study was to make a preliminary estimate of efficacy of adding MICT to conventional rehabilitation on CGH in patients with cervical radiculopathy.MethodsA total of 36 CR patients with CGH were randomly allocated to 3 equally sized groups (A, B and C). The treatment consisted of twelve sessions of conventional rehabilitation (4 weeks) combined with MICT (2 kg for group A, 8 kg for group B and 12 kg for group C). Primary outcomes were CGH intensity (visual analog scale) and frequency (days per week). Secondary outcomes were radicular pain intensity (visual analog scale), cervical range of motion (cervical range of motion instrument), proprioception (cervical range of motion instrument) and muscle strength (MicroFET2 dynamometer), handgrip strength (handheld dynamometer), function (Neck Disability Index), kinesiophobia (Tampa Scale for KInesiophobia), anxiety and depression (Hospital Anxiety and Depresion questionnaire), and quality of life (World Health Organization Quality of Life). Patients were assessed at baseline, one, three and six months after the beginning of treatment. The post hoc Dunn testing was used to determine which traction load had the better effect on CGH symptoms.ResultsAt one, three and six months follow-ups, Group C exhibited the highest improvement in CGH intensity and frequency compared to the other groups (p = 0.021 and p = 0.023; p = 0.012 and p = 0.01; p = 0.005 and p = 0.005). Both groups C and B showed a significant improvement in radicular pain compared to group A at one month follow-up (p = 0.05).The improvement in group C was significantly better in terms of function (p = 0.049) and anxiety (p = 0.011) at three months and quality of life at six months (Psychological p = 0.046 and Environment p = 0.006).ConclusionsThe blend of conventional rehabilitation alongside 12 kg MICT seems to be efficacious in diminishing both the intensity and frequency of CGH in patients with CR. These advantages appear to last for up to six months following the treatment period, potentially leading to decreased CGH severity and occurrence rates, heightened functionality, reduced anxiety levels, and an overall enhancement in quality of life. These findings are preliminary and require confirmation in larger trials.Trial registrationThe study protocol was retrospectively registered at the Pan African Clinical Trial Registry (PACTR202401838955948). Date of registration is 16/01/2024.

Evaluation of Return to Military Activities after Combining Anterior Cruciate Ligament Reconstruction with Modified Lateral Extra-articular Tenodesis Versus Anterior Cruciate Ligament Reconstruction Alone in Primary Anterior Cruciate Ligament Tear in Soldiers. A Randomized Comparative Study

Abstract Background: This study aimed to assess the clinical result, complications, failure rate, and return to resuming military duty of a single-stage anterior cruciate ligament reconstruction (ACLR) procedure utilizing quadrupled semitendinosus tendon graft joint with modified lateral extra-articular tenodesis (LET). This study evaluates the potential impact of combined modified LET with ACLR versus ACLR alone on the rate of return to high-impact military activities, which we call return to sports (RTSs), and the subsequent rate of the anterior cruciate ligament (ACL) graft failure. Materials and Methods: A total of 198 soldiers with primary ACL tears with a high-grade pivot test (grade 3) were included and randomized using the simple randomized method and divided into two groups. A consecutive cohort of military personnel with an isolated ACL tear undergoing ACLR with modified LET (group A, n = 116) and ACLR alone (group B, n = 82) were analyzed between 2016 and 2021. Both groups were followed up for a minimum of 2 years. Soldiers underwent a survey evaluating knee function (knee injury and osteoarthritis outcome score [KOOS]), RTS criteria (RTS type), symptoms (International Knee Documentation Committee [IKDC] subjective), activity level (Tegner score), and fear of movement (Tampa Scale of Kinesiophobia-11) to assess psychological readiness for sport participation. Results: Among these, a mean age of 32 ± 2.93 years underwent primary ACLR with modified LET (n = 116) or without LET (n = 82) procedure. A total of 31 soldiers (15.6%) experienced ACL graft failure, including 26 (31.7%) reconstructions without LET and 5 (4.3%) with LET. Combined with LET during primary ACLR, it lowered the risk of graft failure by 2.8 times. Multivariable analysis revealed a significant reduction in graft rupture risk (relative risk = 0.325, P = 0.029) associated with LET compared to ACLR alone after adjusting for age, anthropometric factors, and tibial slopes. 105 out of 113 (90.5%) soldiers were able to return to military duty in group A (combined ACLR with modified LET), whereas 51 of 81 (62.9%) of the soldiers who underwent ACLR alone (group B) returned to military duty (P = 0.05). Conclusion: At 24 months postoperatively, combined ACLR plus LET showed a significantly higher RTS rate than ACLR alone. The combined ACLR with the modified LET group also showed a lower failure rate than the ACLR alone group. No marked differences were observed in KOOS sub-scores, IKDCsubjective, and Tegner activity scores.

