Tradução para o português e validação da Escala Cooperativa Internacional para Avaliação das Ataxias (Internacional Cooperative Ataxia Rating Scale - Icars)

• Autor(a) principal: Maggi, Fernanda Aparecida [UNIFESP]
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6732260; https://repositorio.unifesp.br/handle/11600/52203
• topic: Scas; International Cooperative Rating Scale; Icars; Translation; Validation studies; Spinocerebellar ataxias; Ataxias espinocerebelares; Tradução; Estudos de validação

Introduction: Spinocerebellar ataxias (SCAs) are a group of neurodegenerative and genetic diseases characterized by progressive gait impairment, speech changes and abnormal oculomotor movements. Clinical observation of the progression and severity of the cerebellar symptoms is mandatory and requires reliable instruments of evaluation. In Brazil, the Scale of the Assessment and Rating of Ataxia (SARA) has been translated and validated for our population. Another scale globally used to evaluate progression and severity of the ataxia is the International Cooperative Rating Scale (ICARS). The main objective of this study was to translate and culturally adapt the ICARS to the Portuguese version (Brazilian Portuguese) and to validate this scale for use in the Brazilian population. Patients and methods: Patients with SCAs were enrolled in the study. ICARS was translated and adapted to Brazilian culture. The steps of this study were translation, translations synthesis, backtranslation, specialists committee meeting, pretest and final assessment. Thirty patients participated in the pretest and other 61 patients were evaluated for construct validity, internal consistency, intra and interrater’s reliability and external consistency (comparison with the Scale of the Assessment and Rating of Ataxia, SARA). Results: Few divergences were found in linguistic equivalence between the original and translated version. According to statistical analysis, this study showed good validity of the construct, without interference of the individual characteristics of gender and age in the scale scores. The high internal consistency and statistically significant ICC (p <0.05), in testretest and interrater reliability analyzes, were observed for the full scale and for the posture, kinetics and dysarthria domains (Cronbach's alpha close to 0.9 and CCI above 90%). The oculomotor domain, however, was weak for the two measurements, with Cronbach's alpha = 0.316, ICC intra = 82.4% and ICC inter = 79.2%. High correlation with SARA was observed. The BlandAltman graphs presented good testretest reliability and relative interrater reliability, with randomly and dispersed data, with no tendency in the evaluations. Conclusion: The ICARS scale is adapted to Brazilian culture and, according to the validation methods above, justify its use in our population.