BACKGROUND: Physical therapists' recommendations to patients to avoid daily physical activity can be influenced by the therapists' kinesiophobic beliefs. Little is known about the amount of influence of a physical therapist's kinesiophobic beliefs on a patient's actual lifting capacity during a lifting test.OBJECTIVE: The objective of this study was to determine the influence of physical therapists' kinesiophobic beliefs on lifting capacity in healthy people.DESIGN: A blinded, cluster-randomized cross-sectional study was performed.METHODS: The participants (n=256; 105 male, 151 female) were physical therapist students who performed a lifting capacity test. Examiners (n=24) were selected from second-year physical therapist students. Participants in group A (n=124) were tested in the presence of an examiner with high scores on the Tampa Scale of Kinesiophobia for health care providers (TSK-HC), and those in group B (n=132) were tested in the presence of an examiner with low scores on the TSK-HC. Mixed-model analyses were performed on lifting capacity to test for possible (interacting) effects.RESULTS: Mean lifting capacity was 32.1 kg (SD=13.6) in group A and 39.6 kg (SD=16.4) in group B. Mixed-model analyses revealed that after controlling for sex, body weight, self-efficacy, and the interaction between the examiners' and participants' kinesiophobic beliefs, the influence of examiners' kinesiophobic beliefs significantly reduced lifting capacity by 14.4 kg in participants with kinesiophobic beliefs and 8.0 kg in those without kinesiophobic beliefs.LIMITATIONS: Generalizability to physical therapists and patients with pain should be studied.CONCLUSIONS: Physical therapists' kinesiophobic beliefs negatively influence lifting capacity of healthy adults. During everyday clinical practice, physical therapists should be aware of the influence of their kinesiophobic beliefs on patients' functional ability.
Objectives: To determine the psychometric properties of a questionnaire to assess fear of movement (kinesiophobia): the Tampa Scale for Kinesiophobia (TSK-NL Heart), and to investigate the prevalence of kinesiophobia in patients attending cardiac rehabilitation.Methods: A total of 152 patients were evaluated with the TSK-NL Heart during intake and 7 days later. Internal consistency, test-retest reliability and construct validity were assessed. For construct validity, the Cardiac Anxiety Questionnaire (CAQ) and the Hospital Anxiety and Depression Scale (HADS) were used. The factor structure of the TSK-NL Heart was determined by a principal component analysis (PCA).Results: After removal of 4 items due to low internal consistency, the TSK-NL Heart showed substantial reliability (intraclass correlation coefficient; ICC: 0.80). A strong positive correlation was found between the TSK-NL Heart and the CAQ (rs: 0.61). Strong positive correlations were found between the TSK-NL Heart and de HADS (Anxiety) (rs: 0.60) and between the TSK-NL Heart and the CAQ (rs: 0.61). The PCA revealed a 3-factor structure as most suitable (fear of injury, avoidance of physical activity, perception of risk). High levels of kinesiophobia were found in 45.4% of patients.Conclusion: The 13-item TSK-NL Heart has good psychometric properties, and we recommend using this version to assess kinesiophobia, which is present in a substantial proportion of patients referred for cardiac rehabilitation.Keywords: Tampa Scale for Kinesiophobia; cardiac rehabilitation; exercise; fear of movement; physical activity; cardiovascular disease
Bij cliënten met musculoskeletale pijn is de effectiviteit van zowel Manuele therapie als ook Fysiotherapie bewezen. Toch blijft het opmerkelijk dat er weinig verschil in effecten wordt gevonden tussen verschillende typen van therapie. Men zou kunnen concluderen dat dit veroorzaakt wordt door andere werkzame bestanddelen dan het type therapie zelf. Deze andere werkzame bestanddelen worden wel Common factors of niet-therapeutische factoren genoemd. Tijdens behandelingen wordt er verbaal en non-verbaal gecommuniceerd met de cliënt met als doel bv. het opbouwen van een relatie, het stimuleren van actief gedrag van de cliënt, de kennis te vergroten van de cliënt, of het komen tot een gezamenlijke besluitvorming (shared decision making). Binnen de psychotherapie is er voldoende bewijs dat deze niet-therapeutische factoren effectief zijn op het eindresultaat van de behandeling. Ook tijdens de anamnese is bekend welke factoren de uitkomsten van de anamnese positief kunnen beïnvloeden. Maar binnen de therapeutische fase van Manuele en Fysiotherapie is er tot op heden weinig onderzoek verricht naar de invloed van deze niet-therapeutische factoren op de uitkomst van de therapie. Mijn onderzoekslijn binnen de Hanzehogeschool richt zich op het effect van verschillende fysiotherapeutische attituden op cliënten met musculoskeletale pijn. Deze attituden bestaan uit gedachten en gedragingen van therapeuten. Dit onderzoek wil de impliciete en intuïtieve communicatie gedurende het therapeutische proces expliciteren. Indien we meer zouden weten over welke attituden positief bijdragen aan de manuele en fysiotherapeutische behandelresultaten zouden we studenten kunnen scholen in dit gedrag en daarmee de effectiviteit van de therapie kunnen vergroten. Op reis naar meer kennis en vaardigheden over dit onderwerp mag ik u vergezellen naar de NeckSTep.