The mediating role of kinesiophobia in pain intensity, physical function, and physical activity level in inflammatory arthritis.

Pain is the main symptom of inflammatory arthritis and it can impair physical functional performance and physical activity level. Some individuals can develop kinesiophobia and experience a vicious circle of worsening health. This study aimed to investigate the association between pain and physical functional performance/physical activity and determine whether kinesiophobia mediates this association. This was a cross-sectional study with individuals diagnosed with inflammatory arthritis (rheumatoid arthritis or spondyloarthritis) treated at a Rheumatology Outpatient Clinic. We assessed pain (Visual Analogue Scale), physical activity (International Physical Activity Questionnaire - long form), kinesiophobia (Tampa Scale for Kinesiophobia), and physical functional performance (Handgrip Strength Dynamometry, 30-second Sit-to-Stand test, Static Muscular Endurance test, and Timed Up and Go test). The mediating effect of kinesiophobia on the relationship between pain intensity and physical functional performance/physical activity was analyzed, and the significance of the mediating effect (kinesiophobia) was tested through a bootstrap approach. Thirty-three individuals with inflammatory arthritis (mean age: 48 ± 12 years) participated in the study. Kinesiophobia mediates the relationship between pain intensity and physical functional performance analyzed by the 30-second Sit-to-Stand test [indirect effect (IE)overall = -0.343, bootstrap 95% confidence interval (CI): -0.698 to -0.002] and by knee flexion at 90º of the dominant limb (IEoverall = -1.55, bootstrap 95% CI: -3.43 to -0.237). In conclusion, pain intensity can affect physical functional performance through kinesiophobia in individuals with inflammatory arthritis.

Effectiveness of a novel multicomponent treatment in women with fibromyalgia: A randomized clinical trial.

Multicomponent treatment is commonly used. However, there are no studies that included graded motor imagery and therapeutic neuroscience education to multicomponent treatment for patients with fibromyalgia This study aims to compare the short-term effects (at 12weeks) of a multicomponent treatment combined with graded motor imagery and therapeutic neuroscience education versus standard treatment in patients with FM. The study was a single-blinded randomized controlled trial. Sixty-five women with a clinical diagnosis of FM were randomly allocated (1:1) into two groups. The experimental group (n = 33) received a novel multicomponent treatment combined with graded motor imagery and neuroscience education. The control group (n = 32) received a standard treatment including pharmacotherapy and standard physician education. The primary outcome was pain intensity assessed with the Numeric Pain Rating Scale (NPRS). The secondary outcomes were changes in the Fibromyalgia Impact Questionnaire (FIQ), the Pain Catastrophizing Scale (PCS), the Tampa Scale of Kinesiophobia (TSK-17), and the Pittsburgh Sleep Quality Index (PSQI) scores. All outcomes were assessed at baseline and 12 weeks. All of the participants completed the trial. The between-group mean differences at 12weeks were: NPRS-1.18 points (95% confidence interval [CI] -0.4 to -1.8; η2 = 0.47; p < .001); FIQ-16.21 points (95% CI -10.9 to -22.1; η2 = 0.58; p < .001); PCS total domain -12.5 points (95% CI -7.2 to -17.8; η2 = 0.61; p < .001); TSK-17-6.15 points (95% CI -3.5 to -8.7; η2 = 0.52; p < .001); and PSQI-2.74 points (95% CI -1.4 to 4.0; η2 = 0.54; p < .001). All differences were statistically significant in favor of the novel multicomponent treatment group and had a large effect size. In the short term, a novel multicomponent treatment, including graded motor imagery and neuroscience education, was an effective therapeutic intervention for improving clinical outcomes compared with standard treatment in women with FM. Additional studies are needed to support long-term clinical effectiveness in these patients.

