Inter- and intrarater reliability of the Ashworth Scale and the Disability Assessment Scale in patients with upper-limb poststroke spasticity.
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.
Brashear
Allison
A
Indiana University School of Medicine, Indianapolis, IN, USA. abrashea@iupui.edu
Zafonte
Ross
R
Corcoran
Michael
M
Galvez-Jimenez
Nestor
N
Gracies
Jean-Michel
JM
Gordon
Mark Forrest
MF
McAfee
Anita
A
Ruffing
Kyle
K
Thompson
Barbara
B
Williams
Michael
M
Lee
Chia-Ho
CH
Turkel
Catherine
C
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