Are the Cross-Culturally Adapted Versions of the Tampa Scale for Kinesiophobia 11-Item Valid, Reliable, and Responsive? A COSMIN-Informed Systematic Review of Measurement Properties

Numerous cultural adaptations of the Tampa Scale of Kinesiophobia 11-item version (TSK-11) scale have emerged since the original version was introduced. We conducted a (COnsensus-based Standards for the selection of health Measurement INstruments) COSMIN-informed systematic review of measurement properties to identify the cross-cultural adaptation of the TSK-11 and report, critically appraise, and systematize its measurement properties. Six databases were searched for studies published since 2005. Studies reporting on the measurement properties of culturally adapted versions of the TSK-11, published in English, Portuguese, and Spanish, were considered for inclusion. The results were synthesized by measurement properties and rated against the COSMIN criteria for good measurement properties. The quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach and presented in a summary of findings table. Twenty-three studies were included, and cultural adaptations for 15 languages were identified: English, Chinese, Cantonese, Swedish, German, Dutch, Arabic, Turkish, Danish, Spanish, Japanese, Brazilian Portuguese, Marathi, Thai, and Persian. There is “high” certainty in the evidence for “sufficient” criterion validity (TSK-17, r = .84) and “insufficient” measurement error (small detectable change range 5.6–6.16). “Moderate” certainty in the evidence for “sufficient” construct validity (87.8% of hypotheses confirmed), test-retest reliability (intraclass correlation coefficient_2,1 = .747–.87), and “low” certainty in evidence for “sufficient” responsiveness. The numerous sources of heterogeneity prevent conclusions from being drawn regarding structural validity. Measurement error, responsiveness, and structural validity of the TSK-11 require further investigation. Clinicians should complement the use of TSK-11 with other instruments. Future studies on the structural validity of the questionnaire should standardize the data analysis methods. Perspective: This article presents the measurement properties of the cross-cultural adaptations of the TSK-11. Clinicians should be aware that cultural and clinical aspects may influence the structural validity of the questionnaire. Using the TSK-11 as a stand-alone instrument may omit relevant clinical progression in the patient's condition.