Validity of the trunk assessment scale for spinal cord injury (TASS) and the trunk control test in individuals with spinal cord injury

The Journal of Spinal Cord Medicine, 2024 · DOI: 10.1080/10790268.2023.2228583 · Published: January 1, 2024

Spinal Cord Injury Rehabilitation Research Methodology & Design

Simple Explanation

This study compares two scales, the Trunk Assessment Scale for Spinal Cord Injury (TASS) and the Trunk Control Test for Spinal Cord Injury (TCT-SCI), to see how well they measure trunk function in people with spinal cord injuries. The TASS was developed because the TCT-SCI might not be suitable for individuals with tetraplegia, as it relies on upper limb support. The TASS focuses on trunk displacement without upper limb support. The study found that both scales correlate with trunk function, but the TASS is more related to lower limb function, while the TCT-SCI is more related to upper limb function and daily activities.

Study Duration

December 2019 and December 2020

Participants

30 individuals with SCIs (age 63.8 ± 10.7 yrs, 17 with tetraplegia)

Evidence Level

Not specified

Key Findings

1
A moderate correlation was found between the TASS and the TCT-SCI, indicating they both measure trunk function but have different focuses.
2
The TASS showed a stronger correlation with lower extremity motor scores (LEMS), while the TCT-SCI showed a stronger correlation with upper extremity motor scores (UEMS).
3
Cut-off points for identifying ambulators with SCIs were 26 for the TASS and 18 for the TCT-SCI, with moderate accuracy for both scales.

Research Summary

This study evaluated the criterion and construct validity of the Trunk Assessment Scale for Spinal Cord Injury (TASS) and the Trunk Control Test for individuals with Spinal Cord Injury (TCT-SCI). The study included 30 participants with SCIs and found a moderate correlation between the TASS and TCT-SCI. Construct validity was supported by several prior hypotheses. The findings suggest that the TASS and TCT-SCI reflect epidemiological differences in the populations in which they were developed, with the TASS potentially more suitable for populations with a higher proportion of tetraplegia.

Practical Implications

Assessment Selection

Clinicians should consider the patient's specific condition (tetraplegia vs. paraplegia) when choosing between the TASS and TCT-SCI for trunk function assessment.

Rehabilitation Focus

Rehabilitation programs should address both trunk function and limb function to improve walking ability and ADLs in individuals with SCIs.

Prognostic Tool

The TASS and TCT-SCI can be used as indicators to identify ambulators with SCIs upon admission to rehabilitation hospitals, aiding in setting realistic goals and tailoring interventions.

Study Limitations

1
The profile of the participants was not closely defined.
2
The TASS may not be able to assess trunk function in individuals with a complete spinal cord injury who need a backrest or upper-limb support to maintain a sitting position.
3
A predictive validation based on a multivariate analysis with additional factors other than trunk function is needed.

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