Validity and Responsiveness of the Trunk Impairment Scale and Trunk Control Measurement Scale in Young Individuals with Cerebral Palsy

ABSTRACT

Aim: This study examines construct validity and responsiveness of the Trunk Impairment Scale (TIS) and Trunk Control Measurement Scale (TCMS) in individuals with cerebral palsy (CP). Methods: Twenty-six individuals with CP (nine males), 8–29 years (mean age 17.6) with gross motor function corresponding to GMFCS I–IV, participated in three weeks of intensive and varied physical training at a health sports center. Trunk control was assessed with the TIS (includes three subscales) and TCMS (includes three subscales), and gross motor function with the Gross Motor Function Measure 66 item set (GMFM-66-IS), before and after the training period. The GMFM-66-IS was used as a comparison measure. Results: The median score of the TCMS subscale dynamic sitting balance, reaching (DSB-R), increased from 6 to 7 (range: 1–10; p = .031), and there was a median change of 3 points in GMFM-66-IS score (p = .036). There were no significant changes in the TIS. The correlations (Spearman's rho), between the TIS, TCMS, and the GMFM-66-IS (pre-scores), ranged between 0.57 and 0.75 (p< .003). Correlations between change scores (pre- and post-scores) were low, and not statistically significant. However, the TCMS DSB-R change score correlated significantly with hours spent on “trunk-targeted training” like paddling/rowing (rho = 0.66; p = .003) and horseback riding (rho = 0.54; p = .011). Conclusions: Our results support construct validity of the TIS and TCMS in young individuals with CP, whereas responsiveness could not be documented. However, the correlations between the TCMS DSB-R change score and hours spent on ‘‘trunk-targeted training’’ suggest that this subscale may have the potential to be used in intervention studies.

KEYWORDS.:

• Assessment tool
• cerebral palsy
• responsiveness
• trunk control
• validity

ACKNOWLEDGMENTS

We would like to thank the participants and the staff at Beitostølen Healthsports Center for their cooperation.

ABOUT THE AUTHORS

Hong Phi Pham is a medical doctor in association with the Department of Laboratory Medicine, Children's and Women's Health at the Norwegian University of Science and Technology in Trondheim, Norway. Anita Eidem is a physiotherapist in the Clinic for Clinical Services at St. Olavs University Hospital in Trondheim, Norway. Gry Hansen is a physiotherapist in the Department of Pediatrics at St. Olavs Hospital in Trondheim, Norway. Astrid Nyquist, PhD, Beitostølen Healthsports Center in Øystre Slidre, Norway. Torstein Vik is a Professor, and Rannei Sæther, PhD, Department of Laboratory Medicine, Children's and Women's Health, and the Department of Pediatrics at St. Olavs Hospital in Trondheim, Norway.