Comparison of short term recovery in patients with midportion Achilles tendinopathy with varying degrees of kinesiophobia treated with the Silbernagel protocol: A prospective single cohort analysis

ObjectiveTo assess short term recovery between individuals with Achilles tendinopathy with varying degrees of kinesiophobia when treated with the Silbernagel protocol. Secondarily to investigate short term change in degree of kinesiophobia. DesignProspective single cohort analysis. SettingUniversity/Clinical. Participants116 participants with midportion Achilles tendinopathy were grouped from their baseline Tampa Scale of Kinesiophobia (TSK) score: Low (≤33), Medium (34–41), and High (≥42). Main outcome measuresSymptom severity, Achilles tendon structure, and function were assessed at baseline and 8-weeks following initiation of the Silbernagel protocol. Differences in recovery between TSK groups were analyzed. ResultsNo group by time interactions were observed for symptoms, structure, or function. A significant interaction of group by time was observed for TSK score. The Medium (n = 66) and High (n = 28) TSK groups significantly decreased TSK score after 8 weeks by 2.4 and 4.4 points respectively while the Low TSK group (n = 22) did not change. ConclusionThere were no differences in short term recovery of symptoms, Achilles tendon structure, and function in individuals with midportion Achilles tendinopathy treated with the Silbernagel protocol regardless of baseline degree of kinesiophobia. Those with moderate and high levels of kinesiophobia at baseline decreased TSK score in the short term.

Correlation of psychosocial factors with pain, posture, function, and disability in chronic mechanical neck pain patients: a cross-sectional study

BackgroundChronic neck pain is a common musculoskeletal condition that has an impact on the function and quality of life of an individual. Psychosocial factors along with the physical factors may have an impact on the perception of pain. Hence, the study aimed to find the correlation of psychosocial factors with pain, posture, function, and disability in chronic mechanical neck pain patients.MethodA cross-sectional study using a convenient sampling method was conducted in 55 chronic mechanical neck pain patients. The pain was assessed using numerical pain rating scale (NPRS), pain pressure threshold (PPT) using a pressure algometer, kinesiophobia using Tampa Scale for Kinesiophobia (TSK), pain catastrophizing using Pain Catastrophizing Scale, Posture analysis was done by various postural angle and flexicurve, cervical muscle endurance was tested using the craniocervical flexion test, cervical proprioception was measured using head repositioning accuracy test and Neck disability index was used to score disability.ResultA significant positive correlation was found between TSK and NDI (r = 0.34, p = 0.01). There is a negative correlation of PTT (right sternocleidomastoid) with Kinesiophobia (r = − 0.35, p = 0.008). There is a moderate positive correlation between posture (shoulder angle on the left side) and TSK (r = 0.3, p = 0.02).ConclusionThe study concludes that psychosocial factors not only have a significant role but are correlated to pain, posture, function, and disability in patients with chronic mechanical neck pain.

EXPLORING THE FEASIBILITY OF PLATELET-RICH PLASMA INJECTIONS FOR INTERVERTEBRAL DISCOPATHY: A PILOT STUDY.

