1,896
Views
30
CrossRef citations to date
0
Altmetric
Research Papers

The Trunk Impairment Scale – modified to ordinal scales in the Norwegian version

, , , , &
Pages 1385-1395 | Received 31 May 2011, Accepted 25 Nov 2011, Published online: 23 Dec 2011
 

Abstract

Purpose: To translate the Trunk Impairment Scale (TIS), a measure of trunk control in patients after stroke, into Norwegian (TIS-NV), and to explore its construct validity, internal consistency, intertester and test–retest reliability. Method: TIS was translated according to international guidelines. The validity study was performed on data from 201 patients with acute stroke. Fifty patients with stroke and acquired brain injury were recruited to examine intertester and test–retest reliability. Construct validity was analyzed with exploratory and confirmatory factor analysis and item response theory, internal consistency with Cronbach’s alpha test, and intertester and test–retest reliability with kappa and intraclass correlation coefficient tests.Results: The back-translated version of TIS-NV was validated by the original developer. The subscale Static sitting balance was removed. By combining items from the subscales Dynamic sitting balance and Coordination, six ordinal superitems (testlets) were constructed. The TIS-NV was renamed the modified TIS-NV (TIS-modNV). After modifications the TIS-modNV fitted well to a locally dependent unidimensional item response theory model. It demonstrated good construct validity, excellent internal consistency, and high intertester and test–retest reliability for the total score.Conclusions: This study supports that the TIS-modNV is a valid and reliable scale for use in clinical practice and research.

Implications for Rehabilitation

  • Trunk control is an essential part of balance and postural control, thereby an important prerequisite for daily activities and function

  • Impairments of trunk control is a common problem in stroke

  • The TIS-modNV is a valid and reliable measure to evaluate impairments in trunk control

  • The TIS-modNV containing ordinal superitems is recommended for use in clinical practice and research

Acknowledgments

The authors wish to thank the Department of Physiotherapy at Haukeland University Hospital, and specifically physiotherapists Helene Christiansen and the members of the expert panel Kari Øen Jones, Olav Gjelsvik (deceased) and Torunn Grenstad for active participation in the translation process, Mona Kristin Aaslund for back-translating the TIS-NV, Torunn Grenstad, Veronica Bøe, Odd Arne Bergset and Silje Daltveit for their dedicated work in testing the patients. Silje Daltveit also collected and plotted the test results for the validity study.

Declaration of Interest: The authors report no declarations of interest. Grants for the study have been received by Bente Gjelsvik from Haukeland University Hospital, Western Norway Health Region and the Norwegian Fund for Post-Graduate Training in Physiotherapy.

Appendix

Trunk Impairment Scale – Modified Norwegian version (TIS-modNV)

Forutsetning: pasienten kan opprettholde utgangsstillingen i 10 sekunder.

Utgangsstillingen for hver deltest er den samme: Pasienten sitter på kanten av en seng eller behandlingsbenk uten rygg—og armstøtte. Lårene har full kontakt med sengen eller benken, føttene har hoftebreddes avstand og er plassert flatt på gulvet. Pasienten er barfot. Knevinkelen er 90°. Armene hviler på lårene. Dersom det er hypertonus til stede, regnes posisjonen i affisert arm som en del av utgangsstillingen. Hodet og trunkus er i midtlinjeposisjon. Alle tester utføres maksimalt 3 ganger, beste omgang teller. Pasienten kan korrigeres mellom forsøkene. Deltestene instrueres verbalt og kan demonstreres.

TIS-modNV—Back-translated version

Prerequisite: The patient can maintain the starting position for 10 seconds.

The starting position for each item is the same: The patient is sitting on the edge of a bed or plinth without back and arm support. The thighs make full contact with the bed or plinth, the feet are hip width apart and are positioned flat on the floor. The patient is barefooted. The angle of the knees is 90°. The arms are resting on the thighs. If there is hypertonia present, the position of the affected arm is counted as part of the starting position. The head and trunk are in a midline position. All tests are performed maximum three times, best performance is scored. The patient may be corrected between attempts. The items are instructed verbally, and demonstrated if needed.

Notes

1 The International Bobath Instructors Training Association, IBITA.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.