Translation and cross-cultural adaptation to Brazilian Portuguese of the Modified Tardieu Scale for muscle tone assessment among patients with spinal cord injury

ABSTRACT Background: Assessment of muscle tone is of great importance for evaluating people with spinal injuries. Objective: To translate and adapt the Modified Tardieu Scale (MTS) to Brazilian Portuguese and validate its use for evaluating patients with spinal cord injury. Methods: The translation and adaptation of the “Escala de Tardieu Modificada” went through the steps of translation, translation synthesis, back-translation and expert committee meeting. Two evaluators rated the tone of the elbow flexors/extensors, wrist extensors, knee flexors/extensors and ankle plantar flexors of 51 patients with spinal cord injury. These patients were reevaluated after one week. Validation included intra and inter-rater reliability (ICC) and internal and external consistency. The Modified Ashworth Scale (MAS) was used in the evaluations, to investigate the correlations. Results: The Brazilian Portuguese version of the MTS is presented in this study. ICCs ranged from 0.60 to 0.99 (intra and inter-examiner) and there was a moderate to strong correlation with MAS. Conclusions: The MTS proved to be adequate for assessing the muscle tone of people with spinal cord injury in Brazil.

摘要 背景：肌张力评估对于脊髓损伤患者的病情评估具有重要临床意义。目的：将改良Tardieu量表（Modified Tardieu Scale, MTS）翻译并适配为巴西葡萄牙语版本，验证其用于脊髓损伤患者肌张力评估的可行性。方法：对“改良Tardieu量表”的巴西葡萄牙语译版依次完成正向翻译、译稿整合、回译及专家委员会审议流程。由2名评估者对51例脊髓损伤患者的肘屈肌/肘伸肌、腕伸肌、膝屈肌/膝伸肌及踝跖屈肌肌张力进行评定，并于1周后对受试者进行复测。信效度检验涵盖组内与组间信度（组内相关系数，ICC）、内部一致性与外部一致性。本研究同时采用改良Ashworth量表（Modified Ashworth Scale, MAS）开展评估，以分析量表间的相关性。结果：本研究成功完成改良Tardieu量表巴西葡萄牙语版本的开发与适配。组内与组间ICC值区间为0.60~0.99，且与改良Ashworth量表呈中至强相关性。结论：改良Tardieu量表适用于巴西人群脊髓损伤患者的肌张力评估工作。