This longitudinal pilot study aimed to evaluate the feasibility, safety and potential benefits of Platelet-Rich Plasma injections into the lumbar intervertebral discs in patients with low back pain and degenerative intervertebral monodiscopathy, assessing potential efficacy on disability. Longitudinal pilot study. Six participants with chronic low back pain and lumbar degenerative intervertebral disc (monodiscopathy) disease underwent 1 Platelet-Rich Plasma injection, with a 1-year follow-up. Platelet-Rich Plasma injections were administered into the lumbar intervertebral disc, and outcomes were measured using the Roland Morris Disability Questionnaire, numeric rating scale for pain, Tampa scale for kinesiophobia and lumbar flexion range. Magnetic resonance imaging analysis assessed disc changes. No adverse events were reported. At the end of the 1-year follow-up, half of the patients showed significant improvements in disability scores at 1 year, while 3 of the 6 patients had no change. Magnetic resonance imaging revealed no significant disc changes. Platelet-Rich Plasma injections show promise for some patients with low back pain and degenerative intervertebral discopathy patients. However, caution is warranted due to study limitations, including small sample size and lack of a control group. Further research is needed to define Platelet-Rich Plasma therapy protocols.

Comparisons and associations of psychological factors and the number of painful sites in wheelchair basketball athletes with and without shoulder pain: A cross-sectional case-control study

Objective To compare psychological factors and the number of painful sites between wheelchair basketball athletes (WBA) with and without shoulder pain and examine their associations with shoulder pain. Design A cross-sectional, case-control study. Methods Forty-three WBA participated. Shoulder pain was assessed with the Wheelchair User's Shoulder Pain Index (WUSPI), pain catastrophizing with the Pain Catastrophizing Scale (PCS), kinesiophobia by the Tampa Kinesiophobia Scale (TKS), self-efficacy with the General Self-Efficacy Scale (GSES), and the number of painful sites using the Nordic Musculoskeletal Questionnaire. Disability and sport-related data were collected. Spearman’s correlation coefficients were calculated. Mann-Whitney U and independent samples t-tests were used for between-group comparisons. Results Athletes with shoulder pain (n = 21) had an increased number of painful sites (P < .050) and higher PCS (P = .003). The WUSPI exhibited moderate associations with the number of painful sites during the last year (rho = .581) and past seven days (rho = .602), and PCS (rho = .470), and a weak association with the TKS (rho = .333)(P < .050). The number of painful sites with disability exhibited moderate associations with PCS (rho = .427) and GSES (rho = –.473)(P < .050). WBA classification levels showed moderate associations with the WUSPI (rho = –.400) and the number of painful sites during the last year (rho = –.437), and a weak association with the number of painful sites during past seven days (rho = –.315)(P < .050). The PCS showed weak associations with the number of painful sites during the last year (rho = .365) and the past seven days (rho = .398)(P < .050). Conclusions Results suggest considering WBA classes, pain catastrophizing, self-efficacy and multisite pain in the pain management of WBA.

Yoga, Physical Therapy and Home Exercise Effects on Chronic Low Back Pain: Pain Perception, Function, Stress, and Quality of Life in a Randomized Trial.

Low back pain is a common health problem. In this study, we investigated the effects of yoga, physical therapy (PT), and home exercise (HE) on pain perception, function, stress, and quality of life in chronic low back pain (cLBP). We randomly assigned 54 participants to three distinct treatment groups: (a) a physical therapy group (PT) who received spinal stabilization exercises (SSE) combined with local heat and transcutaneous electrical stimulation; (b) a home exercise group (HE) who received SSE as part of the home program; and (c) a yoga group who received yoga exercises. The primary outcome measures were a Visual Analog Scale (VAS) for measuring pain, and the Oswestry Disability Index (ODI) to measure function. Secondary outcome measures were the Tampa Kinesiophobia Scale (TKS), Central Sensitization Inventory (CSI), pain sensitivity (L3 and deltoid R/L PPTs), Spielberger State-Trait Anxiety Inventory (STAI), plasma cortisol and DHEA-S levels, Transversus Abdominis (TrA) muscle activation, and the Nottingham Health Profile (NHP). Assessments were conducted before and after a six-week intervention period. All three groups demonstrated improvements in pain on the VAS, function on the ODI, pain sensitivity on the L3 and deltoid R/L PPTs, CSI, anxiety on the STAI, TrA muscle activation, and quality of life on the NHP (p < .05). The PT group exhibited a more pronounced improvement on the ODI score (p < .05) than the other groups. Cortisol levels only decreased in the PT group (p < .05). The exercises did not impact DHEA-S and NHP-S parameters. Thus, all interventions resulted in decreased stress, pain intensity, pain sensitivity, central sensitization, and improved function and quality of life; there was no singularly superior approach between interventions. These findings will aid in tailoring treatment programs for managing cLBP according to individual needs.

