{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T21:03:28Z","timestamp":1793653408028,"version":"4.5.1"},"reference-count":50,"publisher":"The Journal of Rheumatology","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>To determine whether fear of movement and (re)injury [FOM\/(R)I] beliefs, measured with the Tampa Scale for Kinesiophobia 11-item version (TSK-11), influence activity limitations and mediate the relationship between pain severity and activity limitations in axial spondyloarthritis (axSpA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>In 173 patients with axSpA, these data were collected: sex, body mass index, disease duration, medication, activity limitations (BASFI; Bath Ankylosing Spondylitis Functional Index), disease activity [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); BASDAIinf, items 5 and 6; BASDAIpain, items 2 and 3; C-reactive protein and physician\u2019s global assessment], spinal mobility (BASMI; Bath Ankylosing Spondylitis Metrology Index), and FOM\/(R)I (TSK-11). Scaling assumptions and reliability of TSK-11 were tested with item-to-total correlations, item variances, and Cronbach\u2019s alpha coefficient. Hypothesis testing determined TSK-11\u2019s construct validity. Multiple linear regression showed the contribution of TSK-11 to BASFI (enter and backward modeling). Mediation by TSK-11 was analyzed (bias-corrected bootstrapping and Sobel test).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Adequate scale (Cronbach\u2019s alpha = 0.80) and item internal consistency (range item-scale correlations 0.41\u20130.58, except for item 5, r = 0.23), equal item-scale correlations, and item variances were found for TSK-11. Construct validity was confirmed, except for the hypothesized positive relationship between TSK-11 and BASMI. Regression models (enter method, adjusted R<jats:sup>2<\/jats:sup> range 53\u201374%) consistently identified TSK-11 as a determinant of BASFI (\u03b2 range 0.155 to 0.321, p &lt; 0.05), although BASMI (\u03b2 range 0.441 to 0.537) and disease activity (\u03b2 range 0.243 to 0.571, p &lt; 0.05) were the largest determinants. TSK-11 partially mediated the BASDAIpain\/BASFI relationship (B = 0.107; Sobel test, p = 0.004; bias-corrected CI 0.046\u20130.197).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>TSK-11 is a promising and valid tool to assess fearful beliefs in relation to activity limitations in axSpA. Future research applying TSK-11 may reveal FOM\/(R)I as a novel treatment target in axSpA.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.170318","type":"journal-article","created":{"date-parts":[[2017,11,16]],"date-time":"2017-11-16T01:25:38Z","timestamp":1510795538000},"page":"357-366","source":"Crossref","is-referenced-by-count":21,"title":["Activity Limitations in Patients with Axial Spondyloarthritis: A Role for Fear of Movement and (Re)injury Beliefs"],"prefix":"10.3899","volume":"45","author":[{"given":"Thijs W.","family":"Swinnen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan W.S.","family":"Vlaeyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"Dankaerts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Westhovens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"de Vlam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2017,11,15]]},"reference":[{"key":"2018112909375694000_45.3.357.1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22758"},{"key":"2018112909375694000_45.3.357.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2006.06.009"},{"key":"2018112909375694000_45.3.357.3","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20007"},{"key":"2018112909375694000_45.3.357.4","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.108233"},{"key":"2018112909375694000_45.3.357.5","doi-asserted-by":"publisher","DOI":"10.1002\/art.21619"},{"key":"2018112909375694000_45.3.357.6","first-page":"516","article-title":"Impact of functional impairment in ankylosing spondylitis: impairment, activity limitation, and participation restrictions","volume":"32","author":"Dagfinrud","year":"2005","journal-title":"J Rheumatol"},{"key":"2018112909375694000_45.3.357.7","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.104117"},{"key":"2018112909375694000_45.3.357.8","first-page":"CD005468","article-title":"TNF-alpha inhibitors for ankylosing spondylitis","volume":"4","author":"Maxwell","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2018112909375694000_45.3.357.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61134-4"},{"key":"2018112909375694000_45.3.357.10","first-page":"661","article-title":"The formation of autoantibodies and antibodies to TNF-alpha blocking agents in relation to clinical response in patients with ankylosing spondylitis","volume":"28","author":"Arends","year":"2010","journal-title":"Clin Exp Rheumatol"},{"key":"2018112909375694000_45.3.357.11","doi-asserted-by":"publisher","DOI":"10.1186\/ar3369"},{"key":"2018112909375694000_45.3.357.12","first-page":"S-105","article-title":"The ASAS Health Index (ASAS HI) - 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