Cross-cultural adaptation, reliability and construct validity of the Tampa scale for kinesiophobia for temporomandibular disorders (TSK/TMD-Br) into Brazilian Portuguese

J Oral Rehabil. 2017 Jul;44(7):500-510. doi: 10.1111/joor.12515. Epub 2017 May 15.


Fear of movement (kinesiophobia) seems to play an important role in the development of chronic pain. However, for temporomandibular disorders (TMD), there is a scarcity of studies about this topic. The Tampa Scale for Kinesiophobia for TMD (TSK/TMD) is the most widely used instrument to measure fear of movement and it is not available in Brazilian Portuguese. The purpose of this study was to culturally adapt the TSK/TMD to Brazilian Portuguese and to assess its psychometric properties regarding internal consistency, reliability, and construct and structural validity. A total of 100 female patients with chronic TMD participated in the validation process of the TSK/TMD-Br. The intraclass correlation coefficient (ICC) was used for statistical analysis of reliability (test-retest), Cronbach's alpha for internal consistency, Spearman's rank correlation for construct validity and confirmatory factor analysis (CFA) for structural validity. CFA endorsed the pre-specified model with two domains and 12-items (Activity Avoidance - AA/Somatic Focus - SF) and all items obtained a loading factor greater than 0·4. Acceptable levels of reliability were found (ICC > 0·75) for all questions and domains of the TSK/TMD-Br. For internal consistency, Cronbach's α of 0·78 for both domains were found. Moderate correlations (0·40 < r < 0.60) were observed for 84% of the analyses conducted between TSK/TMD-Br scores versus catastrophising, depression and jaw functional limitation. TSK/TMD-Br 12 items and two-factor demonstrated sound psychometric properties (transcultural validity, reliability, internal consistency and structural validity). In such a way, the instrument can be used in clinical settings and for research purposes.

Keywords: kinesiophobia; reliability; surveys and questionnaires; temporomandibular disorders; validation.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Brazil
  • Catastrophization / diagnosis
  • Catastrophization / psychology
  • Chronic Pain / diagnosis*
  • Chronic Pain / etiology
  • Chronic Pain / psychology
  • Cross-Cultural Comparison
  • Female
  • Humans
  • Language*
  • Middle Aged
  • Movement
  • Pain Measurement / standards*
  • Phobic Disorders / diagnosis*
  • Phobic Disorders / psychology
  • Portugal / ethnology
  • Psychometrics
  • Reproducibility of Results
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Temporomandibular Joint Disorders / complications
  • Temporomandibular Joint Disorders / diagnosis*
  • Temporomandibular Joint Disorders / psychology
  • Translations*
  • Young Adult