Reliability and validity of the Trunk Impairment Scale in children and adolescents with cerebral palsy.
The Trunk Impairment Scale is ready for routine use with 5-19-year-old clients who have cerebral palsy.
01Research in Context
What this study did
Saether et al. (2013) checked if the Trunk Impairment Scale works well for kids with cerebral palsy. They tested a group of children and teens aged 5-19. The team looked at how closely two raters agreed and how well the scores matched the Gross Motor Function Measure.
What they found
The scale showed high agreement between different raters and on repeat tests. Scores lined up strongly with the gold-standard gross motor test. The authors say the tool is both reliable and valid for clinic use.
How this fits with other research
Two years earlier the same group published a shorter study. Sæther et al. (2011) showed the scale was reliable; the 2013 paper adds proof that it also measures what it claims. Heyrman et al. (2011) offered a rival tool, the Trunk Control Measurement Scale. Both scales are reliable and valid, so you can pick either one. Arnfield et al. (2013) reviewed brain imaging and motor tools in CP; their call for better standards supports using well-checked scales like the TIS.
Why it matters
You now have a quick, trustworthy way to score trunk control in school-age and teen clients with CP. Add the 15-item TIS to your intake or re-eval packet. A baseline number lets you track change after core-strength programs or adaptive seating trials.
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02At a glance
03Original abstract
Standardized clinical tools are useful for treatment planning and evaluation, however clinical tools to assess quality in trunk movements in children with cerebral palsy (CP) are sparse. We have recently reported good intra- and inter-observer reliability of the Trunk Impairment Scale (TIS) in 5-12 year old children with CP. The aim of this study was to assess reliability in adolescents (13-19 years old), and to assess the construct validity in children and adolescents in the whole age spectrum from 5 to 19 years. Video recordings of 17 children with CP with Gross Motor Function Classification (GMFCS) level I-IV were analyzed by three observers on two occasions. For construct validity the TIS was compared with Gross Motor Function Measure (GMFM), in 37 children with GMFCS levels I-IV. Intraclass correlation coefficients varied between 0.82 and 0.98, and 86% of the kappa values varied between 0.61 and 1.00, suggesting high inter- and intra-observer reliability. The smallest detectable difference (SDD) of the TIS (scale range 0-23) varied between 2.55 and 3.82 for intra- and 4.07-8.23 for inter-observer observations. The high inter-observer SDD was partly due to consistently lower TIS scores by one observer. The correlation between the TIS total score and the dimension scores of the GMFM was high (Spearman's rho: 0.80-0.87), while decreasing GMFCS levels were associated with increasing total TIS score; both findings indicating good construct validity of the TIS. This study suggests that the TIS is a reliable and valid measure of trunk control for both children and adolescents with cerebral palsy.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.03.029