The impact of somatic symptoms on kinesiophobia after esophagectomy among cancer patients: the mediating roles of intrusive rumination and avoidant coping.

Kinesiophobia refers to an irrational fear of physical activities or functional exercise due to the fear of pain or reinjury. Cancer patients who undergo esophagectomy are prone to developing kinesiophobia, which adversely affects their disease prognosis and quality of life. Somatic symptoms are closely related to kinesiophobia, but the mechanisms underlying this relationship remain unclear. Therefore, the current study aimed to explore the chain-mediation roles of intrusive rumination and avoidant coping in the relationship between somatic symptoms and kinesiophobia in cancer patients who underwent esophagectomy. A cross-sectional study was conducted in China from February 2023 to December 2023. A total of 279 postesophagectomy cancer patients were evaluated using the Symptom Check List 90 (SCL-90), Event Related Rumination Inventory (ERRI), Medical Coping Modes Questionnaire (MCMQ), and Tampa Scale of Kinesiophobia (TSK-11). Kinesiophobia was significantly positively correlated with somatic symptoms, intrusive rumination, and avoidant coping (p < 0.001). Somatic symptoms had a direct association with kinesiophobia (β = 0.280, 95% CI (0.200, 0.360), p < 0.001). Furthermore, our model showed that somatic symptoms had a significant indirect association with kinesiophobia through the separate mediating effects of intrusive rumination (β = 0.204, 95% CI (0.145, 0.267), p < 0.001) and avoidant coping (β = 0.049, 95% CI (0.019, 0.088), p < 0.001), as well as through the chain-mediated effects of intrusive rumination-avoidant coping (β = 0.026, 95% CI (0.012, 0.044), p < 0.001). The findings of this study suggested that intrusive rumination and avoidant coping play separate and chain-mediated roles in the relationship between somatic symptoms and kinesiophobia in postesophagectomy cancer patients.

Clinical Measures Associated with Subsequent Injury after Adolescent Concussion: A Prospective Cohort Study

ABSTRACT Purpose To examine associations between clinical measures (self-reported and clinician-administered) and subsequent injury rates in the year after concussion return to play (RTP) among adolescent athletes. Methods We performed a prospective, longitudinal study of adolescents ages 13-18 years. Each participant was initially assessed within 21 days of concussion and again within 5 days of receiving RTP clearance from their physician. Participants completed self-report measures: the Pittsburgh Sleep Quality Index (PSQI) and Tampa Scale of Kinesiophobia (TSK), and clinician-administered measures: single and dual-task tandem gait (TG) and reaction time (RT; simple and clinical) assessments. They then completed monthly surveys for a year after RTP which assessed exposure to injury (sport participation) and subsequent injuries (musculoskeletal or concussions) sustained. We used Poisson regression models to calculate injury rate ratios with number of subsequent injuries sustained as the outcome, adjusted for RTP clearance time and competitive exposures for each measure. Results 41 participants were included (age = 15.5±1.3 years, 56% female, 9.6±4.6 days post-concussion; 38.0±31.5 days to RTP). A higher injury rate per athletic exposure was observed for simple RT≥505 ms vs &lt;505 ms (injury rate ratio = 3.22; 95% confidence interval = 1.56, 7.12; p = 0.002). Injury rates did not significantly differ by PSQI or TSK scores, single/dual-task TG time, or clinical RT. Conclusions Simple reaction time may be one risk factor that is associated with higher rates of subsequent injury after adolescent concussion. A simple reaction time measure incorporated into a comprehensive concussion RTP assessment may identify some individuals at higher risk of subsequent injury in the year following concussion, though further research is needed to better understand this relationship.

