The Toronto Western Spasmodic Torticollis Rating Scale: Reliability in neurologists and physiotherapists

Inter-rater reliability for the Toronto Western Spasmodic Torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale by two ph...

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Published in:	Parkinsonism & related disorders Vol. 18; no. 5; pp. 635 - 637
Main Authors:	Boyce, Melani J., Canning, Colleen G., Mahant, Neil, Morris, John, Latimer, Jane, Fung, Victor S.C.
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01.06.2012
Subjects:	Aged Analysis of Variance Basal ganglia Central nervous system diseases Cervical dystonia Dystonia Female Humans Male Measurement Middle Aged Movement disorders Neurologic Examination - methods Neurologic Examination - standards Neurology Neurology - standards Observer Variation Physical Therapists - standards Reliability Reproducibility of Results Severity of Illness Index Time Factors Torticollis Torticollis - diagnosis Measurement Reliability Cervical dystonia
ISSN:	1353-8020, 1873-5126, 1873-5126
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Abstract	Inter-rater reliability for the Toronto Western Spasmodic Torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale by two physiotherapists and two neurologists. Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters. Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p < 0.001, 95% CI 0.46–0.88). Reliability for the two clinician groups was not significantly different: neurologists ICC (2,1) = 0.75 (p < 0.001, 95% CI 0.44–0.89), physiotherapists ICC (2,1) = 0.82 (p < 0.001, 95% CI 0.30–0.94). The clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool.
AbstractList	Introduction: Inter-rater reliability for the Toronto Western Spasmodic Torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale by two physiotherapists and two neurologists. Methods: Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters. Results: Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p < 0.001, 95% CI 0.46a0.88). Reliability for the two clinician groups was not significantly different: neurologists ICC (2,1) = 0.75 (p < 0.001, 95% CI 0.44a0.89), physiotherapists ICC (2,1) = 0.82 (p < 0.001, 95% CI 0.30a0.94). Conclusions: The clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool. Inter-rater reliability for the Toronto Western Spasmodic Torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale by two physiotherapists and two neurologists. Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters. Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p < 0.001, 95% CI 0.46-0.88). Reliability for the two clinician groups was not significantly different: neurologists ICC (2,1) = 0.75 (p < 0.001, 95% CI 0.44-0.89), physiotherapists ICC (2,1) = 0.82 (p < 0.001, 95% CI 0.30-0.94). The clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool. Inter-rater reliability for the Toronto Western Spasmodic Torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale by two physiotherapists and two neurologists.INTRODUCTIONInter-rater reliability for the Toronto Western Spasmodic Torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale by two physiotherapists and two neurologists.Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters.METHODSSeven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters.Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p < 0.001, 95% CI 0.46-0.88). Reliability for the two clinician groups was not significantly different: neurologists ICC (2,1) = 0.75 (p < 0.001, 95% CI 0.44-0.89), physiotherapists ICC (2,1) = 0.82 (p < 0.001, 95% CI 0.30-0.94).RESULTSReliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p < 0.001, 95% CI 0.46-0.88). Reliability for the two clinician groups was not significantly different: neurologists ICC (2,1) = 0.75 (p < 0.001, 95% CI 0.44-0.89), physiotherapists ICC (2,1) = 0.82 (p < 0.001, 95% CI 0.30-0.94).The clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool.CONCLUSIONThe clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool. Inter-rater reliability for the Toronto Western Spasmodic Torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale by two physiotherapists and two neurologists. Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters. Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p < 0.001, 95% CI 0.46–0.88). Reliability for the two clinician groups was not significantly different: neurologists ICC (2,1) = 0.75 (p < 0.001, 95% CI 0.44–0.89), physiotherapists ICC (2,1) = 0.82 (p < 0.001, 95% CI 0.30–0.94). The clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool. Abstract Introduction Inter-rater reliability for the Toronto Western Spasmodic Torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale by two physiotherapists and two neurologists. Methods Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters. Results Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 ( p < 0.001, 95% CI 0.46–0.88). Reliability for the two clinician groups was not significantly different: neurologists ICC (2,1) = 0.75 ( p < 0.001, 95% CI 0.44–0.89), physiotherapists ICC (2,1) = 0.82 ( p < 0.001, 95% CI 0.30–0.94). Conclusion The clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool.
Author	Boyce, Melani J. Fung, Victor S.C. Morris, John Mahant, Neil Latimer, Jane Canning, Colleen G.
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Cites_doi	10.1212/01.wnl.0000311389.26145.95 10.1002/mds.870030302 10.1002/mds.21145 10.1111/j.1468-1331.2010.03130.x 10.1002/pri.326
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SubjectTerms	Aged Analysis of Variance Basal ganglia Central nervous system diseases Cervical dystonia Dystonia Female Humans Male Measurement Middle Aged Movement disorders Neurologic Examination - methods Neurologic Examination - standards Neurology Neurology - standards Observer Variation Physical Therapists - standards Reliability Reproducibility of Results Severity of Illness Index Time Factors Torticollis Torticollis - diagnosis
Title	The Toronto Western Spasmodic Torticollis Rating Scale: Reliability in neurologists and physiotherapists
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