Physical Medicine and Rehabilitation Department, Hospital Vall D'Hebrón, 119-129, 08035, Barcelona, Spain.
Orthopaedic Surgery Department, Hospital Vall D'Hebrón, 119-129, 08035, Barcelona, Spain.
Spine Deform. 2020 Dec;8(6):1239-1246. doi: 10.1007/s43390-020-00167-5. Epub 2020 Jul 7.
Body image and trunk appearance perception are two crucial attributes in determining the quality of life of individuals with spinal deformities. The Trunk Appearance Perception Scale (TAPS) is a drawing-based instrument used to evaluate this feature. The TAPS does not include a sagittal view of the trunk so it is never been used to assess trunk deformity perception in hyperkyphotic patients. This study aims to analyze the effect of introducing a new drawing on the TAPS scale representing the trunk view in the sagittal plane.
170 non-surgical patients were included (mean age 16.9 years and 77.4% women) distributed in three groups. CONTROL group (no deformity): 22 cases; KYPHOSIS group (sagittal deformity): 49 cases and SCOLIOSIS group (coronal deformity): 99 cases (mean Cobb 42.4º).
Cross-sectional study. A new drawing (TAPS4) was designed to represent the deformity in the sagittal plane with five response options. Clinical (SRS-22 and TAPS 4-items) and radiological (kyphosis T4-T12) data were collected in all patients. The statistical analysis consisted in determining for each group the internal consistency of the 3-items TAPS vs 4-items TAPS, as well as the discriminant validity (correlation with kyphosis magnitude) and convergent validity (correlation with the SRS-22 image subscale). In addition, test-retest reliability of new item 4 was determined in a subgroup of 30 kyphotic patients. During control visit, the patients received a complete physical examination and a full-spine AP and lateral X-ray in standing position using a low-radiation technique and fulfilled instruments TAPS 4 items and SRS-22r.
The three groups were found to have statistically significant differences in the magnitude of kyphosis, quality of life, body image perception, the 3-items TAPS, 4-items TAPS and new item 4 score. The addition of the item 4 to TAPS 3 items did not cause a significant change in the internal consistency of the scales (Cronbach's alpha) (TAPS 3-items 0.8 vs. TAPS 4-items 0.8). Kyphosis magnitude was not correlated with the 3-items TAPS and 4-items TAPS scores; however, in the KYPHOSIS group, a significant negative correlation was observed between kyphosis and item 4 (Rho = - 0.4, p = 0.0001). A significant correlation was found in all groups between TAPS 3-items and TAPS 4-items and SRS-22 image domain; the correlation between item 4 and SRS-22 body image domain was 0.3 in the Scoliosis group and 0.7 in the Kyphosis group.
The 4-items TAPS scale does not provide advantages in the assessment of trunk deformity over the 3-items scale. However, in patients with kyphosis, the item 4 (Kypho-TAPS) alone is a valid and reliable instrument to monitor the perception of the trunk deformity.
身体意象和躯干外观感知是确定脊柱畸形患者生活质量的两个关键属性。躯干外观感知量表（TAPS）是一种用于评估此特征的基于绘图的工具。TAPS 不包括躯干的矢状视图，因此从未用于评估 后凸患者的躯干畸形感知。本研究旨在分析引入新绘图来评估矢状面上的躯干视图对 TAPS 量表的影响。
纳入了 170 名非手术患者（平均年龄 16.9 岁，77.4%为女性），分为三组。对照组（无畸形）：22 例；后凸组（矢状面畸形）：49 例；脊柱侧弯组（冠状面畸形）：99 例（平均 Cobb 42.4°）。
横断面研究。设计了一种新的绘图（TAPS4），用于代表矢状面上的畸形，有五个响应选项。所有患者均收集临床（SRS-22 和 TAPS 四项）和影像学（T4-T12 后凸）数据。统计分析包括确定每组 TAPS 3 项与 TAPS 4 项的内部一致性，以及判别有效性（与后凸幅度的相关性）和收敛有效性（与 SRS-22 图像子量表的相关性）。此外，在后凸患者亚组中确定了新项目 4 的测试-再测试可靠性。在对照就诊时，患者接受了全面的体格检查，并使用低辐射技术在站立位进行全脊柱前后位和侧位 X 光检查，同时填写了 TAPS 4 项和 SRS-22r 量表。
发现三组在后凸幅度、生活质量、身体意象感知、TAPS 3 项、TAPS 4 项和新项目 4 评分方面存在统计学显著差异。将新项目 4 添加到 TAPS 3 项中不会导致量表的内部一致性（Cronbach's alpha）发生显著变化（TAPS 3 项 0.8 与 TAPS 4 项 0.8）。后凸幅度与 TAPS 3 项和 TAPS 4 项评分均无相关性；然而，在后凸组中，后凸与新项目 4 之间存在显著负相关（Rho = -0.4，p = 0.0001）。所有组中 TAPS 3 项和 TAPS 4 项与 SRS-22 图像域之间均存在显著相关性；新项目 4 与 SRS-22 身体图像域之间的相关性在脊柱侧弯组为 0.3，在后凸组为 0.7。
TAPS 4 项量表在评估躯干畸形方面没有优于 TAPS 3 项量表的优势。然而，在后凸患者中，新项目 4（Kypho-TAPS）是一种有效且可靠的监测躯干畸形感知的工具。
