Disability Assessment Scale (DAS)

Overview

A literature search was conducted to identify all relevant publications on the psychometric properties of the Disability Assessment Scale when used with patients with stroke. Only one study was identified. Further studies are required before definitive conclusions can be drawn regarding the reliability and validity of the DAS for use with patients following stroke.

Floor/Ceiling Effects

No studies were identified examining the floor/ceiling effects of the DAS.

Reliability

Internal consistency
No studies have examined the internal consistency of the DAS.

Intra-rater
Brashear et al. (2002) investigated the intra-rater reliability of the DAS in nine patients with spasticity following stroke. All patients were evaluated twice on the same day by 10 trained evaluators. Inter-rater reliability, as calculated using overall weighted kappa scores, was adequate to excellent (k=0.520, 0.530, 0.775 and 0.776 for hygiene, dressing, limb position and pain respectively).

Inter-rater
Brashear et al. (2002) investigated the inter-rater reliability of the DAS in nine patients with spasticity following stroke. All patients were evaluated twice on the same day (at least an hour apart) by 10 trained evaluators. Inter-rater reliability, as calculated using Kendall’s W, was adequate to excellent (Kendall’s W=0.494, 0.557, 0.626 and 0.772 for dressing, limb position, hygiene, and pain respectively).

Test-retest
No studies have examined the test-retest reliability of the DAS.

Validity

Content
No studies have examined the content validity of the DAS.

Criterion

Concurrent
No studies have examined the concurrent validity of the DAS.

Predictive
No studies have examined the predictive validity of the DAS.

Sensitivity/ Specificity
No studies have examined the sensitivity/specificity of the DAS.

Construct

Convergent/Discriminant
No studies have examined the convergent/discriminant validity of the DAS.

Known Groups
No studies have examined the known groups validity of the DAS.

Responsiveness

Brashear et al. (2002) investigated the effect of Botulinum Toxin A on arm flexor spasticity in 126 patients with stroke over a 12-week period. The DAS was administered at baseline 4, 6, 8 and 12-weeks. Although the responsiveness of the DAS was not formally assessed in this study, the scale was sensitive enough to detect an improvement in function following botox treatment.

References
  • Brashear, A., Gordon, M.F., Elovic, E., Kassicieh, V.D., Marciniak, C., Do, M., Lee, C-H, Jenkins, S. et al. (2002). Intramuscular injection of botulinum toxin for the treatment of wrist and finger spasticity after a stroke. New England Journal of Medicine, 347(6), 395-400.
  • Brashear, A., Zafonte, R., Corcoran, M., Galvez-Jimenez, N., Gracies, J-M., Gordon, M.F., et al. (2002). Inter- and Intrarater reliability of the Ashworth Scale and the Disability Assessment Scale in patients with upper-limb poststroke spasticity. Archives of Physical Medicine Rehabilitation, 83, 1349-1351.