Tampa scale for kinesiophobia in individuals with knee osteoarthritis: a cross-sectional psychometric evaluation using item-level and exploratory factor analyses

This study evaluated floor and ceiling (F/C) effects within the Tampa Scale for Kinesiophobia (TSK) and examined item-level correlations with total TSK scores and pain intensity in individuals with knee osteoarthritis (KOA). A cross-sectional study was conducted involving 134 participants diagnosed with KOA. Each TSK item was analyzed to identify F/C effects, with a threshold of 15% set as the criterion for significance. Spearman's rank correlation coefficient was employed to assess the relationships between each TSK item and the total TSK score, as well as between each item and pain intensity. Also, an exploratory factor analysis (EFA), a varimax rotation, was performed on the 17 items. Notably, significant floor effects were observed in items 4 and 12, while a ceiling effect was noted in item 13. Statistically significant correlations between individual items and the total TSK score were identified for all items except for items 8, 12, and 16. Furthermore, a significant correlation was found between item 3 and pain intensity. For the EFA analysis, the data were appropriate, the KMO and Bartlett sphericity tests were 0.748 and p < 0.001. the EFA suggests 4 components which explained 53% of the total variance. Items 4, 8, 12, 13, and 16 of the TSK demonstrated either F/C effects. Correlations with the total TSK score were generally non-significant, with values ranging from r = -0.053 to 0.308. For grouping of the items, 4 components are suggested. Therefore, it is recommended that these items may require further evaluation in future adaptations or psychometric evaluations of the TSK for this population.