Table 6.
Disability Assessment Scale (DAS) for the lower limb.a
| Stroke (N=411) |
MS (N=119) |
CP (N=77) |
TBI (N=45) |
SCI (N=42) |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Tx1 (N=409)c | Tx4 (N=150) | Tx1 (N=117) | Tx4 (N=54) | Tx1 (N=77) | Tx4 (N=31) | Tx1 (N=45) | Tx4 (N=14) | Tx1 (N=42) | Tx4 (N=15) | |
| Dressing, N (%) | ||||||||||
| 0 - No disability | 131 (32.0) | 40 (26.7) | 14 (12.0) | 11 (20.4) | 18 (23.4) | 10 (32.3) | 15 (33.3) | 7 (50.0) | 11 (26.2) | 5 (33.3) |
| 1 - Mild disability | 126 (30.8) | 63 (42.0) | 36 (30.8) | 12 (22.2) | 21 (27.3) | 13 (41.9) | 12 (26.7) | 6 (42.9) | 11 (26.2) | 5 (33.3) |
| 2 - Moderate disability | 116 (28.4) | 39 (26.0) | 32 (27.4) | 19 (35.2) | 25 (32.5) | 6 (19.4) | 12 (26.7) | 1 ( 7.1) | 15 (35.7) | 3 (20.0) |
| 3 - Severe disability | 36 ( 8.8) | 8 ( 5.3) | 35 (29.9) | 12 (22.2) | 13 (16.9) | 2 ( 6.5) | 6 (13.3) | 0 ( 0.0) | 5 (11.9) | 2 (13.3) |
| Odds ratio | 1.6 | 1.9 | 3.5 | 2.5 | 2.2 | |||||
| 95% CI | 1.0, 2.5 | 0.8, 4.5 | 1.3, 9.8 | 0.6, 11.0 | 0.5, 9.5 | |||||
| F-valueb | 2.8 | 1.4 | 3.1 | 0.6 | 0.6 | |||||
| P-value | 0.041 | 0.252 | 0.029 | 0.649 | 0.594 | |||||
| Hygiene, N (%) | ||||||||||
| 0 - No disability | 196 (47.9) | 70 (46.7) | 28 (23.9) | 17 (31.5) | 27 (35.1) | 18 (58.1) | 22 (48.9) | 8 (57.1) | 18 (42.9) | 6 (40.0) |
| 1 - Mild disability | 98 (24.0) | 40 (26.7) | 25 (21.4) | 8 (14.8) | 24 (31.2) | 7 (22.6) | 9 (20.0) | 3 (21.4) | 11 (26.2) | 5 (33.3) |
| 2 - Moderate disability | 82 (20.0) | 33 (22.0) | 35 (29.9) | 17 (31.5) | 18 (23.4) | 4 (12.9) | 9 (20.0) | 3 (21.4) | 7 (16.7) | 3 (20.0) |
| 3 - Severe disability | 33 ( 8.1) | 7 ( 4.7) | 29 (24.8) | 12 (22.2) | 8 (10.4) | 2 ( 6.5) | 5 (11.1) | 0 ( 0.0) | 6 (14.3) | 1 ( 6.7) |
| Odds ratio | 1.2 | 1.5 | 4.4 | 1.2 | 1.1 | |||||
| 95% CI | 0.8, 2.0 | 0.7, 3.6 | 1.5, 13.2 | 0.2, 6.6 | 0.3, 5.2 | |||||
| F-value | 2.0 | 0.4 | 2.6 | 1.5 | 0.5 | |||||
| P-value | 0.108 | 0.736 | 0.056 | 0.218 | 0.709 | |||||
| Limb Posture, N (%) | ||||||||||
| 0 - No disability | 109 (26.7) | 41 (27.3) | 15 (12.8) | 9 (16.7) | 14 (18.2) | 7 (22.6) | 9 (20.0) | 5 (35.7) | 10 (23.8) | 4 (26.7) |
| 1 - Mild disability | 104 (25.4) | 56 (37.3) | 22 (18.8) | 13 (24.1) | 15 (19.5) | 13 (41.9) | 11 (24.4) | 3 (21.4) | 10 (23.8) | 4 (26.7) |
| 2 - Moderate disability | 148 (36.2) | 42 (28.0) | 43 (36.8) | 17 (31.5) | 33 (42.9) | 8 (25.8) | 16 (35.6) | 5 (35.7) | 13 (31.0) | 5 (33.3) |
| 3 - Severe disability | 48 (11.7) | 11 ( 7.3) | 37 (31.6) | 15 (27.8) | 15 (19.5) | 3 ( 9.7) | 9 (20.0) | 1 ( 7.1) | 9 (21.4) | 2 (13.3) |
| Odds ratio | 2.6 | 2.2 | 3.0 | 1.5 | 2.3 | |||||
| 95% CI | 1.6, 4.0 | 1.0, 5.0 | 1.2, 7.9 | 0.4, 6.2 | 0.5, 9.5 | |||||
| F-value | 7.6 | 2.1 | 4.0 | 0.6 | 2.0 | |||||
