Development of the Marathi version of the Tampa scale of kinesiophobia 11: Cross-cultural adaptation, validity, and test–retest reliability in patients with low back pain

Abstract

Background: The Tampa Scale of Kinesiophobia-11 (TSK-11) is used to assess fear of movement in patients with musculoskeletal dysfunction. However, for Indian-specific population, this scale is not available. We aim to cross-culturally adapt the TSK-11 into a regional Indian language (Marathi) and to assess its psychometric properties, validity, and reliability. Materials and Methods: The American Association of Orthopedic Surgeons guidelines were used for cross-cultural adaptation and psychometric testing. Psychometric testing included assessment of internal consistency (Cronbach s alpha) and test–retest repeatability (intraclass coefficient correlation), construct validity (Pearson correlation) by comparing the TSK-11 score to a visual analog scale (VAS) of confidence and pain, as well as the Marathi version of Oswestry Disability Index (ODI). Results: A total of 100 individuals with mean age of 38.9 years (Standard deviation = 11.34) completed the translated TSK-11 questionnaire on two occasions with an interval of one day. The translated Marathi version demonstrated excellent internal consistency (α = 0.85) and test–retest reliability (intraclass correlation coefficient = 0.93, confidence interval 95% = 0.90–0.95). There were moderate correlations between the total score of the TSK-11 questionnaire Marathi version and ODI score (r = 0.72), VAS pain score (r = 0.635), and VAS confidence score (r = −0.603). Receiver operating characteristics analysis indicated that the TSK-11 score was significantly able (P < 0.001) to discriminate the presence or absence of kinesiophobia. Conclusion: The Marathi version of TSK-11 is reliable and valid, with psychometric characteristics similar to the original English version. This assessment tool can be recommended to measure movement-related fear in future patient-oriented outcome studies for the Indian Marathi speaking population with low back pain.