• Bruna Lombardi, Annalisa Orioli, Davide Casavola, and Matteo Paci.
• Functional Rehabilitation Unit, Azienda USL Toscana Centro, Prato, Italy.
• Eur J Phys Rehabil Med. 2017 Aug 1; 53 (4): 516-520.

BackgroundThe Trunk Impairment Scale (TIS) is a widely-used tool aimed to evaluate trunk motor impairment for stroke patients. A validation trial of a translated form of the TIS was never conducted within an Italian population.AimTo describe translation, cultural adaptation, and validation (internal consistency, reliability, and validity) of the Italian version of the TIS (TIS-I).DesignEvaluation of the psychometric properties of a translated, culturally adapted questionnaire.SettingInpatient rehabilitation ward.PopulationSub-acute stroke patients.MethodsThe TIS-I was developed involving forward-backward translation to establish correspondence with the original English latest version. Psychometric testing included internal consistency (Cronbach's alpha) and intra-rater and inter-rater reliability (ICC and Kappa), the standard error of measurement (SEM) and the minimal detectable change (MDC). Concurrent validity was estimated by comparing the TIS-I to the Trunk Control Test, balance subscore of the Fugl-Meyer (FM-BAL) and the mobility section of the Lindmark motor assessment chart (LIND-MOB), and construct validity by comparing the TIS-I to Barthel Index (BI) (Spearman rank correlation coefficient).ResultsThe scale was administered to 41 subjects, showing internal consistency ranged from 0.79 to 0.88. ICC values ranged from 0.725 to 0.933 for inter-rater reliability, with the SEM ranging from 0.52 to 1.11, and from 0.770 to 0.911 for intra-rater reliability, with SEM ranging from 0.52 to 1.64. MDC ranged from 1.44 to 4.55. Kappa values ranged from moderate to almost perfect. Spearman rank correlation coefficient between the TIS-I and the BI, LIND-MOB and FM-BAL was 0.63, 0.79 and 0.74 (P<0.001), respectively. Correlation coefficient between the TIS-I and the TCT was 0.81 (P<0.001).ConclusionsThis study supports the reliability and the validity of the TIS-I as measure of motor impairment of the trunk after stroke.Clinical Rehabilitation ImpactThe TIS-I can be used in daily clinical practice and in research.

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