Cross-cultural adaptation and psychometric properties of the Arabic version of the Central Sensitization Inventory in people with chronic musculoskeletal pain.

The Central Sensitization Inventory (CSI) is a patient-reported screening instrument that can be used to identify and assess central sensitization (CS)/Central Sensitization Syndrome (CSS)-related symptoms. The aim was to translate the CSI into Arabic (CSI-Ar) and to subsequently validate its psychometric properties. Cross-sectional. The CSI was translated and cross-culturally adapted into Arabic, and validated following international standardized guidelines. This study included patients with chronic musculoskeletal pain (n = 264) and healthy control participants (n = 56). Patients completed the CSI-Ar, Pain Catastrophizing Scale (PCS), Depression, Anxiety, and Stress scale (DASS-21), Tampa Scale of Kinesiophobia (TSK), and 5-level EuroQol-5D (EQ-5D). Patients completed the CSI-Ar twice to assess test-retest reliability. To evaluate discriminative validity, healthy controls participants completed the CSI-Ar. Statistical analyses were conducted to test the internal consistency, reliability, and structural, construct and discriminant validity of CSI-Ar. The CSI-Ar showed acceptable internal consistency (Cronbach's alpha = 0.919) and excellent test-retest reliability (intraclass correlation coefficient = 0.874). The CSI-Ar scale had significant correlations (P < 0.001) with all PCS subscales and total score (Spearman's rho = 0.459-0.563, P < 0.001), all DASS-21 subscales and total score (Spearman's rho = 0.599-0.685, P < 0.001), the TSK (Spearman's rho = 0.395, P < 0.001), and the EQ-5D (Spearman's rho = -0.396, P < 0.001). The Mann-Whitney U-test showed a statistically significant difference between the patient group and the healthy control group (P < 0.001), with the healthy controls displaying a lower average CSI-Ar score (12.27 ± 11.50) when compared to the patient group (27.97 ± 16.08). Factor analysis indicated that the CSI-Ar is a unidimensional tool. The CSI-Ar is a reliable and valid screening tool that can be used to assess CS/CSS-related symptoms in Arabic-speaking people with chronic musculoskeletal pain.

Cross-Cultural Adaptation, Reliability, and Validity of the Greek Version of the Fremantle Neck Awareness Questionnaire (FreNAQ-GR) in Patients with Chronic Neck Pain

Background: Neck self-awareness, related to sensorimotor dysfunction, can be monitored with the Fremantle Neck Awareness Questionnaire (FreNAQ). The cross-cultural adaptation of the FreNAQ in Greek (FreNAQ-GR) and an assessment of its psychometric properties were conducted. Methods: This study included 104 participants (65 female) with non-specific chronic neck pain (NSCNP). Once the cross-cultural adaptation process of the FreNAQ-GR was complete, the testing of its construct validity was conducted via an exploratory factor analysis (EFA). The construct validity examination also included a correlational analysis with a Pain Intensity Visual Analogue Scale (PI-VAS), the Neck Disability Index (NDI), the Tampa Scale of Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), and demographics. The internal consistency of the FreNAQ-GR was also examined. A sub-sample of participants (n = 30) completed the FreNAQ-GR again after 5–7 days. Results: The dataset was appropriate for EFA (measure of sampling adequacy KMO = 0.763 and Bartlett’s test of sphericity p &lt; 0.001). The FreNAQ-GR demonstrated a single-factor 6-item structure (items 7–9 removed), explaining 53.69% of the common variance. Statistically significant correlations (Spearman’s) were registered between the FreNAQ-GR (both versions) and the NDI (r = 0.33/0.29, p &lt; 0.001), the TSK (r = 0.46/0.41, p &lt; 0.001), and the PCS (r = 0.37/0.33, p &lt; 0.001). For the 9-item and the 6-item FreNAQ-GR, the internal consistency (Chronbach’s a/McDonald’s ω) was 0.80/0.79 and 0.826/0.816, respectively. The test–retest reliability was excellent for both versions ICC2,1 (95% CI) = 0.98/0.98 (0.97–0.99/0.95–0.99), with low error values SEM = 0.90/0.74 and MDC95% = 2.49/2.05 points. Conclusions: The FreNAQ-GR is suitable for assessing neck self-awareness in Greek-speaking patients with NSCNP.

