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. 2025 Jan 23;9(3):611-618.
doi: 10.1016/j.jseint.2024.12.018. eCollection 2025 May.

Development of a standardized tool for memory-induced kinesiophobia among patients with trauma-related recurrent shoulder instability

Marianne L van Gastel  1   2 , Madu N Soares  1   3 , Theodore P van Iersel  1 , Gwendolyne G M Scholten-Peeters  3 , Karin M C Hekman  4 , Jasper S de Vries  2 , Michel P J van den Bekerom  1   3 , Birit F P Broekman  5   6   7
Affiliations

Development of a standardized tool for memory-induced kinesiophobia among patients with trauma-related recurrent shoulder instability

Marianne L van Gastel et al. JSES Int. .

Abstract

Background: This study aimed to develop a standardized tool for kinesiophobia using visual stimuli and estimate its test-retest reliability for patients with traumatic anterior shoulder instability.

Methods: The research project entailed a sequence of focus group meetings, followed by a web-based survey. An initial set of images designed to induce kinesiophobia was developed based on the results of the focus group meetings. The web-based assessment of this initial set and its correlation to the Tampa scale of kinesiophobia formed the basis for the development of a final kinesiophobia-inducing tool. When finalized, the test-retest reliability of the tool was assessed. A total of 75 patients between the ages of 18 and 57, who had experienced traumatic anterior shoulder instability, participated in the study.

Results: Following the focus group meetings, an initial collection of 17 images was composed. From these, the 5 images that induced the strongest feelings of kinesiophobia were selected as the foundation for the new standardized tool for kinesiophobia. Furthermore, three additional images were included that showed the strongest correlation with the Tampa scale of kinesiophobia, resulting in a tool consisting of 8 images with an excellent overall test-retest reliability.

Conclusion: The outcome of this study was an 8-image standardized reliable tool designed to induce kinesiophobia in patients with traumatic anterior shoulder instability. This tool might be useful in assessing and monitoring kinesiophobia among this patient population.

Keywords: Anterior shoulder instability; Apprehension; Fear of movement; Measurement; Rehabilitation; Shoulder dislocation.

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Figures

Figure 1
Figure 1
Flowchart of inclusion.
Figure 2
Figure 2
The median score of memory-induced kinesiophobia (test n = 69, retest n = 50).
See this image and copyright information in PMC

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