title: Teaching tape for the motor section of the Toronto Western Spasmodic Torticollis Scale.
abstract: The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) assesses the character and severity of cervical dystonia (CD). We developed a teaching tape of the TWSTRS scoring for the motor symptoms of CD. The tape provides investigators with visual representations of each component of the motor section of the TWSTRS as agreed upon by three independently scoring raters. The rate of agreement for the nondichotomous components was always significant, with a Kendall's coefficient of concordance W ranging between 0.98 and 0.76 (p < 0.01 for all measures). For the two dichotomous components, a weighted kappa coefficient was also significant at 0.86 for lateral shift and 0.89 for sagittal shift (p < 0.01 for both measures). Scale deficiencies identified by the raters were an explicit definition of midline for assessment of range of motion, the absence of a separate scoring category assessing dystonic tremor, and the specification of duration for the effect of sensory tricks. These observations should be taken into account in future revisions of the TWSTRS and in refinements of other rating scales for CD.
authors.affiliation: Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Comella
authors.forename: G T
authors.initials: GT
authors.lastname: Stebbins
authors.forename: C G
authors.initials: CG
authors.lastname: Goetz
authors.forename: T A
authors.initials: TA
authors.lastname: Chmura
authors.forename: S B
authors.initials: SB
authors.lastname: Bressman
authors.forename: A E
authors.initials: AE
authors.lastname: Lang
mesh_terms: D004421:Dystonia / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D009043:Motor Activity / Q000502:physiology*; D009333:Neck / Q000503:physiopathology*; D009460:Neurologic Examination / Q000379:methods / Q000592:standards*; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods; D014103:Torticollis / Q000175:diagnosis* / Q000503:physiopathology; D014743:Videotape Recording