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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 2016 Nov 09

lingua: Inglese

Responsiveness and minimal important changes of the tampa scale of kinesiophobia in subjects after lumbar fusion undergoing multidisciplinary cognitive behavioural rehabilitation

Marco MONTICONE 1, 2, Emilia AMBROSINI 2, 3, 6, Barbara ROCCA 2, Calogero FOTI 4, Simona FERRANTE 5

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, Institute of Care and Research (IRCCS), Lissone, Italy; 3 Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy; 4 Chair of Physical Medicine and Rehabilitation, University of Rome "Torvergata", Rome, Italy; 5 Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, 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 important changes (MICs) 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-behavioural rehabilitation program, 180 patients completed the TSK. After the intervention, the global perceived effect (GPE) was analysed to produce a dichotomous outcome (improved vs. stable). Responsiveness for the TSK and its subscales were calculated by distribution [effect size (ES); standardised 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 MIC 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 [95% Confidence Interval (CI)] of 0.999 [0.978; 1.000], 0.998 [0.975; 1.000], 0.990 [0.962; 0.999] for the TSK, Harm and Activity Avoidance subscales, respectively. MIC values [95% CI] greater than 6 [>5; >6], 4 [>3; >5], and 2 [>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.

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marco.monticone@unica.it