Psychological factors including fear of pain, re-injury during movement (kinesiophbia) affect return-to-sport rates after anterior cruciate ligament (ACL) reconstructive surgery. Clinicians often encounter in the daily practice that athletes explain lack of self-confidence or psychological readiness during the sports activity. The Tampa Scale for Kinesiophobia (TSK) has been used to evaluate psychological outcomes in patients with ACL injuries in many countries and translated into Japanese version in 2013. However, no researchers validated its reliability, validity, and responsiveness of TSK for patients with ACL injury up to now. The purpose of this study was to evaluate the measurement properties of the Japanese version of the TSK (TSK-J) in patients with ACL injuries. Cohort study (Diagnostic); Level of evidence, 2. This prospective study was performed in the department of orthopaedic surgery at the university hospital of Juntendo from Sep 2016 and Apr 2017. Patients who diagnosed with ACL injury with or without reconstruction surgery completed several patient-reported outcome measures (PROMs) were included in this study. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) guidelines were used to evaluate reliability, validity, responsiveness, and interpretability of the TSK-J. 222 patients were included in this study. The TSK-J for ACL injured patients showed good internal consistency (Cronbach’s alpha = 0.79) and excellent test-retest reliability (intra-class correlation coefficient, ICC2,1 = 0.90, 95% CI = 0.81 to 0.95). In addtion, the TSK-J was significantly but moderately correlated with the IKDC-SKF (r = − 0.49, P <0.001), VAS-Sports (r = − 0.48, P <0.001), and JACL-25 (r = 0.48, P <0.001). The effect size (ES) was small with the Cohen’s d = − 0.2. The minimal important difference (MID) was − 1.3 points. No significant TSK-J score change was observed over 1-year after ACL reconstruction (r = − 0.12, P <0.001). There were no floor or ceiling effects. Our study demonstrated that the Japanese version of TSK has good reliability. However, its low validity and responsiveness indicate that it may not the best way to assess psychological factors for patients with ACL injury.

中文翻译：

---

坦帕量表在ACL损伤患者中的运动恐惧症的重现性，反应性和验证

心理因素包括对疼痛的恐惧，运动中的再伤害（运动性偏瘫）会影响前交叉韧带（ACL）重建手术后的运动返回率。临床医生在日常练习中经常会遇到运动员解释运动过程中缺乏自信或心理准备的情况。坦帕运动恐惧症量表（TSK）在许多国家/地区已用于评估ACL损伤患者的心理结局，并于2013年转换为日文版。但是，没有研究人员验证TSK对ACL损伤患者的可靠性，有效性和反应性到现在。这项研究的目的是评估ACL损伤患者日文版TSK（TSK-J）的测量特性。队列研究（诊断）；证据水平2。这项前瞻性研究于2016年9月至2017年4月在Juntendo大学医院的整形外科中进行。本研究包括诊断为有或无重建手术的ACL损伤的患者完成了几项患者报告的结局指标（PROM） 。使用基于COnsensus的健康状况测量仪器（COSMIN）选择指南来评估TSK-J的可靠性，有效性，响应性和可解释性。这项研究包括222名患者。ACL受伤患者的TSK-J具有良好的内部一致性（Cronbach's alpha = 0.79）和出色的重测信度（组内相关系数，ICC2,1 = 0.90，95％CI = 0.81至0.95）。另外，TSK-J与IKDC-SKF（r = − 0.49，P <0.001），VAS-Sports（r = − 0.48，P <0.001）和JACL-25（r = 0.48，P < 0.001）。当Cohen d = − 0.2时，效应大小（ES）很小。最小重要差异（MID）为-1.3点。ACL重建后1年内未观察到明显的TSK-J评分变化（r = − 0.12，P <0.001）。没有地板或天花板的影响。我们的研究表明，日语版的TSK具有良好的可靠性。但是，它的低有效性和响应性表明它可能不是评估ACL损伤患者心理因素的最佳方法。最小重要差异（MID）为-1.3点。ACL重建后1年内未观察到明显的TSK-J评分变化（r = − 0.12，P <0.001）。没有地板或天花板的影响。我们的研究表明，日语版的TSK具有良好的可靠性。但是，它的低有效性和响应性表明它可能不是评估ACL损伤患者心理因素的最佳方法。最小重要差异（MID）为-1.3点。ACL重建后1年内未观察到明显的TSK-J评分变化（r = − 0.12，P <0.001）。没有地板或天花板的影响。我们的研究表明，日语版的TSK具有良好的可靠性。但是，它的低有效性和响应性表明它可能不是评估ACL损伤患者心理因素的最佳方法。