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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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European Journal of Physical and Rehabilitation Medicine 2017 August;53(4):516-20

DOI: 10.23736/S1973-9087.17.04371-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

The Italian version of the Trunk Impairment Scale: development and psychometric properties

Bruna LOMBARDI 1, Annalisa ORIOLI 2, Davide CASAVOLA 2, Matteo PACI 1

1 Functional Rehabilitation Unit, Azienda USL Toscana Centro, Prato, Italy; 2 School of Specialization in Physical Medicine and Rehabilitation, University of Florence, Florence, Italy


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BACKGROUND: The Trunk Impairment Scale (TIS) is a widely-used tool aimed to evaluate trunk motor impairment for stroke patients. A validation trial of a translated form of the TIS was never conducted within an Italian population.
AIM: To describe translation, cultural adaptation, and validation (internal consistency, reliability, and validity) of the Italian version of the TIS (TIS-I).
DESIGN: Evaluation of the psychometric properties of a translated, culturally adapted questionnaire.
SETTING: Inpatient rehabilitation ward.
POPULATION: Sub-acute stroke patients.
METHODS: The TIS-I was developed involving forward-backward translation to establish correspondence with the original English latest version. Psychometric testing included internal consistency (Cronbach’s alpha) and intra-rater and inter-rater reliability (ICC and Kappa), the standard error of measurement (SEM) and the minimal detectable change (MDC). Concurrent validity was estimated by comparing the TIS-I to the Trunk Control Test, balance subscore of the Fugl-Meyer (FM-BAL) and the mobility section of the Lindmark motor assessment chart (LIND-MOB), and construct validity by comparing the TIS-I to Barthel Index (BI) (Spearman rank correlation coefficient).
RESULTS: The scale was administered to 41 subjects, showing internal consistency ranged from 0.79 to 0.88. ICC values ranged from 0.725 to 0.933 for inter-rater reliability, with the SEM ranging from 0.52 to 1.11, and from 0.770 to 0.911 for intra-rater reliability, with SEM ranging from 0.52 to 1.64. MDC ranged from 1.44 to 4.55. Kappa values ranged from moderate to almost perfect. Spearman rank correlation coefficient between the TIS-I and the BI, LIND-MOB and FM-BAL was 0.63, 0.79 and 0.74 (P<0.001), respectively. Correlation coefficient between the TIS-I and the TCT was 0.81 (P<0.001).
CONCLUSIONS: This study supports the reliability and the validity of the TIS-I as measure of motor impairment of the trunk after stroke.
CLINICAL REHABILITATION IMPACT: The TIS-I can be used in daily clinical practice and in research.


KEY WORDS: Weights and measures - Torso - Motor disorders - Stroke rehabilitation - Outcome assessment (health care)

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Publication History

Issue published online: August 30, 2017
Article first published online: April 4, 2017
Manuscript accepted: March 22, 2017
Manuscript revised: March 20, 2017
Manuscript received: June 18, 2016

Cite this article as

Lombardi B, Orioli A, Casavola D, Paci M. The Italian version of the Trunk Impairment Scale: development and psychometric properties. Eur J Phys Rehabil Med 2017;53:516-20. DOI: 10.23736/S1973-9087.17.04371-4

Corresponding author e-mail

matteo.paci@applicazione.it