title: Inter- and intrarater reliability of the Ashworth Scale and the Disability Assessment Scale in patients with upper-limb poststroke spasticity.
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.
  
  
  METHODS
  Single-center trial.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  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.
  
  
  METHODS
  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).
  
  
  METHODS
  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.
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA. abrashea@iupui.edu
authors.forename: Allison
authors.initials: A
authors.lastname: Brashear
authors.forename: Ross
authors.initials: R
authors.lastname: Zafonte
authors.forename: Michael
authors.initials: M
authors.lastname: Corcoran
authors.forename: Nestor
authors.initials: N
authors.lastname: Galvez-Jimenez
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gracies
authors.forename: Mark Forrest
authors.initials: MF
authors.lastname: Gordon
authors.forename: Anita
authors.initials: A
authors.lastname: McAfee
authors.forename: Kyle
authors.initials: K
authors.lastname: Ruffing
authors.forename: Barbara
authors.initials: B
authors.lastname: Thompson
authors.forename: Michael
authors.initials: M
authors.lastname: Williams
authors.forename: Chia-Ho
authors.initials: CH
authors.lastname: Lee
authors.forename: Catherine
authors.initials: C
authors.lastname: Turkel
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000534:rehabilitation*; D015203:Reproducibility of Results; D000071939:Stroke Rehabilitation