Farzad Maryam, MacDermid Joy, Packham Tara
Occupational Therapy, Department of Health and Rehabilitation Sciences, Hand and Upper Limb Center, St. Joseph's Health Center, School of Physical Therapy, University of Western Ontario, London, ON, Canada.
Physical Therapy and Surgery, Western University, London, ON, Canada.
Clin J Pain. 2024 Jan 1;40(1):26-34. doi: 10.1097/AJP.0000000000001169.
People with complex regional pain syndrome (CRPS) commonly report a fear of movement that can worsen symptoms and increase disability. The Tampa Scale of Kinesiophobia (TSK) is used to evaluate fear of movement and (re)injury, but findings have been inconsistent in different populations.
To evaluate the psychometric properties of the Persian version of TSK-11 in individuals with upper limb CRPS. Specifically, to determine whether the factor structure aligns with the original 2-factor model, consisting of "activity avoidance" and "somatic focus."
People with CRPS (n=142, mean age=42, 54% female) completed the TSK. The psychometric testing included internal consistency, test-retest reliability (intraclass correlation coefficient), and convergent construct validity. Confirmatory and exploratory factor analyses were performed to evaluate the structural validity.
The TSK-11 showed acceptable internal consistency (Cronbach alpha 0.93) and excellent test-retest reliability (intraclass correlation coefficient=0.93, 95% CI: 0.92-0.94). The Standard Error of Measurement and Minimal Detectable Change were 4.3 and 11.7, respectively. The results also demonstrated excellent criterion validity ( r =0.81). Confirmatory factor analysis demonstrated that the original 2-factor model did not fit. Exploratory factor analysis derived a 2-factor solution with different items. The factor structure accounted for 64.91% of the variance, and the internal consistency of the factors was acceptable (>0.90). Expert consensus suggested naming these 2 factors as fear avoidance and magnification and helplessness.
The TSK-11 demonstrates excellent retest reliability in people with CRPS. The original 2-factor structure was not confirmed, and a new 2-factor structure of the TSK-11 was proposed consisting of subscales for Fear Avoidance Beliefs and Magnification/Helplessness. Given the overlap between these constructs and the construct of pain catastrophizing, further study is needed to clarify both measures' content validity and relative uniqueness.
复杂性区域疼痛综合征（CRPS）患者普遍报告害怕运动，这会使症状恶化并增加残疾程度。坦帕运动恐惧量表（TSK）用于评估对运动和（再）受伤的恐惧，但在不同人群中的研究结果并不一致。
评估波斯语版TSK - 11在患有上肢CRPS个体中的心理测量特性。具体而言，确定其因子结构是否与由“活动回避”和“躯体关注”组成的原始双因子模型一致。
CRPS患者（n = 142，平均年龄 = 42岁，54%为女性）完成了TSK测试。心理测量测试包括内部一致性、重测信度（组内相关系数）和聚合效度。进行验证性和探索性因子分析以评估结构效度。
TSK - 11显示出可接受的内部一致性（克朗巴哈α系数为0.93）和出色的重测信度（组内相关系数 = 0.93，95%置信区间：0.92 - 0.94）。测量标准误和最小可检测变化分别为4.3和11.7。结果还显示出出色的效标效度（r = 0.81）。验证性因子分析表明原始双因子模型不拟合。探索性因子分析得出了一个包含不同条目的双因子解决方案。该因子结构解释了64.91%的方差，各因子的内部一致性可接受（>0.90）。专家共识建议将这两个因子命名为恐惧回避以及放大与无助。
TSK - 11在CRPS患者中显示出出色的重测信度。未证实原始双因子结构，提出了TSK - 11的新双因子结构，由恐惧回避信念和放大/无助子量表组成。鉴于这些结构与疼痛灾难化结构之间的重叠，需要进一步研究以阐明这两种测量方法的内容效度和相对独特性。
