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Reliability and Validity of the TIMPSI for Infants With Spinal Muscular Atrophy Type I

Krosschell, Kristin J. PT, DPT, MA, PCS; Maczulski, Jo Anne MA, OTR/L; Scott, Charles PhD; King, Wendy PT, BA; Hartman, Jill T. PT, DPT; Case, Laura E. PT, DPT, MS, PCS, C/NDT; Viazzo-Trussell, Donata PT, DPT; Wood, Janine PT, DPT; Roman, Carolyn A. PT; Hecker, Eva PT; Meffert, Marianne PT; Léveillé, Maude PT; Kienitz, Krista OTR, CHT, CLT; Swoboda, Kathryn J. MD

doi: 10.1097/PEP.0b013e31828a205f
Research Article

Purpose: This study examined the reliability and validity of the Test of Infant Motor Performance Screening Items (TIMPSI) in infants with type I spinal muscular atrophy (SMA).

Methods: After training, 12 evaluators scored 4 videos of infants with type I SMA to assess interrater reliability. Intrarater and test-retest reliability was further assessed for 9 evaluators during a SMA type I clinical trial, with 9 evaluators testing a total of 38 infants twice. Relatedness of the TIMPSI score to ability to reach and ventilatory support was also examined.

Results: Excellent interrater video score reliability was noted (intraclass correlation coefficient, 0.97–0.98). Intrarater reliability was excellent (intraclass correlation coefficient, 0.91–0.98) and test-retest reliability ranged from r = 0.82 to r = 0.95. The TIMPSI score was related to the ability to reach (P ≤ .05).

Conclusion: The TIMPSI can reliably be used to assess motor function in infants with type I SMA. In addition, the TIMPSI scores are related to the ability to reach, an important functional skill in children with type I SMA.

This multicenter examination of the reliability of the TIMPSI shows its usefulness as a measure of motor function for children with SMA type I.

Department of Physical Therapy and Human Movement Sciences (Dr Krosschell), Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Pediatric Occupational Therapy (Ms Maczulski), Chicago, Illinois; CBS Squared (Dr Scott), Fort Washington, Pennsylvania; Department of Neurology (Ms King), Neuromuscular Disease Center, Ohio State University, Columbus, Ohio; Department of Physical Therapy and Rehabilitation (Dr Hartman), Johns Hopkins Hospital, Baltimore, Maryland; Division of Physical Therapy (Dr Case), Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina; Pediatric Motor Disorders Research Program (Dr Viazzo-Trussell) and Departments of Neurology and Pediatrics (Dr Swoboda), University of Utah School of Medicine, Salt Lake City, Utah; Primary Children's Medical Center (Dr Wood), Salt Lake City, Utah; Department of Rehabilitation Services (Ms Roman), Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics (Mss Hecker and Meffert), Hospital of the University of Cologne, Cologne, Germany; Centre de Réadaptation (Ms Léveillé), Marie-Enfant CHU Sainte-Justine, Montréal, Quebec, Canada; Department of Orthopedics and Rehabilitation (Ms Kienitz), University of Wisconsin Hospital and Clinics, Madison, Wisconsin.

Correspondence: Kristin J. Krosschell, PT, DPT, MA, PCS, Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Ste 1100, 645 N Michigan Ave, Chicago, IL 60611 (k-krosschell@northwestern.edu).

Grant Support: This project was fully funded by Families of Spinal Muscular Atrophy in the United States and its affiliate in Canada. The German site was supported by a grant from Initiative und Forschung fuer SMA.

The authors declare no conflict of interest.

¶Project Cure SMA Investigators Network members: Kathryn J. Swoboda, MD, Departments of Neurology and Pediatrics, Primary Children's Medical Center, and University of Utah School of Medicine, Salt Lake City; Gyula Acsadi, MD, PhD, Division of Neurology, Connecticut Children's Medical Center, Hartford, Connecticut; Thomas Crawford, MD, Departments of Neurology and Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland; Guy D'Anjou, MD, Department of Pediatrics, Hôpital Sainte-Justine, Montreal, Quebec, Canada; Bakri Elsheik, MD, Department of Neurology, Ohio State University, Columbus; John T. Kissel, MD, Department of Neurology, Ohio State University, Columbus; Priya Kishnani, MD, Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina; Kristin J. Krosschell, PT, DPT, MA, PCS, Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Bernard LaSalle, PhD, Biomedical Informatics, University of Utah, Salt Lake City; Sandra P. Reyna, MD, Department of Neurology, University of Utah School of Medicine, Salt Lake City; Mary K. Schroth, MD, Department of Pediatrics, University of Wisconsin Children's Hospital, Madison; Charles Scott, PhD, CBS Squared, Fort Washington, Pennsylvania; Louise R. Simard, PhD, Departments of Biochemistry and Medical Genetics, University of Manitoba, Winnepeg, Mannitoba, Canada; Edward C. Smith, MD, Division of Pediatric Neurology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina; Brunhilde Wirth, Institute of Human Genetics, University Hospital of Cologne, Cologne, Germany, Jürgen-Christoph von Kleist-Retzow, MD, Department of Pediatrics, Hospital of the University of Cologne, Cologne, Germany.

© 2013 Lippincott Williams & Wilkins, Inc.