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Patient-reported outcome measure

TSK-11 Calculator

Tampa Scale of Kinesiophobia, 11-item version

The TSK-11 is the 11-item short form of the Tampa Scale of Kinesiophobia, which drops the four reverse-scored items and items 9 and 14 of the original, scores each remaining statement 1 to 4 for a total of 11 to 44, and reads a higher total as more fear of movement and (re)injury.

Free to use11 items~3 min11–44, lower is better

Fear of movement and (re)injury

Please select the response that best represents your level of agreement or disagreement with each statement.

1I’m afraid that I might injure myself if I exercise.
2If I were to try to overcome it, my pain would increase.
3My body is telling me I have something dangerously wrong.
4People aren’t taking my medical condition seriously enough.
5My accident has put my body at risk for the rest of my life.
6Pain always means I have injured my body.
7Simply being careful that I do not make any unnecessary movements is the safest thing I can do to prevent my pain from worsening.
8I wouldn’t have this much pain if there weren’t something potentially dangerous going on in my body.
9Pain lets me know when to stop exercising so that I don’t injure myself.
10I can’t do all the things normal people do because it’s too easy for me to get injured.
11No one should have to exercise when he/she is in pain.

What the TSK-11 score means

TSK-11 totals run from 11 to 44, where a lower score is better. No severity bands are shown because no cut-offs have been published that we can verify — read the total against the source studies and your own protocol, as described below.

    How the score is calculated

    Stated in full so the calculation can be independently checked, and reproduced by hand if needed.

    Each of the 11 statements is answered on a four-point scale — strongly disagree 1, disagree 2, agree 3, strongly agree 4 — and the 11 scores are added for a total from 11 to 44. A higher total means more fear of movement and (re)injury. The 11 items are items 1, 2, 3, 5, 6, 7, 10, 11, 13, 15 and 17 of the 17-item Tampa Scale of Kinesiophobia; the four reverse-scored items (4, 8, 12 and 16) and items 9 and 14 are left out, so no item needs reversing. No severity bands are shown because we could not verify a published cut-off for the 11-item version.

    Missing data

    No missing-data rule has been published for the scale, so a total is calculated only when every item is answered. A total prorated from partial answers is not comparable with published scores.

    Instrument profile

    Developer
    S. R. Woby, N. K. Roach, M. Urmston and P. J. Watson
    Institution
    United Kingdom
    First published
    2005
    Custodian
    No active licensing programme known to us
    Items
    11
    Response format
    Four-point agreement scale: strongly disagree, disagree, agree, strongly agree
    Score range
    11 to 44
    Direction
    Lower score = better
    Recall period
    Current beliefs about pain and movement
    Completion time
    About 3 minutes
    Age range
    Adults
    Regions
    General Health
    Conditions
    Chronic pain, Chronic low back pain, Persistent musculoskeletal pain, Knee osteoarthritis
    Procedures
    Total knee arthroplasty, Spinal surgery, Rehabilitation after injury
    Languages
    English
    Validity
    The short form was created because the four reverse-scored items and two others performed poorly in the full scale. Because every remaining item is worded in the same direction, the total needs no reverse scoring.
    Responsiveness
    Used to follow change in fear of movement during rehabilitation. No minimal clinically important difference is reported here because we could not verify a published value.

    When to use the TSK-11

    Well suited to

    • A quick check of fear of movement before a graded activity or exposure-based rehabilitation programme, where 11 items are more practical than 17.
    • Research on persistent pain or after joint replacement where the 11-item version is the one used in the comparison cohort.

    Limitations and poor fits

    • Applying the 37-point cut-off of the 17-item scale: the TSK-11 range is 11 to 44.
    • Diagnosing kinesiophobia or any psychological disorder — the total describes belief, it does not diagnose.
    • Mixing TSK-11 totals with 17-item totals in the same analysis.
    • Acute pain, where fear of movement may be a proportionate response to a fresh injury.

    TSK-11 compared with other instruments

    Instruments measuring a related construct, with the practical difference between them.

    InstrumentItemsRangeWhat it adds
    Tampa Scale of Kinesiophobia1717–68The Tampa Scale of Kinesiophobia is a 17-item self-report questionnaire of fear of movement and (re)injury in people with pain, scored 1 to 4 per item (four items reverse-scored) for a total of 17 to 68, where a higher total means more fear and a total above 37 is widely used as the cut-off for high kinesiophobia.
    PSEQ100–60The Pain Self-Efficacy Questionnaire measures how confident a person is in carrying out activities despite their pain, scoring ten statements from 0 to 6 for a total of 0 to 60, where higher scores indicate stronger self-efficacy and 40 or more is the commonly cited threshold for a good functional prognosis.
    STarT Back90–9The STarT Back Screening Tool stratifies patients with low back pain into low, medium and high risk of persistent disabling pain using nine items, of which five form a psychosocial subscale, so that treatment can be matched to risk rather than given uniformly.

    Copyright and permitted use

    Published openly because it is the question every clinician and researcher asks before using an instrument, and almost nobody answers it.

    Free to use

    A shortened scoring of the freely used Tampa Scale of Kinesiophobia, published in 2005 and used without charge in pain research and clinical practice. We have not asked the developers for written permission, so we cannot say it is free of copyright; if a rights holder objects, the item wording will be removed and the page reduced to a profile.

    References

    1. Woby SR, Roach NK, Urmston M, Watson PJ. Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain. 2005.
    2. Miller RP, Kori SH, Todd DD. The Tampa Scale: a measure of kinisophobia. The Clinical Journal of Pain. 1991.

    Editorial status

    Not yet reviewedQueued for clinical review by Sam Tuffun, PT, DPT. Sign-off has not taken place — this is a placeholder assignment, not a completed review.