Measurement properties of assessment tools of Kinesophobia in patients with cardiovascular disease: A systematic review.
Yingying Jia, Nianqi Cui, Tingting Jia and 2 others
PMID 38352287WHAT IT FOUND
Only the Swedish and Chinese versions of the Tampa Scale for Kinesiophobia Heart are tentatively recommended for screening fear of exercise in heart patients.
Most other scales lack evidence on whether scores change meaningfully over time or how accurate they are.
Key findings
01The Swedish and Chinese versions of the Tampa Scale for Kinesiophobia Heart are the only scales given a Level A recommendation for use.
02None of the reviewed scales reported measurement error, and only two reported responsiveness, meaning most cannot reliably detect small but important changes in a patient's fear.
03Most scales assessed content validity only through expert opinion, overlooking whether patients themselves found the questions relevant and clear.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most scales did not report measurement error or responsiveness, so we do not know if a small change in score reflects a real improvement in fear or just random noise. Content validity was rarely tested with patients themselves, relying mostly on expert opinion, so the questions may not fully capture the patient's experience. The review excluded cross-sectional studies from early scale development, which may have limited the evidence available for some newer tools. There is no unified threshold for what constitutes 'high' fear of movement, making it difficult to use these scores to decide when to intervene.
Declared interests
The work was funded by the Scientific Research Fund of Zhejiang Provincial Education Department. The funding organization had no role in the design, implementation, or analysis of the survey. The authors declare no competing interests.
The easy way to misread this
Do not assume that a change in a patient's score on any of these scales represents a true clinical improvement or deterioration. Only the Swedish and Chinese TSK Heart versions have strong evidence for internal consistency, but no scale in this review has proven it can reliably detect small, meaningful changes over time (responsiveness) or account for measurement error.