만성 뇌졸중 환자들의 체간 조절 평가의 재현성과 Barthel Index구분을 위한 임상 유용성 (Reproducibility of Trunk Control Assessment and the Clinical Utility of the Distinguishing Barthel Index in Chronic Stroke Patients)

서지정보

· 발행기관 : 대한물리의학회
· 수록지 정보 : 대한물리의학회지 / 19권 / 3호 / 55 ~ 63페이지
· 저자명 : 안승헌, 박대성

초록

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.

영어초록

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.

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