Can the Tampa Scale of Kinesiophobia identify chronic neck pain patients at risk of non-recovery?

Abstract

Background: Kinesiophobia has been associated with poor outcome in chronic neck pain (CNP) patients undergoing physical therapy. This has led to the assumption that the Tampa Scale of Kinesiophobia (TSK-13) would be a useful screening tool, allowing early identification of patients at risk for a poor outcome with an opportunity to modify the treatment accordingly.
Objective: To determine the accuracy of the TSK-13 in predicting poor outcomes in CNP patients undergoing physical therapy treatment.
Methods: A prospective cohort study design with a consecutive sample of 32 CNP patients was conducted. Patients were assessed at the baseline and 7 weeks after starting a multimodal physical therapy treatment. Based on a previous study, poor outcome was defined as a change in the Neck Disability Index of less than 27% (minimal clinically important difference). A Receiver Operating Characteristic curve was used to estimate the cutoff score in the TSK-13 with better than chance predictive value. Validity indexes were used to determine relationships between the baseline measure of the TSK-13 and the non-recovery status according to the NDI score.
Results: At 7 weeks post-treatment, 47% (15/32) of the participants indicated nonrecovery. A ROC curve analysis revealed an optimal cut-off score for the TSK-13 of 30 points (sensitivity of 46.7% and a specificity of 52.9%). The area under the receiver operating curve indicated that the TSK-13 was no better than chance, suggesting poor prediction of non-recovery (0.44, 95% CI: 0.242 – 0.645). The baseline score ≥ 30 on
the TSK-13 had a positive likelihood ratio of 0.88 and a negative predictive value as 1.13.
Conclusions: The findings of this preliminary study suggested that the TSK-13 has no potential to predict CNP patients at risk of non-recovery with physical therapy treatment at 7 weeks post-treatment.

Full text

Title: Can the Tampa Scale of Kinesiophobia identify chronic neck pain patients at risk
of non-recovery?
Duarte, S.
1
; Cruz, E.B.
2
Background: Kinesiophobia has been associated with poor outcome in chronic neck
pain (CNP) patients undergoing physical therapy. This has led to the assumption that
the Tampa Scale of Kinesiophobia (TSK-13) would be a useful screening tool, allowing
early identification of patients at risk for a poor outcome with an opportunity to
modify the treatment accordingly.
Objective: To determine the accuracy of the TSK-13 in predicting poor outcomes in
CNP patients undergoing physical therapy treatment.
Methods: A prospective cohort study design with a consecutive sample of 32 CNP
patients was conducted. Patients were assessed at the baseline and 7 weeks after
starting a multimodal physical therapy treatment. Based on a previous study, poor
outcome was defined as a change in the Neck Disability Index of less than 27%
(minimal clinically important difference). A Receiver Operating Characteristic curve
was used to estimate the cutoff score in the TSK-13 with better than chance predictive
value. Validity indexes were used to determine relationships between the baseline
measure of the TSK-13 and the non-recovery status according to the NDI score.
Results: At 7 weeks post-treatment, 47% (15/32) of the participants indicated non-
recovery. A ROC curve analysis revealed an optimal cut-off score for the TSK-13 of 30
points (sensitivity of 46.7% and a specificity of 52.9%).
The area under the receiver
operating curve indicated that the TSK-13 was no better than chance, suggesting poor
prediction of non-recovery (0.44, 95% CI: 0.242 – 0.645). The baseline score ≥ 30 on
the TSK-13 had a positive likelihood ratio of 0.88 and a negative predictive value as
1.13.
Conclusions: The findings of this preliminary study suggested that the TSK-13 has no
potential to predict CNP patients at risk of non-recovery with physical therapy
treatment at 7 weeks post-treatment.
Key words: Chronic neck pain, kinesiophobia, Tampa Scale of kinesiophobia, predictive validity.