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Reproducibility of Trunk Control Assessment and the Clinical Utility of the Distinguishing Barthel Index in Chronic Stroke Patients

  • Journal of the Korean Society of Physical Medicine
  • Abbr : J Korean Soc Phys Med
  • 2024, 19(3), pp.55-63
  • Publisher : The Korean Society of Physical Medicine
  • Research Area : Medicine and Pharmacy > Physical Therapy > Other physical therapy
  • Received : March 28, 2024
  • Accepted : May 23, 2024
  • Published : August 31, 2024

Seung Heon An 1 Park Dae-Sung 2

1국립재활원
2건양대학교

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ABSTRACT

PURPOSE: This study examined the test-retest reliability and clinical utility of the Modified Trunk Impairment Scale (mTIS), Trunk Control Test (TCT), and Postural Assessment Scale for Stroke – Trunk Control (PASS-TC) in patients with chronic stroke. METHODS: Thirty-eight stroke patients were reassessed using the mTIS, TCT, and PASS-TC with a seven-day interval between assessments. The test-retest reliability was evaluated using the intraclass correlation coefficient (ICC2,1), the standard error of measurement (SEM), the minimal detectable change (MDC), and MDC%, as well as Bland–Altman analysis. The relationship between the mTIS, TCT, PASS-TC scores, and the Barthel Index (BI) was also investigated. RESULTS: The test-retest reliability for the mTIS, TCT, and PASS-TC was high, with ICC values ranging from .91 to .94 (95% confidence interval: .83–.97). The MDCs for the mTIS and TCT were 2.35 and 13.9, respectively, while the MDC for the PASS-TC was 2 .54, a ll below 20% o f the maximum possible score, indicating reliable measurement. The optimal mTIS cut-off score for distinguishing between mild (75–95 points) and severe (50–74 points) dependence on the BI was ≥ 9.5, with an accuracy of 79%. Patients with an mTIS score ≥ 9.5 (out of 15) showed an 18-fold higher likelihood of achieving a mild level of functional independence than those with a score < 9.5. CONCLUSION: The mTIS, TCT, and PASS-TC showed high test-retest reliability and no systematic errors in chronic stroke patients. The MDC values were reliable, indicating meaningful change. Among these, the mTIS is a sensitive and a useful tool for predicting functional independence in clinical practice and is straightforward to apply.

Citation status

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