The intra-rater, inter-rater and concurrent validity of the Modified Total Body Rotation Test (MTBRT)

Relevance: Ageing can lead to a reduction of flexibility and body rotation which can compromise postural control and balance, impacting on functional and mobility in older adults. This can lead to an increased potential for falling. In turn, this impacts on quality of life for the individual as well as having implications for stretched health and social care resources required to maintain independence. The MTBRT is an outcome measurement tool devised to assess total body rotation and used to identify compromised levels of physical and functional ability in older adults. The aim of the study was to explore the MTBRT for potential use with older populations by novice practitioners. Face validity of the measure when used was also explored through reflective pieces. Purpose: To investigate the reliability and validity of a new outcome measure, the Modified Total Body Rotation Test (MTBRT), for potential use in clinical environments. Methods: 20 healthy volunteers, a convenience sample from Cardiff University staff and students, aged 20-56 years (mean 27 years) were used as the sample population. Exclusion criteria included any balance or coordination issues, unstable musculoskeletal disorders or acute exacerbations of chronic conditions. Three 3rd year physiotherapy students [the researchers] acted as the novice raters. Using a same subject, correlation design, the 3 collaborating researchers gathered mean scores of the MTBRT (cm) and The Timed-Up-and-Go (TUG) Test (seconds) in a randomised order over 3 visits. Analysis: The degree of correlation was analysed using Pearson’s Correlation Coefficient for concurrent validity and two way mixed Intra-class Correlation Coefficient for intra and inter-rater reliability. Significance of p=0.05, Correlation levels of 0.5 (moderate) and 0.8 (excellent) were used. Face validity was determined by peer reflection by the 3 researchers based on use and literature review. Results: Concurrent validity using TUG r= -0.559 (p=0.01) demonstrating a moderate, negative correlation between the two measures. Intra-rater reliability r=0.966 (p=0.00) and inter-rater reliability r=1.00 (p=0.00) showed excellent reliability. Face validity was felt to be good. Conclusions: The MTBRT demonstrates excellent reliability when used by single or multiple raters and correlates moderately with the TUG, a validated tool used with older populations. Reflections concluded that the MTBRT is a quick and easy outcome measure for use by novice raters. This establishes the need to investigate this further with an older population of participants. Impact and Implications: The MTBRT is a valid and reliable tool which can be used in clinical environments to compliment the assessment of an individual with whole-body rotation deficit. Funding Acknowledgments: None. This study was undertaken as part of 3 BSc Dissertation projects. References: Stanziano D et al 2010. The Modified Total Body Rotation Test. A rapid, reliable assessment of physical function in Older Adults. Journal of American Geriatric Society, 58(10) pp1965-69 Key-Words: Modified Total Body Rotation Test, Older Adults, Outcome Measure