| P-value | < 0.0001 | 0.099 | 0.009 | 0.614 | 0.129 | |||||
| Pain, N (%) | ||||||||||
| 0 - No disability | 201 (49.1) | 83 (55.3) | 37 (31.6) | 14 (25.9) | 32 (41.6) | 14 (45.2) | 22 (48.9) | 8 (57.1) | 17 (40.5) | 6 (40.0) |
| 1 - Mild disability | 103 (25.2) | 40 (26.7) | 23 (19.7) | 18 (33.3) | 21 (27.3) | 7 (22.6) | 10 (22.2) | 6 (42.9) | 7 (16.7) | 5 (33.3) |
| 2 - Moderate disability | 74 (18.1) | 23 (15.3) | 31 (26.5) | 13 (24.1) | 13 (16.9) | 8 (25.8) | 9 (20.0) | 0 ( 0.0) | 10 (23.8) | 1 ( 6.7) |
| 3 - Severe disability | 31 ( 7.6) | 4 ( 2.7) | 26 (22.2) | 9 (16.7) | 11 (14.3) | 2 ( 6.5) | 4 ( 8.9) | 0 ( 0.0) | 8 (19.0) | 3 (20.0) |
| Odds ratio | 1.9 | 2.0 | 1.9 | 2.5 | 1.6 | |||||
| 95% CI | 1.2, 3.1 | 0.9, 4.2 | 0.7, 5.2 | 0.5, 12.4 | 0.3, 7.6 | |||||
| F-value | 10.7 | 1.5 | 1.9 | 0.5 | 0.4 | |||||
| P-value | < 0.0001 | 0.205 | 0.127 | 0.663 | 0.755 | |||||
| Mobility, N (%) | ||||||||||
| 0 - No disability | 90 (22.0) | 25 (16.7) | 4 ( 3.4) | 4 ( 7.4) | 10 (13.0) | 4 (12.9) | 6 (13.3) | 4 (28.6) | 8 (19.0) | 4 (26.7) |
| 1 - Mild disability | 73 (17.8) | 43 (28.7) | 10 ( 8.5) | 9 (16.7) | 11 (14.3) | 12 (38.7) | 6 (13.3) | 3 (21.4) | 3 ( 7.1) | 4 (26.7) |
| 2 - Moderate disability | 165 (40.3) | 63 (42.0) | 42 (35.9) | 20 (37.0) | 28 (36.4) | 10 (32.3) | 21 (46.7) | 7 (50.0) | 14 (33.3) | 5 (33.3) |
| 3 - Severe disability | 81 (19.8) | 19 (12.7) | 61 (52.1) | 21 (38.9) | 28 (36.4) | 5 (16.1) | 12 (26.7) | 0 ( 0.0) | 17 (40.5) | 2 (13.3) |
| Odds ratio | 2.1 | 4.3 | 5.2 | 7.2 | 8.0 | |||||
| 95% CI | 1.3, 3.3 | 1.7, 11.3 | 1.9, 14.8 | 1.5, 34.3 | 1.8, 34.6 | |||||
| F-value | 4.4 | 4.1 | 4.9 | 2.8 | 3.8 | |||||
| P-value | 0.004 | 0.007 | 0.003 | 0.049 | 0.013 | |||||
CI: confidence interval, CP: cerebral palsy, MS: multiple sclerosis, N: number of patients, SCI: spinal cord injury, TBI: traumatic brain injury, Tx: treatment session.
DAS objectively evaluates functional impairment resulting from spasticity across several subscales, including dressing, hygiene, limb posture, and pain (Brashear et al., 2002b). Patients were scored on a 4-point scale (range: 0–3) for each subscale, where a “0” represents no disability and a “3” represents severe disability (normal activities limited). DAS was assessed by the clinician at treatment session 1 and at each subsequent treatment session. However, to allow for comparison across etiologies, only treatment sessions 1 and 4 are shown here. Complete DAS data tables are provided in the supplemental materials for each etiology.
Data were analyzed using ordinal logistic regression. The F-value and level of significance (P-value) are shown for each subscale for the comparison across treatment sessions 1 to 4.
Data from treatment session 1 for each etiology were used as the reference for statistical analysis.