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Intra- and inter-observer reliability of the Trunk Impairment Scale for children with cerebral palsy
Rannei Sæther1, Lone Jørgensen
1Department of Clinical Services, Physiotherapy section, St. Olavs Hospital, Trondheim, Norway. rannei.sether@stolav.nl
Insights
The Trunk Impairment Scale (TIS) reliably measures trunk control in children with cerebral palsy (CP). This validated scale aids in treatment planning and evaluation for pediatric CP patients.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Movement Science
Background:
- Standardized scales for assessing trunk movement quality in children with dysfunction are limited.
- Reliability of clinical assessment tools is crucial for effective treatment planning and outcome evaluation.
Purpose of the Study:
- To evaluate the intra- and inter-observer reliability of the Trunk Impairment Scale (TIS) in children diagnosed with cerebral palsy (CP).
Main Methods:
- A reliability study involving video analysis of 25 children (20 with CP, 5 controls), aged 5-12 years.
- Three observers assessed trunk movement quality using the TIS on two separate occasions.
- Statistical analyses included Intraclass Correlation Coefficients (ICC), kappa values, and Bland-Altman plots.
Main Results:
- The TIS demonstrated very high relative reliability for total and subscale scores (ICC [1,1] and [3,1] ranging from .94 to 1.00).
- Kappa values for individual items ranged from .45 to 1.00, indicating good to excellent agreement.
- Bland-Altman analysis confirmed the consistency of TIS scores.
Conclusions:
- The Trunk Impairment Scale (TIS) is a reliable tool for assessing trunk control in children aged 5-12 years with cerebral palsy.
- The TIS can be confidently used in clinical settings for treatment planning and monitoring progress in pediatric CP.
Abstract:
Standardized scales to evaluate qualities of trunk movements in children with dysfunction are sparse. An examination of the reliability of scales that may be useful in the clinic is important. The aim of this study was to examine the reliability of the Trunk Impairment Scale (TIS) for children with cerebral palsy (CP). Standardized scales are useful for treatment planning and evaluation. This was an intra- and inter-observer reliability study. Video recordings of 25 children, 20 with CP and 5 with no motor impairment, in the age group 5-12 years of age, were analyzed by three observers on two occasions. Intraclass correlation coefficients (ICC [1,1] and [3,1]) with 95% confidence intervals, standard error of measurement, kappa values and percent agreement, and Bland-Altman Plots were calculated. The relative reliability (intra- and inter-observer reliability) was very high for the total score and subscale score of the TIS: ICC [1,1] and [3,1] varied between .94 and 1.00. Kappa values for the items ranged from .45 to 1.00. The absolute reliability values for the parameters are reported. The Bland-Altman analysis showed consistency of scores. This study indicates that TIS is a reliable measure of trunk control for children, 5-12 years of age, with CP.
