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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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European Journal of Physical and Rehabilitation Medicine 2017 June;53(3):351-8

DOI: 10.23736/S1973-9087.16.04362-8

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Responsiveness and minimal clinically important changes for the Tampa Scale of Kinesiophobia after lumbar fusion during cognitive behavioral rehabilitation

Marco MONTICONE 1, 2 , Emilia AMBROSINI 2, 3, Barbara ROCCA 2, Calogero FOTI 4, Simona FERRANTE 3

1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; 2 Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Salvatore Maugeri Foundation and Institute of Research and Care, Lissone, Italy; 3 Laboratory of Neuroengineering and Medical Robotics, Department of Electronics, Information and Bioengineering, Polytechnic University of Milan, Milan, Italy; 4 Division of Physical Medicine and Rehabilitation, University of Rome Tor Vergata, Rome, Italy


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BACKGROUND: The Tampa Scale of Kinesiophobia (TSK) is a commonly-used measure for the assessment of fear of movement beliefs in chronic complaints, but its responsiveness in subjects after lumbar fusion has been never reported.
AIM: Evaluating the responsiveness and minimal clinically important differences (MCIDs) for the TSK and its subscales after lumbar fusion.
DESIGN: Population-based cohort study.
SETTING: Secondary care rehabilitation hospital.
POPULATION: In-patients undergoing rehabilitation after lumbar fusion.
METHODS: At the beginning and end of a four-week motor and cognitive-behavioral rehabilitation program, 180 patients completed the TSK. After the intervention, the global perceived effect (GPE) was analyzed to produce a dichotomous outcome (improved vs. stable). Responsiveness for the TSK and its subscales were calculated by distribution (effect size [ES], standardized response mean [SRM]) and anchor-based methods (receiver operating characteristics (ROC) curves; correlations between change scores of the TSK and its subscales and GPE). ROC curves were also used to compute MCID values.
RESULTS: The ES ranged from 1.63 to 1.77 and the SRM from 1.25 to 1.39 for TSK and its subscales. The ROC analyses revealed a value of area under the curve (0.999 [95% CI: 0.978; 1.000], 0.998 [95% CI: 0.975; 1.000], 0.990 [95% CI: 0.962; 0.999] for the TSK, Harm and Activity Avoidance subscales, respectively). MCID values greater than 6 (95% CI: >5; >6), 4 (95% CI: >3; >5), and 2 (95% CI: >2; >2) were achieved for the TSK, Harm and Activity Avoidance subscales, respectively. Correlations between change scores of the TSK and its subscales and GPE were high (0.786-0.830).
CONCLUSIONS: The TSK and its subscales were sensitive in detecting clinical changes in subjects undergoing rehabilitation after lumbar fusion.
CLINICAL REHABILITATION IMPACT: The obtained MCID values will help in the design of future randomized controlled trials and in the interpretation of the clinical impact of a rehabilitation program after lumbar fusion.


KEY WORDS: Phobic disorders - Diagnostic techniques and procedures - ROC curve - Minimal clinically important difference

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Publication History

Issue published online: June 15, 2017
Article first published online: November 9, 2016
Manuscript accepted: November 7, 2016
Manuscript revised: October 6, 2016
Manuscript received: June 15, 2016

Per citare questo articolo

Monticone M, Ambrosini E, Rocca B, Foti C, Ferrante S. Responsiveness and minimal clinically important changes for the Tampa Scale of Kinesiophobia after lumbar fusion during cognitive behavioral rehabilitation. Eur J Phys Rehabil Med 2017;53:351-8. DOI: 10.23736/S1973-9087.16.04362-8

Corresponding author e-mail

marco.monticone@unica.it