The Relationship of Kinesiophobia with Pain and Quality of Life in Idiopathic Scoliosis

Study Design. Prospective, multi-centric, cross-sectional study. Objective. To analyze the construct validity of the Tampa Scale of Kinesiophobia (TSK) in a cohort of patients with adolescent idiopathic scoliosis (AIS). Summary of the Background Data. Back pain is not uncommon in AIS. The fear of movement (kinesiophobia) in response to pain is related to back pain. TSK psychometric properties in AIS patients have not been properly analyzed. Methods. Patients with AIS and no prior spine surgery were prospectively included. They fulfilled the Spanish version of the TSK-11 questionnaire, a pain intensity numerical rating scale (NRS), refined SRS-22 (SRS-22r), the Hospital Anxiety and Depression Scale (HADS), and item 7 of the Core Outcome Measurement Index (COMI). The sample was split into two groups for the statistical analysis: adolescents and young adults. Cronbach alpha was used to assess internal consistency. Discriminant and concurrent validity were obtained by computing Pearson correlation coefficients between the TSK score and several criterion measures. Results. A total of 275 patients were included—198 adolescents (mean age of 14.6 yrs) and 77 young adults (mean age of 26.9 yrs). The Cobb of largest curve means were 44.9° and 48.9°, respectively. In the adolescent group, the TSK mean (±SD) was 21.5 (±5.93), with a floor effect of 2.5%. In the adult group, the TSK mean was 24.2 (±6.63), with a floor effect of 3.9%. The ceiling effect was 0% in both groups. Cronbach alphas for the adolescent and adult groups were 0.76 and 0.79, respectively. No correlation was found in any group between the TSK score and the curve magnitude or pattern (Lenke classification). The TSK was significantly correlated with HAD depression and SRS-22r in both groups. However, these correlations were weaker in adolescents. In adults, the TSK also significantly correlates with NRS and work/school absenteeism. Conclusion. The Spanish version of TSK-11 is a reliable and valid instrument to analyze kinesiophobia in AIS. However, the weak correlation between kinesiophobia and pain intensity, disability, and emotional condition in adolescents requires further study. Level of Evidence: 4