Duke Activity Status Index cut-off scores for assessing functional capacity after stroke

Abstract

Purpose

To determine the Duke Activity Status Index (DASI) cut-off scores and verify if they would be able to discriminate between chronic stroke individuals, who had poor, from those who had good functional capacity (FC).

Materials and methods

Cross-sectional study, where 92 individuals with chronic stroke had their FC measured by DASI scores and were classified into community and non-community walkers. Both the receiver operating characteristic and the area under the curve were used to determine the best DASI cut-off values that could discriminate between individuals, who had poor, from those who had good FC. Binary logistic regression analysis is used to investigate the ability of DASI scores in predicting community walkers.

Results

DASI cut-off value of 31.95 showed to be sensitive and specific to differentiate between individuals, who had poor from good FC. The regression analysis revealed that the chance of individuals, who had better FC (≥ 31.95) be community walkers was 10.69 (95%CI:4–32.75) times higher than that of those who had poor FC (< 31.95). The model demonstrated good predictive ability.

Conclusions

The DASI cut-off value of 31.95 showed to be sensitive and specific to distinguish between chronic stroke individuals, who had poor, from those who had good FC.

IMPLICATIONS FOR REHABILITATION

• The identification of individuals, who have good and poor functional capacity, is important for clinical reasoning and decision-making in stroke rehabilitation.

• The Duke Activity Status Index (DASI) is a clinically useful tool for the assessment of functional capacity, based upon the performance of common daily living activities.

• The DASI cut-off of 31.95 points was able to discriminate between individuals with stroke, who had poor, from those who had good functional capacity.

• The chance of individuals, who had good functional capacity (DASI ≥ 31.95) be community walkers was 10.69 times higher than that of those who had poor functional capacity (DASI < 31.95).

• The findings support the use of the DASI as a simple tool for the assessment of functional capacity, especially in low-resource settings.

Keywords:

• Stroke
• cut-off value
• functional capacity
• gait
• community walkers

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This work was supported by the following Brazilian Government Funding Agencies: CAPES (Code 001), CNPq [304434/2014-0], and FAPEMIG [PPM 0082/2016].