Assessment Overview

Purpose: Measure static and dynamic sitting balance and coordination of an individual after a stroke as well as assess trunk impairment.

Summary: The patient starts each test sitting on the edge of a bed or treatment table without a back or arm support. Thighs should be supported, knees in 90 degrees of knee flexion, arms resting on legs (or resting position if hypertonia present), trunk and head in midline, and feet flat on the ground. There are 17 items on the measure and scores range from 0 to 23. If scoring 0 on the first item, the total score of the test will result in a score of 0. The patient is allowed 3 trials of each measure if needed and the highest measure is recorded. The TIS takes 20 minutes to complete and no training is required to administer the test.

Equipment: Step - if patient unable to reach the floor.

ICF Category: Activity, body structure, body function

Assessment Handout

Assessment Psychometrics

The TIS is recommended for use in patients with acute, subacute, and chronic stroke and is recommended for use in acute care, inpatient rehabilitation, skilled nursing facilities, outpatient rehabilitation, and home health. Students do not need to learn how to administer this tool, but they should be exposed to it. The TIS is appropriate for use in research. See below for psychometrics of the TIS:

• Concurrent Validity:

  • Subacute: Excellent correlation with Trunk Control Test (r=0.83)

  • Acute: Excellent correlation with Postural Assessment Scale (r=0.849)

• Construct Validity:

  • Acute to Subacute: Validity of dynamic sitting balance and coordination subscale (chi-square 42.65, 7.87 respectively)

  • Subacute: Adequate correlation with Barthel Index (r=0.86)

  • Subacute to Chronic: Excellent correlation with Barthel Index (ρ=0.86)

• Content Validity: Subacute: Achieved through literature review, observation, experience, and rehabilitation specialists

• Floor/Ceiling Effects:

  • Acute to Subacute: Poor ceiling effects for static sitting balance

  • Chronic: No ceiling effects

• Interrater Reliability:

  • Subacute to Chronic: Excellent (ICC=0.99)

• Mean Data:

  • Subacute total: 14

  • Chronic total: 11

• Responsiveness: Not established

• Test-retest:

  • Subacute: Excellent reliability for clinical care and research (ICC=0.96)

  • Chronic: Excellent (ICC=0.96)

Instructional Video