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Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons with Neck and Back Pain

Year 2025, Volume: 9 Issue: 2, 382 - 388, 31.05.2025

Zuhal Abasıyanık , Yusuf Emük , Seviye Çifitci , Turhan Kahraman

https://doi.org/10.30621/jbachs.1630633

Abstract

Purpose: Kinesiophobia is a significant concern in persons with neck and back pain. This study aimed to evaluate the measurement properties of the Single-Item Kinesiophobia Scale (SKS) including test-retest reliability and convergent validity.

Material and Methods: A total of 101 participants (n=38 with neck pain and n=63 with back pain) were included. The SKS was applied twice 7-14 days apart. Test-retest reliability was assessed using intraclass correlation coefficients (ICCs). Validity was examined through correlations with established measures: the Tampa Scale for Kinesiophobia (TKS), Visual Analog Scale (VAS) during activity and rest, Neck Disability Index (NDI), and Oswestry Disability Index (ODI). Floor/ceiling effects and score distribution were also analyzed.

Results: The SKS demonstrated moderate test-retest reliability [neck pain: ICC=0.56 (95%CI: 0.30–0.75), back pain: 0.52 (95%CI: 0.31–0.68)] in the back pain group. It demonstrated moderate correlations with the TKS (rho=0.446-0.555) but small correlations with the VAS (rho=0.261–0.265) and ODI (rho=0.278) in the back pain group. No significant correlations were found between the SKS and VAS or NDI in the neck pain group.

Conclusion: The SKS is a simple and feasible screening tool for kinesiophobia but should be used alongside comprehensive measures due to its moderate psychometric properties and limitations.

Keywords

Kinesiophobia Pain Neck Pain Back Pain

Ethical Statement

The Non-interventional Clinical Research Ethics Committee of Izmir Katip Celebi University (Date: 21.04.2022, Approval Number: 0178) approved the study.

Supporting Institution

The present study was supported by the Scientific and Technological Research Council of Turkey (TUBITAK) within the scope of 2209-National/International Research Projects Fellowship Programme for Undergraduate Students 2022.

Thanks

The authors acknowledge the students Şiyar Erbağa, Elif Yalım, and Pervin Bala for their help in data collection.

References

  • Kori SH, Miller RP, Todd DD. Kinesiophobia: A new view of chronic pain behavior. Pain Management. 1990; 3:35–43.
  • Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain 2000;85(3):317–332.
  • Crombez G, Eccleston C, Van Damme S, Vlaeyen JWS, Karoly P. Fear-avoidance model of chronic pain: The next generation. Clin J Pain 2012;28(6):475–483.
  • Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma K, Vlaeyen JWS. The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence. J Behav Med 2007;30(1):77–94.
  • Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: A systematic review. Br J Sports Med 2019;53(9):554–559.
  • Alschuler KN, Hoodin F, Murphy SL, et al. Factors contributing to physical activity in a chronic low back pain clinical sample: A comprehensive analysis using continuous ambulatory monitoring. Pain 2011;152(11):2521–2527.
  • Uluğ N, Yakut Y, Alemdaroğlu İ, Yılmaz Ö. Comparison of pain, kinesiophobia and quality of life in patients with low back and neck pain. J Phys Ther Sci 2016;28(2):665–670.
  • Antunes RS, Macedo BG de, Amaral T da S, Gomes H de A, Pereira LSM, Rocha FL. Pain, kinesiophobia and quality of life in chronic low back pain and depression. Acta Ortop Bras 2013;21(1):27–29.
  • Picavet HSJ. Pain Catastrophizing and Kinesiophobia: Predictors of Chronic Low Back Pain. Am J Epidemiol 2002;156(11):1028–1034.
  • Gunay Ucurum S. The relationship between pain severity, kinesiophobia, and quality of life in patients with non-specific chronic neck pain. J Back Musculoskelet Rehabil 2019;32(5):677–683.
  • Soysal M, Kara B, Arda MN. Assessment of physical activity in patients with chronic low back or neck pain. Turk Neurosurg 2013;23(1):75–80.
  • Varallo, G., Scarpina, F., Giusti, E. M., Cattivelli, R., Guerrini Usubini, A., Capodaglio, P., & Castelnuovo, G. Does kinesiophobia mediate the relationship between pain intensity and disability in individuals with chronic low-back pain and obesity? Brain sciences 2021;11(6), 684.
  • Dupuis F, Cherif A, Batcho C, Massé-Alarie H, Roy JS. The Tampa Scale of Kinesiophobia: A Systematic Review of Its Psychometric Properties in People with Musculoskeletal Pain. Clin J Pain 2023;39(5):236-247.
  • Woby SR, Roach NK, Urmston M, Watson PJ. Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain 2005;117(1-2):137-44.
  • Knapik A, Saulicz E, Gnat R. Kinesiophobia- introducing a new diagnostic tool. J Hum Kinet 2011;28:25-31.
  • Verwoerd AJH, Luijsterburg PAJ, Timman R, Koes BW, Verhagen AP. A single question was as predictive of outcome as the Tampa Scale for Kinesiophobia in people with sciatica: an observational study. J Physiother 2012; 58(4):249–254.
  • Kline P. Psychometrics and psychology. London, United Kingdom: Academic Press; 1979.
  • Mokkink LB, de Vet HCW, Prinsen CAC, et al. COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures. Quality of Life Research 2018;27(5):1171–1179.
  • Tunca Yilmaz Oznur, Yakut Yavuz, Uygur Fatma, Ulug Naime. Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. Fizyoterapi Rehabilitasyon 2011;22(1):44–49.
  • Aslan E, Karaduman A, Yakut Y, Aras B, Simsek İE, Yagli N. The Cultural Adaptation, Reliability and Validity of Neck Disability Index in Patients with Neck Pain A Turkish Version Study. Spine (Phila Pa 1976) 2008;33(11):362–365.
  • Fairbank J, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000; 25(22):2940–2953.
  • Yakut E, Düger T, Öksüz Ç, et al. Validation of the Turkish Version of the Oswestry Disability Index for Patients with Low Back Pain. Spine (Phila Pa 1976) 2004;29(5):581–585.
  • Ohnhaus EE, Adler R. Methodological problems in the measurement of pain: A comparison between the verbal rating scale and the visual analogue scale. Pain 1975;1(4):379–384.
  • Munro BH. Statistical Methods for Health Care Research. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.
  • Cohen J. Statistical Power Analysis for the Behavioural Science (Effect sizes ANOVA and Pearsons Coefficents). Vol. 3. 1988.
  • McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveys adequate? Quality of Life Research 1995;4(4):293–307.
  • Linton SJ, Shaw WS. Impact of psychological factors in the experience of pain. Phys Ther 2011;91(5):700–711.
  • Bilgin S, Cetin H, Karakaya J, Kose N. Multivariate Analysis of Risk Factors Predisposing to Kinesiophobia in Persons with Chronic Low Back and Neck Pain. J Manipulative Physiol Ther 2019;42(8):565–571.

Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons with Neck and Back Pain

Year 2025, Volume: 9 Issue: 2, 382 - 388, 31.05.2025

Zuhal Abasıyanık , Yusuf Emük , Seviye Çifitci , Turhan Kahraman

https://doi.org/10.30621/jbachs.1630633

Abstract

References

  • Kori SH, Miller RP, Todd DD. Kinesiophobia: A new view of chronic pain behavior. Pain Management. 1990; 3:35–43.
  • Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain 2000;85(3):317–332.
  • Crombez G, Eccleston C, Van Damme S, Vlaeyen JWS, Karoly P. Fear-avoidance model of chronic pain: The next generation. Clin J Pain 2012;28(6):475–483.
  • Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma K, Vlaeyen JWS. The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence. J Behav Med 2007;30(1):77–94.
  • Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: A systematic review. Br J Sports Med 2019;53(9):554–559.
  • Alschuler KN, Hoodin F, Murphy SL, et al. Factors contributing to physical activity in a chronic low back pain clinical sample: A comprehensive analysis using continuous ambulatory monitoring. Pain 2011;152(11):2521–2527.
  • Uluğ N, Yakut Y, Alemdaroğlu İ, Yılmaz Ö. Comparison of pain, kinesiophobia and quality of life in patients with low back and neck pain. J Phys Ther Sci 2016;28(2):665–670.
  • Antunes RS, Macedo BG de, Amaral T da S, Gomes H de A, Pereira LSM, Rocha FL. Pain, kinesiophobia and quality of life in chronic low back pain and depression. Acta Ortop Bras 2013;21(1):27–29.
  • Picavet HSJ. Pain Catastrophizing and Kinesiophobia: Predictors of Chronic Low Back Pain. Am J Epidemiol 2002;156(11):1028–1034.
  • Gunay Ucurum S. The relationship between pain severity, kinesiophobia, and quality of life in patients with non-specific chronic neck pain. J Back Musculoskelet Rehabil 2019;32(5):677–683.
  • Soysal M, Kara B, Arda MN. Assessment of physical activity in patients with chronic low back or neck pain. Turk Neurosurg 2013;23(1):75–80.
  • Varallo, G., Scarpina, F., Giusti, E. M., Cattivelli, R., Guerrini Usubini, A., Capodaglio, P., & Castelnuovo, G. Does kinesiophobia mediate the relationship between pain intensity and disability in individuals with chronic low-back pain and obesity? Brain sciences 2021;11(6), 684.
  • Dupuis F, Cherif A, Batcho C, Massé-Alarie H, Roy JS. The Tampa Scale of Kinesiophobia: A Systematic Review of Its Psychometric Properties in People with Musculoskeletal Pain. Clin J Pain 2023;39(5):236-247.
  • Woby SR, Roach NK, Urmston M, Watson PJ. Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain 2005;117(1-2):137-44.
  • Knapik A, Saulicz E, Gnat R. Kinesiophobia- introducing a new diagnostic tool. J Hum Kinet 2011;28:25-31.
  • Verwoerd AJH, Luijsterburg PAJ, Timman R, Koes BW, Verhagen AP. A single question was as predictive of outcome as the Tampa Scale for Kinesiophobia in people with sciatica: an observational study. J Physiother 2012; 58(4):249–254.
  • Kline P. Psychometrics and psychology. London, United Kingdom: Academic Press; 1979.
  • Mokkink LB, de Vet HCW, Prinsen CAC, et al. COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures. Quality of Life Research 2018;27(5):1171–1179.
  • Tunca Yilmaz Oznur, Yakut Yavuz, Uygur Fatma, Ulug Naime. Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. Fizyoterapi Rehabilitasyon 2011;22(1):44–49.
  • Aslan E, Karaduman A, Yakut Y, Aras B, Simsek İE, Yagli N. The Cultural Adaptation, Reliability and Validity of Neck Disability Index in Patients with Neck Pain A Turkish Version Study. Spine (Phila Pa 1976) 2008;33(11):362–365.
  • Fairbank J, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000; 25(22):2940–2953.
  • Yakut E, Düger T, Öksüz Ç, et al. Validation of the Turkish Version of the Oswestry Disability Index for Patients with Low Back Pain. Spine (Phila Pa 1976) 2004;29(5):581–585.
  • Ohnhaus EE, Adler R. Methodological problems in the measurement of pain: A comparison between the verbal rating scale and the visual analogue scale. Pain 1975;1(4):379–384.
  • Munro BH. Statistical Methods for Health Care Research. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.
  • Cohen J. Statistical Power Analysis for the Behavioural Science (Effect sizes ANOVA and Pearsons Coefficents). Vol. 3. 1988.
  • McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveys adequate? Quality of Life Research 1995;4(4):293–307.
  • Linton SJ, Shaw WS. Impact of psychological factors in the experience of pain. Phys Ther 2011;91(5):700–711.
  • Bilgin S, Cetin H, Karakaya J, Kose N. Multivariate Analysis of Risk Factors Predisposing to Kinesiophobia in Persons with Chronic Low Back and Neck Pain. J Manipulative Physiol Ther 2019;42(8):565–571.
There are 28 citations in total.

