Validity and Reliability of the Tampa Scale for Kinesiophobia for Adolescents with Heart Disease

Kinesiophobia (KP) is the fear of movement or physical activity (PA) that is related to a medical condition. In adolescents, KP is associated with depression, anxiety, and impaired quality of life (QoL). Adolescents with heart disease (HD) often avoid PA. Factors that may moderate PA avoidance, such as KP, have not been adequately studied in this population. Purpose: To assess the validity and reliability of a newly adapted Tampa Scale for KP for adolescents with HD (TSK-Heart-A). Methods: The TSK-Heart-A survey consists of 17 Likert scale items, producing a summary score (SS) ranging from 17 (low KP) to 68 (high KP). Following content and face validity, adolescents (age 12-18 years) with arrhythmia disorders or Fontan palliation were recruited. The PROMIS pediatric anxiety and depression short forms, PedsQL generic core and cardiac module, and a PA questionnaire for adolescents (PAQ-A) were used for criterion validity. The TSK-Heart-A was completed twice (20.4 ± 6.3 days apart) for assessment of internal and test-retest reliability. Pearson correlations and Cronbach's alpha determined validity and reliability, respectively. Results: Adolescents (n = 63) were 15.5 ± 1.8 years-old, 50.8% female, and 69.8% had arrhythmia disorder. Mean TSK-Heart-A SS was 33.8 ± 7.8 (range: 20 to 56). The TSK-Heart-A SS correlated significantly with PROMIS T-scores (anxiety: 49.7 ± 12.2, r = 0.48; depression: 46.9 ± 12.7, r = 0.41), PedsQL score (generic QoL: 75.2 ± 18.9, r = -0.61; cardiac QoL: 74.7 ± 17.5, r = -0.56), and PAQ-A (score: 2.0 ± 0.7, r = -0.35). Test-retest and internal reliability had a total score of r = 0.77 (p = 0.89). Conclusions: The new TSK-Heart-A survey is valid and reliable and suggests KP is present in some adolescents with HD.