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Pain-Related Fear: A Critical Review of the Related Measures
Open accessAbstract
Objectives: In regards to pain-related fear, this study aimed to: (1) identify existing measures and review their measurement properties, and (2) identify the optimum measure for specific constructs of fear-avoidance, pain-related fear, fear of movement, and kinesiophobia. Design: Systematic literature search for instruments designed to measure fear of pain in patients with persistent musculoskeletal pain. Psychometric properties were evaluated by adjusted Wind criteria. Results: Five questionnaires (Fear-Avoidance Beliefs Questionnaire (FABQ), Fear-Avoidance of Pain Scale (FAPS), Fear of Pain Questionnaire (FPQ), Pain and Anxiety Symptoms Scale (PASS), and the Tampa Scale for Kinesiophobia (TSK)) were included in the review. The main findings were that for most questionnaires, there was no underlying conceptual model to support the questionnaire's construct. Psychometric properties were evaluated by diverse methods, which complicated comparisons of different versions of the same questionnaires. Construct validity and responsiveness was generally not supported and/or untested. Conclusion: The weak construct validity implies that no measure can currently identify who is fearful. The lack of evidence for responsiveness restricts the current use of the instruments to identify clinically relevant change from treatment. Finally, more theoretically driven research is needed to support the construct and thus the measurement of pain-related fear.
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Kinesiophobia has been identified as a barrier to return to sport and a predictor of poor outcomes after ACL reconstruction in youth athletes.
“Kinesiophobia, often described as pain-related fear, fear of movement, and/or fear of reinjury, has also been identified as a barrier to RTS and a predictor of poor outcomes after ACLR in youth athletes (Lundberg et al., 2011; DiSanti et al., 2018).”
From The relationship between psychological readiness to return to sport and kinesiophobia in teens and young adults after anterior cruciate ligament reconstruction (2025) · cites this paper as Lundberg et al., 2011
The Introduction defines kinesiophobia in terms of fear of movement and reinjury, and the References list a study titled “Fear of re-injury: a hindrance for returning to sports after anterior cruciate ligament reconstruction.” The review does not report that kinesiophobia predicts poor outcomes after ACL reconstruction in youth athletes; that population and predictive claim are unsupported by our copy. (LLM, conf=0.84)
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Metadata
- Authors
- Lundberg, M., Grimby-Ekman, A., Verbunt, J., & Simmonds, M. J.
- Affiliations
- Division of Occupational Orthopedics, Department of Orthopedics, Sahlgrenska University Hospital, University of Gothenburg, Göteborg, Sweden
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and Academy at University of Gothenburg, Göteborg, Sweden
- Department of Rehabilitation Medicine, Maastricht University Medical Center and Research School CAPHRI, M D Maastricht University, 6211 LK Maastricht, The Netherlands
- A.T. Still Research Institute, A.T. Still University, Kirksville, MO 63501, USA
- Venue
- Pain Research and Treatment
- Publisher
- Hindawi Limited
- Published
- 2011-11-15
- Volume
- 2011
- Pages
- 1-26
- ISSN
- 2090-1542 (ISSN-L)
- 2090-1550
- PMC
- PMC3236324
- OpenAlex
- W2051121036
- Cited by
- 211
- References
- 9
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 18 · 2023: 28 · 2022: 21 · 2021: 22 · 2020: 19 · 2019: 14 · 2018: 13 · 2017: 11 · 2016: 9 · 2015: 11 · 2014: 16 · 2013: 8 · 2012: 4
- FWCI
- 11.72
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Pain Research and Treatment (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- fear of pain, fear-avoidance beliefs, kinesiophobia, psychometric properties, construct validity, responsiveness, chronic musculoskeletal pain, Fear-Avoidance Beliefs Questionnaire, Tampa Scale for Kinesiophobia
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