Associations between pain-related fear and lumbar movement variability during activities of daily living in patients with chronic low back pain and healthy controls

Low back pain (LBP) is a global issue involving biological, psychological, and social factors. Pain-related fear has been shown to influence movement behavior, however, its association with some measures of movement behavior, such as spinal movement variability, remains inconclusive. To further investigate this, spinal kinematics during various activities of daily living (i.e., walking, running, lifting, and stair climbing) of 49 patients with chronic LBP and a group of 51 sex-, age-, and BMI-matched healthy controls were used to calculate lumbar spine movement variability which was quantified using different indices (i.e., coefficient of variation, coupling angle variability in vector coding, deviation phase of the continuous relative phase and an angle-angular velocity variability). General and task-specific pain-related fear was assessed using the Tampa Scale of Kinesiophobia and the Photograph Series of Daily Activities—Short Electronic Version, respectively. Linear regression analyses showed no significant association between movement variability and pain-related fear, however, the sample consisted of younger individuals with moderate disability and with low levels of pain and pain-related fear. In addition, the different variability indices were weakly correlated and varied greatly depending on the method used and the task performed. Therefore, comparisons between studies with different movement variability calculation methods or different activities should be treated with caution.

A 7-item Tampa Scale for Kinesiophobia in people with femoroacetabular impingement syndrome: evaluation of structural validity, hypothesis testing, internal consistency and minimally important change

BackgroundThe 17-item Tampa Scale for Kinesiophobia (TSK) is a commonly used patient-reported outcome measure (PROM) to assess kinesiophobia, but the measurement properties of the TSK in people with femoroacetabular impingement syndrome (FAIS) are unknown. Objectives1) Revise the existing TSK by removing items, as needed, with inadequate functioning to optimise the TSK for people with FAIS, and 2) evaluate construct validity (both structural validity and hypothesis testing), internal consistency, and minimal important change. MethodsCross-sectional cohort study including 153 young adults with FAIS. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate structural validity and the TSK was revised to remove items with poor function, improving CFA model fit. Hypothesis testing, internal consistency (Cronbach's α) and minimal important change (distribution-based method) were also evaluated. ResultsA 7-item version of the TSK provided the best CFA model fit with 10-items functioning poorly and needing to be removed. The 7-item TSK was uni-dimensional (single factor in EFA) and had adequate structural validity (Standardised Root Measure Square = 0.0771). The 7-item TSK had insufficient hypothesis testing with moderate correlations to 8/14 PROMs measuring different constructs. The 7-item TSK had adequate internal consistency (α = 0.783). The minimal important change of the 7-item TSK was 6.00 points (0–100 point scale). ConclusionWe found that the ‘7-item TSK for FAIS’, had superior structural validity to the original 17-item scale, suggesting that it may be more appropriate for use in this population. Further studies should evaluate other measurement properties of the 7-item scale.

