Assessing the validity and reliability of the Turkish version of the Trunk Impairment Scale in stroke patients

Sinem Sag, Raikan Buyukavci, Fusun Sahin, Mustafa Serdar Sag, Beril Dogu, Banu Kuran, Sinem Sag, Raikan Buyukavci, Fusun Sahin, Mustafa Serdar Sag, Beril Dogu, Banu Kuran

Abstract

Objective: To determine the validity and reliability of the Turkish version of the Trunk impairment scale (TIS), used in the evaluation of somatic, motor, and coordination disturbances in stroke patients, and provide a culturally adapted version for use in the Turkish population.

Methods: A total of 80 patients who were either hospitalized at our facility and rehabilitated for stroke or admitted at our outpatient clinics were included in this study. Reliability was evaluated by the internal consistency (Cronbach α) and test reproducibility [intra-class correlation coefficient (ICCC)] methods, and validity was evaluated by the correlation between subgroups and the total scores of the TIS and Berg Balance Scale (BBS), Brunnstrom phases, Barthel index (BI), Rivermead mobility index (RMI), and Short Form-36 (SF-36) scores.

Results: The mean age of the patients was 63.00±12.1 years. Out of a total of 80 subjects, 34 were female and 46 were male. The reliability of the scale was evaluated by the internal consistency, inter- and intra-observer reliability, and test reproducibility. The findings showed that the Turkish form of the scale was reliable at a good level. The test values were as follows; Cronbach α: >0.70, ICCC: 0.969-1, subgroups and total score comparison: 0. The correlation between TIS and BBS was considerably high in the validity analysis (p<0.001). Further, significant associations among the BI, RMI, KF-36, Brunnstrom, and TIS scores were found (p<0.001), which indicate the structural validity of this scale.

Conclusion: TIS is a scale used in measuring the motor derangement that develops after a stroke. It has sufficient reliability, internal consistency, and validity for use in clinical practice and stroke investigations. Our study has shown that TIS used for the evaluation of body balance is valid and reliable for the Turkish population.

Keywords: Reliability and validity; stroke; trunk impairment scale.

Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

References

    1. Wade DT, Skilbeck CE, Hewer RL. Predicting Barthel ADL score at 6 months after an acute stroke. Arch Phys Med Rehabil. 1983;64:24–8.
    1. Loewen SC, Anderson BA. Predictors of stroke outcome using objective measurement scales. Stroke. 1990;21:78–81.
    1. Verheyden G, Nieuwboer A, Van de Winckel A, De Weerdt W. Clinical tools to measure trunk performance after stroke:a systematic review of the literature. Clin Rehabil. 2007;21:387–94.
    1. Verheyden G, Willems AM, Ooms L, Nieuwboer A. Validity of the trunk impairment scale as a measure of trunk performance in people with Parkinson's disease. Arch Phys Med Rehabil. 2007;88:1304–8.
    1. Verheyden G, Nuyens G, Nieuwboer A, Van Asch P, Ketelaer P, De Weerdt W. Reliability and validity of trunk assessment for people with multiple sclerosis. Phys Ther. 2006;86:66–76.
    1. Pham HP, Eidem A, Hansen G, Nyquist A, Vik T, Sæther R. Validity and Responsiveness of the Trunk Impairment Scale and Trunk ControlMeasurement Scale in Young Individuals with Cerebral Palsy. Phys Occup Ther Pediatr. 2016;36:440–52.
    1. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.
    1. Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Standardize Mini Mental Test'in Türk Toplumunda Hafif Demans Tanısında Geçerlik ve Güvenilirliği. Türk Psikiyatri Derg. 2002;13:273–81.
    1. Küçükdeveci AA, Yavuzer G, Tennant A, Süldür N, Sonel B, Arasil T. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitationin Turkey. Scand J Rehabil Med. 2000;32:87–92.
    1. Ware JE. SF-36 Health Survey Update. In: Maruish ME, editor. The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. 3rd ed. USA: Lawrence Erlbaum Associates; 2004. pp. 693–718.
    1. Demirsoy C. Master Thesis. İstanbul: Boğaziçi University; 1999. The MOS-SF 36 health survey:A validation studt with a Turkish sample.
    1. Ohene-Frempong K, Weiner SJ, Sleeper LA, Miller ST, Embury S, Moohr JW, et al. Cerebrovascular accidents in sickle cell disease:rates and risk factors. Blood. 1998;91:288–94.
    1. Wade DT. Personal physical disability. In: Wade DT, editor. Measurement in Neurological Rehabilitation. Oxford: Oxford University Pres; 1992. pp. 71–82.
    1. Collen FM, Wade DT, Robb GF, Bradshaw CM. The Rivermead Mobility Index:a further development of the Rivermead Motor Assessment. Int Disabil Stud. 1991;13:50–4.
    1. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly:validation of an instrument. Can J Public Health. 1992;83(Suppl 2):S7–11.
    1. Berg K, Wood-Dauphinee S, Williams JI. The Balance Scale:reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med. 1995;27:27–36.
    1. Şahin F, Büyükavcı R, Sağ S, Doğu B, Kuran B. Reliability and Validity of the Turkish Version of the Berg Balance Scale in Patients With Stroke. Turk Phys Med and Rehab. 2013;59:170–5.
    1. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 2000;25:3186–91.
    1. Guillemin F. Cross-cultural adaptation and validation of health status measures. Scand J Rheumatol. 1995;24:61–3.
    1. Petersen MA, Groenvold M, Bjorner JB, Aaronson N, Conroy T, Cull A, et al. European Organisation for Research and Treatment of Cancer Quality of Life Group. Use of differential item functioning analysis to assess the equivalence of translations of a questionnaire. Qual Life Res. 2003;12:373–85.
    1. Küçükdeveci AA. Osteoartritte işlevsel değerlendirme ölçütleri. Turk J Geriatrics. 2011;14:37–44.
    1. Aboderin I, Venables G. Stroke management in Europe. Pan European Consensus Meeting on StrokeManagement. J Intern Med. 1996;240:173–80.
    1. Bohannon RW. Lateral trunk flexion strength:impairment, measurement reliability and implications following unilateral brain lesion. Int J Rehabil Res. 1992;15:249–51.
    1. Brinkman J, Kuypers HG. Splitbrain monkeys:cerebral control of ipsilateral and contralateral arm, hand, and finger movements. Science. 1972;176:536–9.
    1. Taoka M, Toda T, Iwamura Y. Representation of the midline trunk, bilateral arms, and shoulders in the monkey postcentral somatosensory cortex. Exp Brain Res. 1998;123:315–22.
    1. Côté R, Hachinski VC, Shurvell BL, Norris JW, Wolfson C. The Canadian Neurological Scale:a preliminary study in acute stroke. Stroke. 1986;17:731–7.
    1. Kottke FJ. Neurophysiologic therapy for stroke. In: Licht S, editor. Stroke and Its Rehabilitation. Baltimore: Waverly Press; 1975. pp. 256–324.
    1. Verheyden G, Nieuwboer A, Feys H, Thijs V, Vaes K, De Weerdt W. Discriminant ability of the Trunk Impairment Scale:A comparison between stroke patients and healthy individuals. Disabil Rehabil. 2005;27:1023–8.
    1. Verheyden G, Vereeck L, Truijen S, Troch M, Lafosse C, Saeys W, et al. Additional exercises improve trunk performance after stroke:a pilot randomized controlled trial. Neurorehabil Neural Repair. 2009;23:281–6.
    1. Verheyden G, Nieuwboer A, Mertin J, Preger R, Kiekens C, De Weerdt W. The Trunk Impairment Scale:a new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004;18:326–34.
    1. Verheyden G, Hughes J, Jelsma J, Nieuwboer A, De Weerdt W. Assesing motor impairment of the trunk in patients with traumatic brain injury:reliability and validity of the trunk impairment scale. S Afr J Physiother. 2006;62:23–8.
    1. Verheyden G, Nieuwboer A, De Wit L, Feys H, Schuback B, Baert I, et al. Trunk performance after stroke:an eye catching predictor of functional outcome. J Neurol Neurosurg Psychiatry. 2007;78:694–8.

Source: PubMed

3
Abonnere