Details

Primary Language English
Subjects Pain
Journal Section Research Article
Authors

Zuhal Abasıyanık 0000-0003-3086-8102

Yusuf Emük 0000-0002-4128-4340

Seviye Çifitci 0009-0008-4459-3019

Turhan Kahraman 0000-0002-8776-0664

Publication Date May 31, 2025
Submission Date January 31, 2025
Acceptance Date April 14, 2025
Published in Issue Year 2025 Volume: 9 Issue: 2

Cite

APA Abasıyanık, Z., Emük, Y., Çifitci, S., Kahraman, T. (2025). Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons with Neck and Back Pain. Journal of Basic and Clinical Health Sciences, 9(2), 382-388. https://doi.org/10.30621/jbachs.1630633
AMA Abasıyanık Z, Emük Y, Çifitci S, Kahraman T. Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons with Neck and Back Pain. JBACHS. May 2025;9(2):382-388. doi:10.30621/jbachs.1630633
Chicago Abasıyanık, Zuhal, Yusuf Emük, Seviye Çifitci, and Turhan Kahraman. “Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons With Neck and Back Pain”. Journal of Basic and Clinical Health Sciences 9, no. 2 (May 2025): 382-88. https://doi.org/10.30621/jbachs.1630633.
EndNote Abasıyanık Z, Emük Y, Çifitci S, Kahraman T (May 1, 2025) Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons with Neck and Back Pain. Journal of Basic and Clinical Health Sciences 9 2 382–388.
IEEE Z. Abasıyanık, Y. Emük, S. Çifitci, and T. Kahraman, “Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons with Neck and Back Pain”, JBACHS, vol. 9, no. 2, pp. 382–388, 2025, doi: 10.30621/jbachs.1630633.
ISNAD Abasıyanık, Zuhal et al. “Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons With Neck and Back Pain”. Journal of Basic and Clinical Health Sciences 9/2 (May 2025), 382-388. https://doi.org/10.30621/jbachs.1630633.
JAMA Abasıyanık Z, Emük Y, Çifitci S, Kahraman T. Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons with Neck and Back Pain. JBACHS. 2025;9:382–388.
MLA Abasıyanık, Zuhal et al. “Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons With Neck and Back Pain”. Journal of Basic and Clinical Health Sciences, vol. 9, no. 2, 2025, pp. 382-8, doi:10.30621/jbachs.1630633.
Vancouver Abasıyanık Z, Emük Y, Çifitci S, Kahraman T. Validity and Reliability of The Single-Item Kinesiophobia Scale in Persons with Neck and Back Pain. JBACHS. 2025;9(2):382-8.
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