The effects of open/closed kinetic chain exercises in water on the electrical activity of selected lumbar muscles, lumbopelvic control, ground reaction force and psychological factors in men with chronic non-specific low back pain: A study protocol for a randomized clinical trial

Background and aimResearch has documented chronic non-specific low back pain (CNSLBP) as one of the primary causes of absenteeism at work, often accompanied by the use of health insurance and healthcare services. Considering little research on the consequences of open/closed kinetic chain (O/CKC) exercises in water on CNSLBP improvement, the present study is to investigate the effects of such interventions on the electrical activity of selected lumbar muscles, pain, lumbopelvic control (LPC), ground reaction force (GRF), and psychological factors in men with CNSLBP. Materials and methodsThis is a randomized controlled trial that involves individuals with CNSLBP between the ages of 40 and 60 years. Participants are randomly assigned, using block randomization, to one of the following groups: open kinetic chain (OKC) exercises, closed kinetic chain (CKC) exercises, or controls. The training groups engage in the exercises for eight weeks, with three sessions per week and 60 min each at the University of Bu-Ali Sina pool, following the prescribed workout routine. The primary outcomes of the electrical activity of the multifidus (MF), transversus abdominis (TrA), gluteus medius (GM), and quadratus lumborum (QL) muscles are measured by an electromyography (EMG) device. Additionally, the pressure biofeedback (BFB) device and the visual analog scale (VAS) are utilized to assess LPC and pain intensity, respectively. The secondary outcomes of the GRF, along with foot pressure and kinesiophobia, are subsequently measured by the Tampa Scale of Kinesiophobia (TSK). ConclusionBy comparing the outcomes between the OKC exercise group, CKC exercise group, and control group, this study aims to determine the differential effects of these two water-based exercise interventions on the various physical and psychological parameters in individuals with CNSLBP. The findings provide valuable insights into the most effective approach to water-based rehabilitation for individuals with CNSLBP. By comparing the outcomes of OKC and CKC exercises, healthcare professionals can make informed decisions when designing tailored rehabilitation programs for this patient population. The results also contribute to the development of evidence-based guidelines for the management of CNSLBP using water-based exercises.

Exploring the Interplay Between Kinesiophobia, Lumbar Joint Position Sense, Postural Stability, and Pain in Individuals With Chronic Low Back Pain: A Cross-Sectional Analysis

ObjectiveThe objectives of the study were to (1) determine the association between kinesiophobia and lumbar joint position sense (JPS) in individuals with chronic low back pain (CLBP); (2) examine the relationship between kinesiophobia and postural stability in individuals with CLBP; and (3) investigate whether pain intensity mediates the relationship between kinesiophobia, lumbar JPS, and postural stability in individuals with CLBP. MethodsIn this cross-sectional study, a total of 83 individuals diagnosed with CLBP were included. The level of fear of movement was assessed using the Tampa Scale for Kinesiophobia (TSK). Lumbar JPS was measured using the active target repositioning technique, which involved evaluating JPS in 3 directions: lumbar flexion, side-bending to the left, and side-bending to the right. The repositioning accuracy of the lumbar joint was quantified in degrees using a dual digital inclinometer. Postural stability was assessed using a stabilometric force platform, which measured anterior to posterior (A-P) sway, medial to lateral (M-L) sway, and the ellipse area in mm². ResultsThe findings of this study revealed a statistically significant and moderate positive correlation between kinesiophobia and lumbar JPS in various directions, including flexion (r = 0.51, P < .001), side-bending to the left (r = 0.37, P = .001), and side-bending to the right (r = 0.34, P = .002). Similarly, a significant positive association was observed between kinesiophobia and postural stability, as indicated by the correlation coefficients: A-P sway (r = .47, P < .001), M-L sway (r = 0.58, P < .001), and ellipse area (r = 0.51, P < .001). Furthermore, the analysis revealed that pain significantly mediated the relationship between kinesiophobia and both lumbar JPS (P < .05) and postural stability (P < .05). These findings were demonstrated through mediation analysis. ConclusionsThis study identified a significant association between kinesiophobia, lumbar JPS, and postural stability. Additionally, we observed the presence of pain as a potential mediator in this relationship. However, it is important to note that our cross-sectional study design precludes establishing causality or determining the direct mediation effect of pain on adverse outcomes.