Pain-related fear of (re-)injury in patients with low back pain: Estimation or measurement in manual therapy primary care practice? A pilot study

BACKGROUND: Manual physical therapists (MPTs) working in primary care get limited information about patient's courses of (chronic) low back pain (LBP). Identification of kinesiophobia is mostly based on clinical perception. OBJECTIVE: The aim of this study was to evaluate the association between the scores with which manual physical therapists in a primary care setting identify kinesiophobia in patients with low back pain, and the patients' self-reported measures of kinesiophobia. METHODS: The cross-sectional study comprised 104 patients with LBP and 17 MPTs. Patients first independently completed the Tampa Scale for Kinesiophobia (TSK-17). The therapists, blinded to the TSK-scores, rated their perception of a patient's kinesiophobia using the Visual Analogue Scale-Estimation (VAS-est) and the accuracy of their ratings using the Visual Analogue Scale-Accuracy (VAS-ac). Kendall's tau b was used to determine the level of correlation between scores on the TSK-17 and the VAS-est. RESULTS: Patients' mean scores on the TSK-17 were 35.6 (SD 7.6). The mean scores on the VAS-est and VAS-ac were 34.2 mm (SD 23.6) and 70.4 mm (SD 7.4) respectively. The TSK-17 scores showed a 'fair' association with the VAS-est scores (Kendall's tau b = 0.38; p <= 0.01) and a 'fair' association with the scores on the VAS-ac (Kendall's tau b = 0.28; p <= 0.05). CONCLUSION: The results suggested discordance between identification by MPTs and the patient-completed measures of kinesiophobia.