Literature DB >> 12370866

Inter- and intrarater reliability of the Ashworth Scale and the Disability Assessment Scale in patients with upper-limb poststroke spasticity.

Allison Brashear1, Ross Zafonte, Michael Corcoran, Nestor Galvez-Jimenez, Jean-Michel Gracies, Mark Forrest Gordon, Anita McAfee, Kyle Ruffing, Barbara Thompson, Michael Williams, Chia-Ho Lee, Catherine Turkel.   

Abstract

OBJECTIVE: To evaluate the reliability of the Ashworth Scale and the Disability Assessment Scale (DAS) in poststroke patients with upper-limb spasticity and functional disability.
DESIGN: Single-center trial.
SETTING: University medical center. PARTICIPANTS: Nine patients > or = 6 months poststroke with upper-limb spasticity and impairment in the areas of hygiene, dressing, limb posture, or pain were included in the analysis.
INTERVENTIONS: Ten experienced medical professionals rated each patient in randomized order twice on the same day (results based on mean of evaluations at times 1 and 2). Elbow, wrist, finger, and thumb flexion tones were assessed by using the Ashworth score (range, 0-4), and functional disability was assessed using the DAS (range, 0-3). MAIN OUTCOME MEASURES: Intra- and interrater reliability of the Ashworth Scale and DAS.
RESULTS: For the Ashworth parameters, 38 of 40 evaluations indicated excellent (weighted kappa > or = .75) or good (weighted kappa > or = .4) intrarater reliability. For DAS parameters, 31 of 40 evaluations indicated excellent or good intrarater reliability. The interrater reliability was also good for both the Ashworth Scale (Kendall W=.598-.792) and DAS (Kendall W=.494-.772) with statistically significant agreement found among raters (all P<.001).
CONCLUSIONS: In patients with upper-limb spasticity after stroke, the Ashworth Scale and DAS had good intra- and interrater reliability when used by trained medical professions. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

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Year:  2002        PMID: 12370866     DOI: 10.1053/apmr.2002.35474

Source DB:  PubMed          Journal:  Arch Phys Med Rehabil        ISSN: 0003-9993            Impact factor:   3.966


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