Dizziness is an unpleasant symptom which can cause anxiety and fear of movement (kinesiophobia) which may lead to avoidance of physical activity. There are no reliable and valid questionnaires available to detect kinesiophobia in patients with peripheral vestibular dizziness.
Objective
To adapt the Tampa Scale for Kinesiophobia (TSK-SV) to TSK-SV Dizziness and to investigate the questionnaire´s reliability and validity.
Methods
The TSK-SV was adapted to TSK-SV Dizziness in patients with peripheral vestibular disorder. Test-retest reliability and internal consistency was calculated. Face and content validity construct and a confirmatory factor analysis were performed. Concurrent validity was assessed in relation to Hospital anxiety and depression scale (HADS-A, HADS-D), Dizziness Handicap Inventory (DHI), Short form−36, Self-reported physical activity, assessment of dynamic and static balance function.
Results
TSK-SV dizziness showed excellent test-retest reliability (intraclass correlation coefficient 0.91) and excellent internal consistentcy (Cronbach’s alpha 0.76). Confirmatory factor analysis provided acceptable model fit for the modified second-order factor model. In concurrent validity moderate to large associations between TSK-SV dizziness, HADS-A, HADS-D and DHI total sum.
Conclusions
This study supports the reliability and validity of the TSK-SV dizziness questionnaire for clinical use in patients with peripheral vestibular dizziness.
NeuhauserHK. The epidemiology of dizziness and vertigo. Handb Clin Neurol2016; 137: 67–82.
2.
HülseRBiesdorfAHörmannK, et al.Peripheral vestibular disorders: an epidemiologic survey in 70 million individuals. Otol Neurotol2019; 40(1): 88–95.
3.
BisdorffAVon BrevernMLempertT, et al.Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res2009; 19(1-2): 1–13.
4.
FigtreeWVCMenantJCChauAT, et al.Prevalence of vestibular disorders in independent people over 50 that experience dizziness. Front Neurol2021; 12: 658053.
5.
HanBISongHSKimJS. Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises. J Clin Neurol2011; 7(4): 184–196.
6.
WhitneySLAlghadirAHAnwerS. Recent evidence about the effectiveness of vestibular rehabilitation. Curr Treat Options Neurol2016; 18(3): 13.
7.
MacDowellSGWellonsRBissellA, et al.The impact of symptoms of anxiety and depression on subjective and objective outcome measures in individuals with vestibular disorders. J Vestib Res2018; 27(5-6): 295–303.
8.
WeidtSBruehlABStraumannD, et al.Health-related quality of life and emotional distress in patients with dizziness: a cross-sectional approach to disentangle their relationship. BMC Health Serv Res2014; 14: 317.
9.
WhitneySLSpartoPJFurmanJM. Vestibular rehabilitation and factors that can affect outcome. Semin Neurol2020; 40(1): 165–172.
10.
KoriSHToddDD. Kinesiophobia: a new view of chronic pain behavior. Pain Manag1990; 62: 363–372.
11.
VlaeyenJWKole-SnijdersAMRotteveelAM, et al.The role of fear of movement/(re)injury in pain disability. J Occup Rehabil1995; 5(4): 235–252.
12.
BäckMJanssonBCiderA, et al.Validation of a questionnaire to detect kinesiophobia (fear of movement) in patients with coronary artery disease. J Rehabil Med2012; 44(4): 363–369.
13.
RussekLGardnerSMaguireK, et al.A cross-sectional survey assessing sources of movement-related fear among people with fibromyalgia syndrome. Clin Rheumatol2015; 34(6): 1109–1119.
14.
VlaeyenJWSKole-SnijdersAMBoerenRG, et al.Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain1995; 62(3): 363–372.
15.
LundbergMStyfJCarlssonS. A psychometric evaluation of the Tampa scale for kinesiophobia - from a physiotherapeutic perspective. Physiother Theory Pract2004; 20: 121–133.
16.
SeverEKiliçGAlgunZC. The effects of vestibular rehabilitation on kinesiophobia and balance with individuals who has vestibular hypofunction. Indian J Otolaryngol Head Neck Surg2022; 74(Suppl 3): 4319–4324.
17.
BränströmHFahlströmM. Kinesiophobia in patients with chronic musculoskeletal pain: differences between men and women. J Rehabil Med2008; 40(5): 375–380.
18.
ZigmondASSnaithRP. The hospital anxiety and depression scale. Acta Psychiatr Scand1983; 67(6): 361–370.
19.
BjellandIDahlAAHaugTT, et al.The validity of the hospital anxiety and depression scale. An updated literature review. J Psychosom Res2002; 52(2): 69–77.
20.
JacobsonGPNewmanCW. The development of the dizziness handicap inventory. Arch Otolaryngol Head Neck Surg1990; 116(4): 424–427.
21.
WhitneySLWrisleyDMBrownKE, et al.Is perception of handicap related to functional performance in persons with vestibular dysfunction?Otol Neurotol2004; 25(2): 139–143.
22.
JarlsäterSMattssonE. Test of reliability of the dizziness handicap inventory and the activities-specific balance confidence scale for use in Sweden. Adv Physiother2003; 5: 137–144.
23.
PowellLEMyersAM. The Activities-specific balance confidence (ABC) scale. J Gerontol A Biol Sci Med Sci1995; 50a(1): M28–M34.
