A clinical tool to measure trunk control in children with cerebral palsy: the Trunk Control Measurement Scale

Abstract

In this study the psychometric properties of the Trunk Control Measurement Scale (TCMS) in children with cerebral palsy (CP) were examined. Twenty-six children with spastic CP (mean age 11 years 3 months, range 8-15 years; Gross Motor Function Classification System level I n = 11, level II n = 5, level III n = 10) were included in this study. To determine the discriminant ability of the TCMS, 30 typically developing (TD) children (mean age 10 years 6 months, range 8-15 years) were also included. For inter-rater reliability, two testers scored all children simultaneously. To determine test-retest reliability, participants were reassessed on a second test occasion. For construct validity, the Gross Motor Function Measure (GMFM) was administered. Intraclass correlation coefficients (ICC) ranged from 0.91 to 0.99 for inter-rater and test-retest reliability. Kappa and weighted kappa values ranged for all but one item from 0.45 to 1. The standard error of measurement was 2.9% and 3.4%, and the smallest detectable difference for repeated measurements was 8% and 9.43% between raters and test-retest, respectively. Cronbach's alpha coefficients ranged from 0.82 to 0.94. Spearman rank correlation with the GMFM was 0.88 and increasing coefficients were found from dimension B to E. Subscale and total TCMS scores showed significant differences between children with CP and TD children (p < 0.0001). The results support the reliability and validity of the TCMS in children with spastic CP. The scale gives insight into the strengths and weaknesses of the child's trunk performance and therefore can have valuable clinical use.