Comella C L, Stebbins G T, Goetz C G, Chmura T A, Bressman S B, Lang A E
Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA.
Mov Disord. 1997 Jul;12(4):570-5. doi: 10.1002/mds.870120414.
The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) assesses the character and severity of cervical dystonia (CD). We developed a teaching tape of the TWSTRS scoring for the motor symptoms of CD. The tape provides investigators with visual representations of each component of the motor section of the TWSTRS as agreed upon by three independently scoring raters. The rate of agreement for the nondichotomous components was always significant, with a Kendall's coefficient of concordance W ranging between 0.98 and 0.76 (p < 0.01 for all measures). For the two dichotomous components, a weighted kappa coefficient was also significant at 0.86 for lateral shift and 0.89 for sagittal shift (p < 0.01 for both measures). Scale deficiencies identified by the raters were an explicit definition of midline for assessment of range of motion, the absence of a separate scoring category assessing dystonic tremor, and the specification of duration for the effect of sensory tricks. These observations should be taken into account in future revisions of the TWSTRS and in refinements of other rating scales for CD.
多伦多西部痉挛性斜颈评定量表（TWSTRS）用于评估颈部肌张力障碍（CD）的特征和严重程度。我们制作了一盘关于TWSTRS对CD运动症状评分的教学录像带。该录像带为研究人员提供了TWSTRS运动部分各组成部分的视觉呈现，这是由三位独立评分的评估者共同认可的。非二分法组成部分的一致性率始终显著，肯德尔和谐系数W在0.98至0.76之间（所有测量值p < 0.01）。对于两个二分法组成部分，加权kappa系数在横向移位方面为0.86，矢状移位方面为0.89，也均具有显著性（两项测量值p < 0.01）。评估者发现的量表不足之处包括：用于评估运动范围的中线的明确定义、缺乏评估肌张力障碍性震颤的单独评分类别，以及感觉技巧效果的持续时间的具体规定。在TWSTRS的未来修订以及其他CD评定量表的完善过程中，应考虑这些观察结果。