24.
WareJEJr. SF-36 health survey update. Spine2000; 25(24): 3130–3139.
25.
PerssonLOKarlssonJBengtssonC, et al.The Swedish SF-36 health survey II. Evaluation of clinical validity: results from population studies of elderly and women in gothenborg. J Clin Epidemiol1998; 51(11): 1095–1103.
26.
The Swedish National Board of Health and Welfare. T.S.N.B.o.H.a. Welfare, B.D.P.i.t.S.H. Indikatorer, and n.g.a.i. System: Health situation, Indicators, [Appendix], Editors. 2011.
27.
OlssonSJEkblomÖAnderssonE, et al.Categorical answer modes provide superior validity to open answers when asking for level of physical activity: a cross-sectional study. Scand J Publ Health2016; 44(1): 70–76.
28.
KallingsLVOlssonSJGEkblomÖ, et al.The SED-GIH: a single-item question for assessment of stationary Behavior-A study of concurrent and convergent validity. Int J Environ Res Publ Health2019; 16(23): 4766.
29.
KammerlindASBergquist LarssonPLedinT, et al.Reliability of clincal balance tests and subjective ratings in dizziness and disequilibrium. Adv Physiother2005; 7(3): 96–107.
30.
BohannonRWLarkinPACookAC, et al.Decrease in timed balance test scores with aging. Phys Ther1984; 64(7): 1067–1070.
31.
BohannonRW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing1997; 26(1): 15–19.
32.
RydwikEBerglandAForsénL, et al.Investigation into the reliability and validity of the measurement of elderly people’s clinical walking speed: a systematic review. Physiother Theory Pract2012; 28(3): 238–256.
33.
MokkinkLBTerweeCBPatrickDL, et al.The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res2010; 19(4): 539–549.
34.
AltmanD (ed). Practical statistics for medical research 1999. Chapman & Hall, pp. 187–188.
35.
CohenJ. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates, 1988.
36.
BlandJMAltmanDG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet1986; 1(8476): 307–310.
37.
TavakolMDennickR. Making sense of Cronbach’s alpha. Int J Med Educ2011; 2: 53–55.
KlineRB.Principles and Practice of Structural Equation Modeling. 4th ed. New York, NY: Guilford Press, 2016.
40.
LindellEKollénLJohanssonM, et al.Benign paroxysmal positional vertigo, dizziness, and health-related quality of life among older adults in a population-based setting. Eur Arch Otorhinolaryngol2021; 278(5): 1637–1644.
41.
LindellEKollénLFiniziaC. Dizziness symptoms, balance confidence, and vestibular function in older women reporting dizziness and unsteadiness. Otol Neurotol2022; 43(4): e482–e488.
42.
WobySRRoachNKUrmstonM, et al.Psychometric properties of the TSK-11: a shortened version of the Tampa scale for kinesiophobia. Pain2005; 117(1-2): 137–144.
43.
HuangHNagaoMAritaH, et al.Reproducibility, responsiveness and validation of the Tampa scale for kinesiophobia in patients with ACL injuries. Health Qual Life Outcome2019; 17(1): 150.
44.
BronsteinAMLempertT. Management of the patient with chronic dizziness. Restor Neurol Neurosci2010; 28(1): 83–90.
45.
HeinrichsNEdlerCEskensS, et al.Predicting continued dizziness after an acute peripheral vestibular disorder. Psychosom Med2007; 69(7): 700–707.
46.
PothierDDShahPQuiltyL, et al.Association between catastrophizing and dizziness-related disability assessed with the dizziness catastrophizing scale. JAMA Otolaryngol Head Neck Surg2018; 144(10): 906–912.
47.
ShigetohH. Hypervigilance to pain affects activities of daily living: an examination using the Japanese version of the pain vigilance awareness questionnaire. J Phys Ther Sci2017; 29(12): 2094–2096.
48.
DunlapPMMarchettiGFSpartoPJ, et al.Exploratory factor analysis of the vestibular activities avoidance instrument. JAMA Otolaryngol Head Neck Surg2021; 147(2): 144–150.
49.
VlaeyenJWLintonSJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain2012; 153(6): 1144–1147.
50.
BrandtTDieterichM. ‘Excess anxiety’ and ‘less anxiety’: both depend on vestibular function. Curr Opin Neurol2020; 33(1): 136–141.
51.
BullFCAl-AnsariSSBiddleS, et al.World health organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med2020; 54(24): 1451–1462.
52.
KamoTOgiharaHTanakaR, et al.Relationship between physical activity and dizziness handicap inventory in patients with dizziness -A multivariate analysis. Auris Nasus Larynx2022; 49(1): 46–52.
53.
VereeckLTruijenSWuytsFL, et al.The dizziness handicap inventory and its relationship with functional balance performance. Otol Neurotol2007; 28(1): 87–93.
54.
DunlapPMSpartoPJMarchettiGF, et al.Fear avoidance beliefs are associated with perceived disability in persons with vestibular disorders. Phys Ther2021; 101(9): pzab147.
55.
Ohlsson-NevoEHiyoshiANorénP, et al.The Swedish RAND-36: psychometric characteristics and reference data from the mid-swed health survey. J Patient-Rep Outcomes2021; 5(1): 66.
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