The Trunk Appearance Perception Scale (TAPS): a new tool to evaluate subjective impression of trunk deformity in patients with idiopathic scoliosis

Abstract

BackgroundOutcome assessment in idiopathic scoliosis should probably include patients' perception of their trunk deformity in addition to self-image. This can be accomplished with the Walter Reed Visual Assessment Scale (WRVAS). Nevertheless, this instrument has some shortcomings: the drawings are abstract and some figures do not relate to the corresponding radiological deformity. These considerations prompted us to design the Trunk Appearance Perception Scale (TAPS).MethodsPatients with idiopathic scoliosis and no prior surgical treatment were included. Each patient completed the TAPS and SRS-22 questionnaire and underwent a complete radiographic study of the spine. The magnitude of the upper thoracic, main thoracic, and thoracolumbar/lumbar structural curves were recorded. The TAPS includes 3 sets of figures that depict the trunk from 3 viewpoints: looking toward the back, looking toward the head with the patient bending over and looking toward the front. Drawings are scored from 1 (greatest deformity) to 5 (smallest deformity), and a mean score is obtained.ResultsA total of 186 patients (86% females), with a mean age of 17.8 years participated. The mean of the largest curve (CMAX) was 40.2°. The median of TAPS sum score was 3.6. The floor effect was 1.6% and ceiling effect 3.8%. Cronbach's alpha coefficient was 0.89; the ICC for the mean sum score was 0.92. Correlation coefficient of the TAPS mean sum and CMAX was -0.55 (P < 0.01). Correlation coefficients between TAPS mean sum score and SRS-22 scales were all statistically significant, ranging from 0.45 to 0.52 (P < 0.05).ConclusionsThe TAPS is a valid instrument for evaluating the perception patients have of their trunk deformity. It shows excellent distribution of scores, internal consistency, and test-retest reliability, and has good capacity to differentiate the severity of the disease. It is simple and easy to complete and score, the figures are natural, and a new frontal view is included.

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“…All patients completed a set of Patient-Reported Outcome Scores that included the validated Spanish version of SRS-22 [13], SAQ [10,11] and TAPS [14] questionnaires on the day of the visit. Questionnaires were administered using paper-based forms completed by the patients themselves without any assistance from the attending physician or the patients' parents prior to consultation.…”

“…The Appearance domain is based on 10 drawings (items 1-10) with a score of 1 (least deformity) to 5 (greatest deformity) and a possible range from 10 to 50. The Expectations domain comprises four questions (items [11][12][13][14] and answers consisting of a five-point Likert scale, with a total sum ranging from 4 (lower expectations) to 20 (higher expectations) [9,10]. For the statistical analysis questions, 6 and 13 were used.…”

“…Each drawing is scored from 1 (greatest deformity) to 5 (least deformity), and a mean total is obtained, ranging from 1 to 5 [14].…”

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“…Após a elaboração das ilustrações, a interpretação dos resultados e a forma de cálculo para a Escala criada teve como base as utilizadas nos desenhos da Trunk Appearance Perception Scale (TAPS), proposta por Bago et al 17 e já aplicada em pacientes com DP em um estudo realizado por Bissolotti et al…”

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“…The design of the Trunk Appearance Perception Scale (TAPS) [52] was based on the strengths of the WRVAS: simplicity, and ease of completion and scoring. The scale includes only three sets of drawings corresponding to three views of the torso: looking towards the back, looking towards the head with the patient bending forward (Adam's test), and looking towards the front.…”