Kinesiophobia plays a central role in understanding adult pain mechanisms, yet its assessment and theoretical relevance in pediatric pain remain poorly understood. Research to clarify the role of kinesiophobia in pediatric populations requires a valid and reliable measure of the construct. The most commonly used measure is the Tampa Scale of Kinesiophobia (TSK). Unfortunately, prior research in pediatric populations with different TSK versions has shown suboptimal psychometric performance, leaving the field without a reliable tool to evaluate fear-avoidance processes. This study provides the first comprehensive evaluation of the validity of the 11-item TSK (TSK-11) in pediatric populations. A total of 536 participants aged 8-18 years were recruited across three hospital units in Spain. Participants completed the TSK-11 in Spanish plus measures of pain intensity, pain interference, pain catastrophizing, pain anxiety, and physical functioning. A subsample (n=50) completed the TSK-11 again 3 months later. Internal consistency was good for the total score (α=.88) and the Activity Avoidance (α=.82) and Harm (α=.85) subscales. Test-retest reliability was excellent (ICC=.89). CFA supported the expected two-factor structure. Participants with chronic pain (totals score 24.70) and chronic post-surgical pain (M=27.81) had higher TSK-11 scores than participants without chronic pain (M=22.89), with significant differences for the total score and Harm subscale. Large correlations were observed with pain interference (r=.63), anxiety (r=.59), catastrophizing (r=.56), fear of pain (r=.58), and pain intensity (r=.55). Findings support the TSK-11 as a reliable, valid, and theoretically coherent brief kinesiophobia measure capable of advancing mechanistic and clinical research in pediatric populations. PERSPECTIVE: This study provides the first comprehensive validation of the TSK-11 in pediatric populations, supporting its reliability, validity, and theoretical coherence for assessing kinesiophobia. The findings offer researchers and clinicians a brief, psychometrically sound tool to advance understanding of fear-avoidance mechanisms in pediatric chronic pain.
https://linkinghub.elsevier.com/retrieve/pii/S1526590026002385
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