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Patient-reported outcome measure

Tampa Scale of Kinesiophobia Calculator

Tampa Scale of Kinesiophobia

The 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.

Free to use17 items~5 min17–68, 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.
4My pain would probably be relieved if I were to exercise.
5People aren’t taking my medical condition seriously enough.
6My accident has put my body at risk for the rest of my life.
7Pain always means I have injured my body.
8Just because something aggravates my pain does not mean it is dangerous.
9I am afraid that I might injure myself accidentally.
10Simply being careful that I do not make any unnecessary movements is the safest thing I can do to prevent my pain from worsening.
11I wouldn’t have this much pain if there weren’t something potentially dangerous going on in my body.
12Although my condition is painful, I would be better off if I were physically active.
13Pain lets me know when to stop exercising so that I don’t injure myself.
14It’s really not safe for a person with a condition like mine to be physically active.
15I can’t do all the things normal people do because it’s too easy for me to get injured.
16Even though something is causing me a lot of pain, I don’t think it’s actually dangerous.
17No one should have to exercise when he/she is in pain.

What the Tampa Scale of Kinesiophobia score means

Tampa Scale of Kinesiophobia scores run from 17 to 68, where a lower score is better. The bands below are conventional reporting categories, not diagnostic cut-offs.

  • At or below the commonly used cut-off17–37

    A total of 37 or less is not classed as high kinesiophobia under the convention most studies use. It does not mean fear of movement is absent — 17 is the floor of the scale, and any score above it records some fear.

  • Above the cut-off — high kinesiophobia38–68

    A total above 37 is widely used to flag high fear of movement and (re)injury. It is a convention in the literature, not a validated diagnostic threshold.

How the score is calculated

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

Each of the 17 statements is answered on a four-point scale: strongly disagree 1, disagree 2, agree 3, strongly agree 4. Items 4, 8, 12 and 16 are reverse scored, so for those four strongly disagree scores 4 and strongly agree scores 1. The 17 item scores are added to give a total from 17 to 68, and a higher total means more fear of movement and (re)injury. A total above 37 is widely used as the cut-off for high kinesiophobia, a convention rather than a validated diagnostic threshold. The 11-item short form (TSK-11) is a separate instrument with its own range of 11 to 44.

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
R. P. Miller, S. H. Kori and D. D. Todd
Institution
Tampa, Florida, United States
First published
1991
Custodian
No active licensing programme known to us
Items
17
Response format
Four-point agreement scale: strongly disagree, disagree, agree, strongly agree
Score range
17 to 68
Direction
Lower score = better
Recall period
Current beliefs about pain and movement
Completion time
About 5 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
Widely used to measure fear-avoidance beliefs in chronic low back pain and other persistent pain. The four reverse-scored items have performed poorly in later analyses, which is why the 11-item short form drops them.
Responsiveness
Used to track change in fear of movement during rehabilitation and graded activity programmes. No minimal clinically important difference is reported here because we could not verify a published value.

When to use the Tampa Scale of Kinesiophobia

Well suited to

  • Screening for fear of movement before a graded activity or exposure-based rehabilitation programme in a patient with persistent pain.
  • Describing fear-avoidance beliefs in a research cohort with chronic low back pain or another persistent musculoskeletal pain condition.
  • Following change in fear of movement across a course of rehabilitation.

Limitations and poor fits

  • Diagnosing kinesiophobia or any psychological disorder — the total flags a patient for a closer clinical look; it does not diagnose.
  • Acute pain, where fear of movement may be a proportionate response to a fresh injury rather than a maladaptive belief.
  • Applying the 37 cut-off as if it were validated: it is a convention in the literature.
  • Mixing scores from the 17-item and 11-item versions — the ranges differ.

Tampa Scale of Kinesiophobia compared with other instruments

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

InstrumentItemsRangeWhat it adds
TSK-111111–44The 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.
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

First reported in 1991 and used without charge throughout pain research and clinical practice, with no licensing programme known to us. 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. Miller RP, Kori SH, Todd DD. The Tampa Scale: a measure of kinisophobia. The Clinical Journal of Pain. 1991.
  2. Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995.
  3. 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.

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.