Fujiwara Toshiyuki, Liu Meigen, Tsuji Tetsuya, Sonoda Shigeru, Mizuno Katsuhiro, Akaboshi Kazuto, Hase Kimitaka, Masakado Yoshihisa, Chino Naoichi
Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjyuku, Tokyo, Japan.
Am J Phys Med Rehabil. 2004 Sep;83(9):681-8. doi: 10.1097/01.phm.0000137308.10562.20.
The purpose of this study was to investigate reliability, validity, internal structure, and responsiveness of our newly developed Trunk Impairment Scale (TIS) for patients with stroke.
A total of 73 patients with stroke participated in this prospective study. Interrater reliability (weighted kappa statistics), content validity (principal component analysis), concurrent validity (Spearman's rank correlation with the Trunk Control Test), predictive validity (prediction of discharge FIM scores), and responsiveness (standardized response mean values) were examined. Internal consistency and item difficulties were analyzed with Rasch analysis.
The weighted kappa of each TIS item ranged from 0.66 to 1.0. Principal component analysis revealed that the TIS measured a domain similar to the Stroke Impairment Assessment Set trunk items but different from the Stroke Impairment Assessment Set motor and visuospatial items. The TIS correlated with the Trunk Control Test (r = 0.91). To predict discharge FIM motor scores, addition of the TIS as one of the predictors to age, time from onset, and admission FIM score increased the adjusted R2 from 0.66 to 0.75. With Rasch analysis, the misfit was acceptable, except for the abdominal muscle strength item. The difficulty patterns were similar at admission and discharge, except for the abdominal muscle strength item. The responsiveness of the TIS was satisfactory and comparable with that of the Trunk Control Test (standardized response mean values, 0.94 and 1.06).
Our newly developed TIS is reliable, valid, and responsive for use in stroke outcome research.
本研究旨在调查我们新开发的用于中风患者的躯干功能障碍量表（TIS）的信度、效度、内部结构和反应度。
共有73例中风患者参与了这项前瞻性研究。检验了评分者间信度（加权kappa统计量）、内容效度（主成分分析）、同时效度（与躯干控制测试的Spearman等级相关性）、预测效度（出院时FIM评分的预测）和反应度（标准化反应均值）。采用Rasch分析来分析内部一致性和项目难度。
每个TIS项目的加权kappa值范围为0.66至1.0。主成分分析表明，TIS测量的领域与中风损伤评估量表的躯干项目相似，但与中风损伤评估量表的运动和视觉空间项目不同。TIS与躯干控制测试相关（r = 0.91）。为了预测出院时FIM运动评分，将TIS作为预测因子之一加入年龄、发病时间和入院时FIM评分中，调整后的R2从0.66增加到0.75。通过Rasch分析，除了腹肌力量项目外，不匹配情况是可以接受的。除了腹肌力量项目外，入院和出院时的难度模式相似。TIS的反应度令人满意，与躯干控制测试相当（标准化反应均值分别为0.94和1.06）。
我们新开发的TIS在中风结局研究中具有可靠性、有效性和反应度。
