The Toronto Western Spasmodic Torticollis Rating Scale: reliability in neurologists and physiotherapists

Abstract

Introduction: Inter-rater reliability for the Toronto Western Spasmodic Torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale by two physiotherapists and two neurologists.

Methods: Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters.

Results: Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p < 0.001, 95% CI 0.46-0.88). Reliability for the two clinician groups was not significantly different: neurologists ICC (2,1) = 0.75 (p < 0.001, 95% CI 0.44-0.89), physiotherapists ICC (2,1) = 0.82 (p < 0.001, 95% CI 0.30-0.94).

Conclusion: The clinical severity subscale of the Toronto Western Spasmodic Torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool.