Outcome measurement instruments used in the evaluation of key psychological constructs in people with tendinopathy: A scoping review

OBJECTIVE: To identify and describe the pain-related psychological outcome measurement instruments used to measure kinesiophobia, pain beliefs, pain self-efficacy and fear avoidance beliefs in tendinopathy research. DESIGN: Scoping review following the Joanna Briggs Institute Framework and the PRISMA-ScR reporting guideline. LITERATURE SEARCH: Seven electronic databases (MEDLINE, PsychINFO, EMBASE, CINAHL, Scopus, Web of Science and Google Scholar) were searched from inception to March 23rd, 2025, for published tendinopathy studies. STUDY SELECTION CRITERIA: Eligible studies included adults (≥18 years) with a clinical diagnosis of tendinopathy that reported at least one recorded psychological outcome measurement instrument for the constructs of interest. DATA SYNTHESIS: Data were collated for study characteristics, tendon site (synonyms used), psychological construct, outcome measurement instrument type/version/frequency, cutoff scores and pre-post intervention scores. RESULTS: Ninety-three studies (n = 7041 participants) were included: 25 RCTs, 55 observational studies and 13 other designs. Kinesiophobia was the most frequently assessed construct (69%) using various versions of the Tampa Scale of Kinesiophobia. Pain self-efficacy (21.5%) was primarily measured with the Pain Self Efficacy Questionnaire; Fear avoidance beliefs (19.4%) with the Fear Avoidance Beliefs Questionnaire and pain beliefs (1.1%) with unvalidated instruments. Baseline kinesiophobia and fear-avoidance scores generally indicated low to moderate severity with minimal pre-post intervention change scores. CONCLUSION: Considerable heterogeneity and conceptual ambiguity were identified in assessing psychological constructs in tendinopathy. These findings highlight the need for greater standardisation and consensus in outcome measurement to enhance consistency, interpretability, and clinical applicability in tendinopathy research and practice.