Tradução e validação da escala “composite spasticity index” em pacientes com sequela de acidente vascular encefálico

• Autor(a) principal: Almeida, Raphaela Rocha
• Data de Publicação: 2017
• Outros Autores: Fontes, Vanessa Almeida
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: http://ri.ufs.br/jspui/handle/riufs/8341
• topic: Distúrbios do movimento; Acidente vascular cerebral; Pacientes; Espasticidade; Tradução/Validação; Confiabilidade; AVE; Spasticity; Stroke; Reliability; Translation/Validation

Objective: To translate the “Composite Spasticity Index" (CSI) to Brazilian Portuguese and validate the Brazilian version in patients with stroke. Methods: Methodological study type addressing translation and validation of clinical measurements. The original CSI scale published originally in English has been translated and validated (reliability, reproducibility of results and construct validity) in the upper and lower limbs of individuals with stroke, recruited at the Center for Physiotherapy of the municipality of Lagarto, Sergipe. The translation and validation steps were in accordance with the statements of the COnsensus Based Standards for the Selection of Health status Measurement INstruments (COSMIN) and Guidelines For Reporting Reliability and Agreement Studies (GRRAS). The reliability test-retest and Inter-rater were evaluated by the Intra Class Coefficient (ICC). The convergent and discriminant validity was evaluated by the Spearman coefficient, level of significance p < 0.05, and Confidence intervals (IC) to 95%. Results/discussion: During the translation stage, the physiotherapists involved in the process indicated consensus on most items of the scale, and only small adjustments had been suggested to the final version of Brazilian index composed of spasticity (ICE). In the validation process, 16 individuals with stroke, 64 years (± 12.5), participated in the study. The statistical analysis of reliability Intra-rater for the paretic upper limb (MS), rater 1 was: ICC= 0.83, IC= (0.50-0.94), p < 0.01; For the rater 2: ICC= 0.96, IC= (0.88-0.99), p < 0,0001. In the paretic lower limb (MI) the rater 1 had: ICC = 0.70, IC (0.21-0.89), p < 0.01; rater 2: ICC= 0.50, IC= (0.24-0.84), p < 0.01. The reliability Inter-rater for paretic upper-limb (MS) presented ICC= 0.87, IC= (0.62-0.95), p < 0.0001, for MI: ICC= 0.85, IC= (0.59-0.95), p < 0.0001. The convergent validity of the ICE with the Modified Scale of Ashworth (EMA) for MS had a coefficient of Spearman's rhô= 0.64, p < 0.01, the MI had: Spearman's rhô= 0.08, p > 0.05. The discriminant validity of ICE for MS with MiniBesTest had a coefficient of Spearman's rhô = -0.60, p < 0.05. The discriminant validity of ICE for MI was performed with the Box and Blocks test, where the coefficient of Spearman's rhô = 0.73, p < 0.01. The reliability of the ICE Inter-rater for the upper limb and lower limb were excellent. Although, the Intra-rater reliability were excellent for the upper limb and good for the lower limb, the convergent validity of ICE with the Ashworth for upper limb obtained a good correlation but it did not occur to the lower limb. The discriminant validity with MiniBESTest (for the MS) and Box and Blocks (for the MI) was surprisingly good, indicating that the greater the spasticity is, worse is the performance in those tests. Conclusion: The Brazilian version of ICE is a reliable and reproducible measurement to assess the upper and lower limbs of individuals with hemiparesis after stroke. The Brazilian version of CSI (ICE) has a high convergent and discriminant validity in the evaluation of paretic upper limb. However, the construct validity of ICE as well as the EMA to evaluate spasticity of lower limbs should be reviewed.