title: Construct Validity of the Trunk Impairment Classification System in Relation to Objective Measures of Trunk Impairment.
abstract: OBJECTIVE
  To determine the validity of the Trunk Impairment Classification system (TIC) with 4 possible scores (0, most impaired; 0.5; 1.0; 1.5, least impaired) in relation to objective, instrumented measures of impairment.
  
  
  METHODS
  Cross-sectional design.
  
  
  METHODS
  National wheelchair rugby and basketball competitions of The Netherlands and Belgium.
  
  
  METHODS
  Volunteer sample of athletes (N=34) with a minimum of 1-year experience in their sport.
  
  
  METHODS
  Static sitting balance tasks on a stable and unstable surface; dynamic sitting balance tasks in anterior-posterior, left-right, and oblique directions; and trunk muscle strength tasks in forward, left, right, and backward directions.
  
  
  METHODS
  Sway area of the center of pressure in static sitting balance, maximum excursion of center of pressure displacement in dynamic sitting balance, and maximum isometric force in trunk muscle strength.
  
  
  RESULTS
  Athletes with TIC score 0 were not able to sit unsupported. The Kruskal-Wallis test showed a significant difference in trunk muscle strength (P<.001) and dynamic balance in the oblique direction forward to the left and backward to the right between the TIC scores (P=.012). Post hoc analysis showed a significant difference between TIC score 0 and the other TIC scores for trunk muscle strength in all directions. There was a significant difference between TIC score 1.5 on one hand and TIC scores 0.5 and 1.0 on the other hand for dynamic balance in the right oblique direction.
  
  
  CONCLUSIONS
  The TIC is a valid scale for trunk impairment, which measures neuromusculoskeletal trunk impairment, independent of the health condition causing the impairment. Additional research is needed for coordination impairment and to assess whether TIC scores 0.5 and 1.0 should continue as separate scores.
authors.affiliation: Sint Maartenskliniek, Rehabilitation Centre, Nijmegen, The Netherlands. Electronic address: v.altmann@maartenskliniek.nl.
authors.forename: Viola C
authors.initials: VC
authors.lastname: Altmann
authors.affiliation: Sint Maartenskliniek, Research, Nijmegen, The Netherlands.
authors.forename: Brenda E
authors.initials: BE
authors.lastname: Groen
authors.affiliation: Sint Maartenskliniek, Research, Nijmegen, The Netherlands.
authors.forename: Karlijn H
authors.initials: KH
authors.lastname: Groenen
authors.affiliation: Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Yves C
authors.initials: YC
authors.lastname: Vanlandewijck
authors.affiliation: Sint Maartenskliniek, Research, Nijmegen, The Netherlands.
authors.forename: Jacques
authors.initials: J
authors.lastname: van Limbeek
authors.affiliation: Sint Maartenskliniek, Research, Nijmegen, The Netherlands.
authors.forename: Noël L
authors.initials: NL
authors.lastname: Keijsers
mesh_terms: D000293:Adolescent; D000328:Adult; D001490:Basketball / Q000502:physiology*; D001530:Belgium; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000145:classification*; D005538:Football / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D004856:Postural Balance; D060726:Torso / Q000503:physiopathology*; D014910:Wheelchairs
keywords: Disability evaluation; Postural balance; Rehabilitation; Torso