Lack of value in screening for fear of movement via the Tampa Scale for
Kinesiophobia
Greg McIntosh MSc, Chris Gregg MHealSc, Hamilton Hall MD, Chris Hoffman MD,
Tom Carter BSc PT
CBI Health Group Research Department, Toronto, Canada; The Back Institute,
Wellington, New Zealand
Introduction. The purpose of this study was to assess the role of baseline screening for
fear of movement and pain-related fear - Tampa Scale for Kinesiophobia (TSK) - in a
cohort of low back pain (LBP) patients completing active exercise-based treatment.
Methods. This was a prospective study of LBP cases (n=416) treated at four spine care
rehabilitation clinics in New Zealand between January 2008 and October 2012. In
addition to baseline data on pain, function, sociodemographics, all patients completed a
Tampa Scale for Kinesiophobia (TSK). All patients had mechanical LBP with no
neurology, as determined by the Saskatchewan Spine Pathway triage methodology.
Results. The mean age of the cohort was 39.9 years (SD=11.3, range=18-69) with 63.7%
males. The median symptom duration was 173 days (29% acute, 71% chronic). The
average overall TSK score was 40.8 (SD=9.03, range 6-70).
There were no baseline statistically significant differences in TSK scores based on
dominant pain location, medication use, constancy, work status, presence of sleeping
difficulties, symptom duration, smoking status, legal consultation or pain classification.
Males had significantly higher scores than females (41.9 v 38.6) (p=0.001).
There was no correlation between TSK scores and age or baseline function. For clinical
outcomes, there was no correlation between TSK scores and number of days in treatment,
change in numerical pain rating or functional improvement. There were no statistically
significant differences in TSK scores based on global pain rating or return to work status.
Discussion. The presence of pain-related fear, as measured by the Tampa Scale for
Kinesiophobia (TSK) was not associated with higher disability, poorer function or more
pain in this sample. In addition, baseline characteristics were similar regardless of TSK
score. The lack of differences by TSK score revealed that screening for fear of
movement was not worth the effort and provided little clinical benefit.