Kinesiophobia Severity Categories and Clinically Meaningful Symptom Change in Persons With Achilles Tendinopathy in a Cross-Sectional Study: Implications for Assessment and Willingness to Exercise

Ruth L. Chimenti; Andrew A. Post; Karin Gravare Silbernagel; Katherine Hadlandsmyth; Kathleen A. Sluka; G. Lorimer Moseley; Ebonie Rio

doi:10.3389/fpain.2021.739051

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Kinesiophobia Severity Categories and Clinically Meaningful Symptom Change in Persons With Achilles Tendinopathy in a Cross-Sectional Study: Implications for Assessment and Willingness to Exercise

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Kinesiophobia Severity Categories and Clinically Meaningful Symptom Change in Persons With Achilles Tendinopathy in a Cross-Sectional Study: Implications for Assessment and Willingness to Exercise

Ruth L. Chimenti, Andrew A. Post, Karin Gravare Silbernagel, Katherine Hadlandsmyth, Kathleen A. Sluka, G. Lorimer Moseley and Ebonie Rio

Frontiers in Pain Research, Vol.2, 739051

09/01/2021

DOI: 10.3389/fpain.2021.739051

PMCID: PMC8915659

PMID: 35295417

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Abstract

Objectives: (1) Validate thresholds for minimal, low, moderate, and high fear of movement on the 11-item Tampa Scale of Kinesiophobia (TSK-11), and (2) Establish a patient-driven minimal clinically important difference (MCID) for Achilles tendinopathy (AT) symptoms of pain with heel raises and tendon stiffness.Methods: Four hundred and forty-two adults with chronic AT responded to an online survey, including psychosocial questionnaires and symptom-related questions (severity and willingness to complete heel raises and hops). Kinesiophobia subgroups (Minimal ≤ 22, Low 23–28, Moderate 29–35, High ≥ 36 scores on the TSK-11), pain MCID subgroups (10-, 20-, 30-, >30-points on a 0- to 100-point scale), and stiffness MCID subgroups (5, 10, 20, >20 min) were described as median [interquartile range] and compared using non-parametric statistics.Results: Subgroups with higher kinesiophobia reported were less likely to complete three heel raises (Minimal = 93%, Low = 74%, Moderate = 58%, High = 24%). Higher kinesiophobia was associated with higher expected pain (Minimal = 20.0 [9.3–40.0], Low = 43.0 [20.0–60.0], Moderate = 50.0 [24.0–64.0], High = 60.5 [41.3–71.0]) yet not with movement-evoked pain (Minimal = 25.0 [5.0–43.0], Low = 31.0 [18.0–59.0], Moderate = 35.0 [20.0–60.0], High = 43.0 [24.0–65.3]). The most common pain MCID was 10 points (39% of respondents). Half of respondents considered a 5-min (35% of sample) or 10-min (16%) decrease in morning stiffness as clinically meaningful.Conclusions: Convergent validity of TSK-11 thresholds was supported by association with pain catastrophizing, severity of expected pain with movement, and willingness to complete tendon loading exercises. Most participants indicated that reducing their pain severity to the mild range would be clinically meaningful.

Chronic Pain

catastrophizing

fear of movement

minimal clinically importance difference

tendinopathy

Details

Title: Subtitle: Kinesiophobia Severity Categories and Clinically Meaningful Symptom Change in Persons With Achilles Tendinopathy in a Cross-Sectional Study: Implications for Assessment and Willingness to Exercise
Creators: Ruth L. Chimenti - Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, United States
Andrew A. Post - Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, United States
Karin Gravare Silbernagel - Department of Physical Therapy, University of Delaware, Newark, DE, United States
Katherine Hadlandsmyth - Department of Anesthesia, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Kathleen A. Sluka - Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, United States
G. Lorimer Moseley - Sansom Institute for Health Research, IIMPACT in Health, University of South Australia, Adelaide, SA, Australia
Ebonie Rio - School of Allied Health, LaTrobe Sport and Exercise Medicine Research Center, La Trobe University, Bundoora, VIC, Australia
Resource Type: Journal article
Publication Details: Frontiers in Pain Research, Vol.2, 739051
DOI: 10.3389/fpain.2021.739051
PMID: 35295417
PMCID: PMC8915659
NLM abbreviation: Front Pain Res (Lausanne)
eISSN: 2673-561X
Publisher: Frontiers Media S.A
Grant note: DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences; DOI: 10.13039/100005924, name: International Association for the Study of Pain; DOI: 10.13039/501100000925, name: National Health and Medical Research Council
Language: English
Date published: 09/01/2021
Academic Unit: Psychiatry; Iowa Neuroscience Institute; Nursing; Anesthesia; Physical Therapy and Rehabilitation Science; Neuroscience and Pharmacology
Record Identifier: 9984129908302771

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