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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



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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