van Iersel Theodore P, Larsen van Gastel Marianne, Versantvoort Astrid, Hekman Karin M C, Sierevelt Inger N, Broekman Birit F P, van den Bekerom Michel P J
Shoulder and elbow unit, Department of Orthopedic Surgery, OLVG, Amsterdam, The Netherlands.
Amsterdam Shoulder and Elbow Centre of Expertise (ASECE), Amsterdam, The Netherlands.
Arthrosc Sports Med Rehabil. 2023 Jul 24;5(4):100768. doi: 10.1016/j.asmr.2023.100768. eCollection 2023 Aug.
To assess content validity and to modify the Tampa Scale of Kinesiophobia (TSK) to make it suitable for application in patients with anterior shoulder instability.
A four-round Delphi method was performed to establish expert consensus on developing the Tampa Scale of Kinesiophobia for patients with anterior shoulder instability (TSK-SI) using an expert group of Dutch shoulder-specialized orthopedic surgeons and physiotherapists. During round 1, experts were asked to score the 17 items of the original TSK on relevance and construction using the COSMIN guidelines. With this feedback, questions were reviewed and modified. During round 2, experts were asked to score the modified items. This process was repeated until consensus was established. Then, patients were asked to participate in a moderator-guided, three-step-test interview using a Web-based platform to assess the modified scale. Sessions were recorded and evaluated by the working group. The modified scale was finally adjusted on the basis of the input of these patients.
Thirty Dutch shoulder experts were included, of which 25 completed all 4 rounds, after which consensus was established. One question was added to the modified scale based on feedback in round 1, establishing the 18-item TSK-SI. Sixteen patients with shoulder instability were included, which all completed the three-step test interview. Following this, question 4 (changed to present tense) and question 7 (hypothetical component added) were adjusted, resulting in the final TSK-SI.
This consensus modification of the TSK to TSK-SI can support the content validity of the instrument to assess kinesiophobia in patients with anterior shoulder instability. These modifications may improve the responsiveness and validity of the TSK-SI, as it does not match all the items of the original TSK.
Level V, consensus statement.
评估内容效度，并对坦帕运动恐惧量表（TSK）进行修订，使其适用于前肩不稳患者。
采用四轮德尔菲法，由荷兰肩部专科骨科医生和物理治疗师组成的专家组就开发前肩不稳患者的坦帕运动恐惧量表（TSK-SI）达成专家共识。在第一轮中，要求专家根据COSMIN指南对原始TSK的17个项目在相关性和结构方面进行评分。根据这些反馈，对问题进行审查和修改。在第二轮中，要求专家对修改后的项目进行评分。重复这个过程，直到达成共识。然后，让患者使用基于网络的平台参与由主持人引导的三步测试访谈，以评估修改后的量表。会议由工作组进行记录和评估。最终根据这些患者的意见对修改后的量表进行调整。
纳入了30名荷兰肩部专家，其中25名完成了所有4轮，之后达成了共识。根据第一轮的反馈，在修改后的量表中增加了一个问题，形成了18项的TSK-SI。纳入了16名肩部不稳患者，他们都完成了三步测试访谈。在此之后，对问题4（改为现在时态）和问题7（添加假设成分）进行了调整，形成了最终的TSK-SI。
将TSK修订为TSK-SI的这一共识性修改能够支持该工具在评估前肩不稳患者运动恐惧方面的内容效度。这些修改可能会提高TSK-SI的反应性和效度，因为它与原始TSK的所有项目并不完全匹配。
V级，共识声明。
