Assessment of the Validity and Reliability of the Turkish Version of the Modified Tampa Scale for Kinesiophobia in Patients With Shoulder Pain

BACKGROUND Kinesiophobia is a cognitive and emotional response that can negatively influence pain behavior and rehabilitation outcomes in individuals with shoulder pain. The aim of this study was to examine the reliability and structural validity of the Turkish version of the modified 18-item Tampa Scale for Kinesiophobia (TSK-18) in patients with shoulder pain. MATERIAL AND METHODS This multicenter methodological study included 180 patients with acute or subacute shoulder pain. The scale was translated and culturally adapted into Turkish according to ISPOR guidelines. Structural validity was assessed using exploratory and confirmatory factor analyses. Construct validity was evaluated through hypothesis testing by examining associations with pain intensity, disability, and quality-of-life measures. Internal consistency was assessed using Cronbach's alpha for the total scale and subscales, and test-retest reliability was evaluated using the intraclass correlation coefficient (ICC). RESULTS Data from 180 patients were analyzed. Exploratory factor analysis supported a 2-factor structure (activity avoidance and somatic focus), explaining 43.17% of the total variance. Confirmatory factor analysis showed poor model fit (χ²/df=6.12, CFI=0.63, TLI=0.53, RMSEA=0.16). The Cronbach's alpha was 0.75 for the total scale, with subscale values of 0.72 and 0.70. Several items demonstrated low test-retest reliability (ICC<0.50). Very weak correlations were found between TSK-18 scores and pain intensity (visual analog scale; r=0.176), with no significant associations with disability or functional outcomes. CONCLUSIONS The Turkish TSK-18 demonstrates acceptable internal consistency and a multidimensional structure but limited construct support, necessitating further validation studies.