Reliability And Validity Evaluation Of The Chinese Version Of The Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS) And Its Correlation With TCM Syndromes Of Spastic Torticollis

Objective: The purpose of this study was to evaluate the reliability and validity of the Chinese version of the Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS),and to provide an effective tool for evaluating patients with spastic torticollis.At the same time,the correlation between TCM syndrome types of Spastic Torticollis and the Chinese version of the Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS)was discussed,which provided possible objective basis for TCM dialectical classification of spastic torticollis.Methods: 1.Firstly,the English version of the Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS)was translated,retranslated and sinicized according to Brislin's translation principles to determine the first draft of the Chinese version of TWSTRS scale.Then 61 patients with Spastic Torticollis were investigated and evaluated by TWSTRS scale,and the statistical results were analyzed by SPSS 23.0.Cronbach?s ?reliability coefficient was used to measure the homogeneity reliability.The interval of retest reliability was one week,and pearson correlation analysis was used to calculate the correlation between the two scales.The reliability interval of raters was one day,and pearson correlation analysis was used to calculate the correlation between the two scales.In the evaluation of validity,factor analysis was used to evaluate the structural validity,and CVI was used to evaluate the content validity.2.the patients who were diagnosed as spastic torticollis in outpatient department and inpatient department of neurology institute affiliated hospital of Anhui university of traditional Chinese medicine were collected the symptoms,tongue picture,pulse condition and so on.According to the collected data of patients with TCM syndrome type division,we statisticed ST patients TCM syndrome type distribution.At the same time,the Chinese version of the Toronto Western Spasmodic Torticollis Rating Scale was used to evaluate ST patients,and the scores of the scale and related clinical data were collected.To explore the correlation between TCM syndrome types andthe Chinese version of the Toronto Western Spasmodic Torticollis Rating Scale,and analyzeed and investigated the relevant data by using relevant statistical methods,and draw a conclusion Results: 1.The Chinese version of Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS)was obtained through translation,retranslation and localization.The TWSTRS consisted of three subscales: torticollis severity,disability and pain score,there were 20 items.The result of measurement characteristic analysis shows that:1.reliability of the Chinese version of TWSTRS:In internal consistency,Cronbach?s?coefficient was 0.816,Cronbach ?s ?coefficients of the three subscales were 0.419 for torticollis,0.871 for disability and 0.908 for pain.In the retest reliability,the correlation coefficient of the two measurements in the total table was 0.956,retest correlation coefficients of three subscales were 0.824,0.931 and 0.902(p<0.01).Among the rater-to-rater reliability,the correlation coefficient between the two raters in the aggregate table was 0.924,and the correlation coefficients of the three subscales were 0.897,0.928 and 0.873,respectively.2.Validity of the Chinese version of TWSTRS:construct validity:Factor analysis was performed on 20 entries,and 7 common factors were selected,and their cumulative contribution rate of variance was 73.671 %.The mean scale level content validity index(S-CVI/Ave)of the total scale was 0.97.2.the TCM syndromes of ST patients were 35 cases(57.4 %)of liver depression and qi stagnation,wind and yang movement,26 cases(42.6 %)of liver and kidney deficiency and qi and blood deficiency.3.There was no statistical significance between TCM syndrome types of ST patients and gender and western medicine types of patients.It was statistically significant with age and course of disease.The syndrome of liver depression and qi stagnation,wind and yang movement were concentrated in the youth group,and the course of disease was relatively short;Liver and kidney deficiency,qi and blood deficiency syndrome concentrated in the elderly group,and the course of disease was longer.4.The total score of ST patients with liver and kidney deficiency and qi and blood deficiency syndrome was significantly higher than that of liver depression and qi stagnation and wind yang internal movement syndrome,the difference was statistically significant(p<0.01).The scores of sorticollis severity subscale and disability degree subscale of liver and kidney deficiency and qi and blood deficiency syndrome were higher than those of liver depression and qi stagnation and wind-yang internal movement syndrome,the difference was statistically significant(p<0.01).The scores of pain score subscale of liver depression and qi stagnation and wind yang internal movement syndrome were higher than those of liver and kidney deficiency and qi and blood deficiency syndrome,and the difference was statistically significant(p<0.01).Conclusions: 1.The Chinese version of Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS)has good reliability and validity,which can be used to assess the condition of patients with Spastic Ttorticollis in China.However,due to cultural background and scale itself,some items of the scale need to be further revise.2.ST patients with different TCM syndrome types of disease severity was different,syndrome disease severity of liver and kidney deficiency,qi and blood deficiency was significantly greater than the liver depression and qi stagnation,wind yang movement syndrome.Therefore,TWSTRS scale scores can be used as one of the reference basis for ST clinical TCM syndrome differentiation.