뇌졸중 환자들을 위한 한국어판 modified Version of Trunk Impairment Scale의 신뢰도
The Reliability of the modified Trunk Impairment Scale(Korean Version) in Stroke Patients
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초록
본 연구의 목적은 수정된 체간 장애 척도(modified Trunk Impairment Scale, mTIS)의 신뢰도를 조사하는 것이다. 본 연구에 만성 뇌졸중 환자 48명이 참여하였고 한국어판 mTIS의 신뢰도 분석은 측정자간 카파 계수(Kappa coefficient)와 관찰 일치비율(%)로 표기하였으며, mTIS 총점의 측정자간 신뢰도(Inter-rater reliability)는 급간내상관계수(Intra class coefficient, ICC2,1)와 Cronbach’s α 계수로 표기하였고, 표준오차 측정(Standard Error Measurement, SEM)과 최소 감지 변화(Minimal Detectable Change, MDC)를 이용하였다. 문항과 총점간의 상관성은 mTIS의 개별 항목과 전체 점수와의 관계를 스피어만 계수(Spearman coefficient) 로 표기하였다. 본 연구 결과 mTIS의 개별 항목 중 1~3, 6번 항목의 Kappa 계수는 .41~.58 로서 신뢰도 수준은 보통이었고, 4, 5번 항목은 .62, .64로서 높은 수준이었다. 관찰 일치 비율은 69%~79%이었다. mTIS의 Cronbach’s α=0.81로서 수용할만하였고, mTIS의 측정자간 신뢰도 ICC2,1=0.90(0.83~0.94), SEM과 MDC는 각각 1.07점, 2.97점이었다. mTIS 개별 항목과 총점과의 상관관계는 r=.63~.86으로 중등에서 높은 상관관계가 있었다. mTIS의 신뢰도는 만족할만한 수준으로서 뇌졸중 환자들의 체간 움직임 시 보상 작용을 파악할 수 있고 천장효과 없이 질적인 체간 조절 능력을 평가하는데 유용한 평가 도구가 될 수 있을 것이다.
Abstract
The purpose of this study was to establish the inter-rater reliability of the modified Trunk Impairment Scale (mTIS) for stroke that translated into Korean in chronic stroke patients. The subjects participated in this study were forty-eight stroke patients with hemiparesis. The mTIS scale was administered in 2 testing sessions 3 days apart. Inter-rater reliability (intraclass correlation coefficient ICC2,1), Internal consistency and Kappa coefficient was used to examine the level of agreement between raters. Absolute reliability indices, the standard error of measurement (SEM), and the Minimal Detectable Change (MDC). The item-to-total correlation was examined by correlating the total score of mTIS to the individual item of mTIS. The mTIS meets the following requirements: (1) The percentage agreement of these items ranged from 69%~79%, item-to-total correlations were all significant, ranging from r=.63~.86 (p<.01). (2) The Kappa coefficient of the 1~3, 6 items of mTIS ranged .41~.58, the 4, 5 items were .62, .64. mTIS showed good internal consistency (Cronbach’s α of 0.81). Inter-rater reliability was good for mTIS(ICC2,1=0.90(0.83~0.94)), SEM and MDC were 1.07, 2.97. mTIS was a reliable assessment tool of trunk performance for patients with stroke, it could be a useful tool to evaluate the compensation move ment without ceiling effect.
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