Objective
To identify and describe the pain-related psychological outcome measurement instruments used to measure kinesiophobia, pain beliefs, pain self-efficacy and fear avoidance beliefs in tendinopathy research.
Design
Scoping review following the Joanna Briggs Institute Framework and the PRISMA-ScR reporting guideline.
Literature search
Seven electronic databases (MEDLINE, PsychINFO, EMBASE, CINAHL, Scopus, Web of Science and Google Scholar) were searched from inception to March 23rd, 2025, for published tendinopathy studies.
Study selection criteria
Eligible studies included adults (=18 years) with a clinical diagnosis of tendinopathy that reported at least one recorded psychological outcome measurement instrument for the constructs of interest.
Data synthesis
Data were collated for study characteristics, tendon site (synonyms used), psychological construct, outcome measurement instrument type/version/frequency, cutoff scores and pre-post intervention scores.
Results
Ninety-three studies (n=7041 participants) were included: 25 RCTs, 55 observational studies and 13 other designs. Kinesiophobia was the most frequently assessed construct (69%) using various versions of the Tampa Scale of Kinesiophobia. Pain self-efficacy (21.5%) was primarily measured with the Pain Self Efficacy Questionnaire; Fear avoidance beliefs (19.4%) with the Fear Avoidance Beliefs Questionnaire and pain beliefs (1.1%) with unvalidated instruments. Baseline kinesiophobia and fear-avoidance scores generally indicated low to moderate severity with minimal pre-post intervention change scores.
Conclusion
Considerable heterogeneity and conceptual ambiguity were identified in assessing psychological constructs in tendinopathy. These findings highlight the need for greater standardisation and consensus in outcome measurement to enhance consistency, interpretability, and clinical applicability in tendinopathy research and practice.
Carl Stubbs, Sean Mc Auliffe, Caoimhe Barry-Walsh, Ruth L Chimenti, Jack Mest, Kieran O'Sullivan, Inge van den Akker-Scheek, Peter Malliaras
Disease Category: Rehabilitation
Disease Name: Tendinopathy
Age Range: 18 - 120
Sex: Either
Nature of Intervention: Any
- Recommendations for outcome measures (measurement/how)
- Systematic review of outcome measures/measurement instruments
- Systematic review