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Psychometric Properties of the Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in Patients With Shoulder Pain
Authors:Paul E Mintken  Joshua A Cleland  Julie M Whitman  Steven Z George
Institution:a University of Colorado Denver, School of Medicine, Department of Physical Therapy, Aurora, CO
b Wardenburg Health Center at the University of Colorado Boulder, Boulder, CO
c Department of Physical Therapy, Franklin Pierce University, Concord, NH
d Concord Hospital, Concord, NH
e Regis University Manual Therapy Fellowship Program, Denver, CO
f Evidence in Motion's Orthopedic Manual Physical Therapy Program, Louisville, KY
g School of Physical Therapy, Regis University, Denver, CO
h Department of Physical Therapy, Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL
Abstract:Mintken PE, Cleland JA, Whitman JM, George SZ. Psychometric properties of the Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in patients with shoulder pain.

Objective

To investigate the reliability and validity of 2 commonly used measures of pain related fear in patients with shoulder pain.

Design

A preplanned secondary analysis of a prospective single-arm trial involving a repeated-measures design.

Setting

Outpatient physical therapy clinics.

Participants

Patients (N=80) with a primary report of shoulder pain.

Intervention

All patients completed the outcome measures at baseline and at follow-up.

Main Outcome Measures

Patients completed a modified Fear-Avoidance Beliefs Questionnaire (FABQ), the 11-item version of Tampa Scale of Kinesiophobia (TSK-11), and the Shoulder Pain and Disability Index (SPADI) at baseline and at a 48-hour follow-up. Patients were dichotomized as improved or stable at follow-up based on the Global Rating of Change.

Results

Factor analysis indicated 3 stable factors for the FABQ and 1 stable factor for the TSK-11. Shoulder specific scoring for the FABQ and TSK-11 were used in subsequent analyses. Test-retest reliability intraclass correlation coefficient (ICC) was substantial for the FABQ and the TSK-11. The FABQ correlated significantly with SPADI pain and disability scores, while the TSK-11 correlated significantly only with SPADI pain scores. The shoulder-specific FABQ-W (work beliefs subscale) was a better than chance predictor of missing days of work during the 48-hour study period.

Conclusions

The modified FABQ and TSK-11 may be appropriate for use in patients with shoulder pain. Shoulder-specific scoring of these measures resulted in substantial test-retest reliability, and the FABQ correlated with the SPADI for pain and disability. The FABQ also showed potential for prediction of short-term work loss in this sample. Pain-related fear may be an important variable in patients with shoulder pain and merits future consideration in longitudinal studies.
Keywords:Avoidance learning  Fear  Psychology  Movement  Rehabilitation
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