Leeds Adult Spasticity Impact Scale (LASIS)

Evidence Reviewed as of before: 13-06-2012
Author(s): Annabel McDermott, OT
Editor(s): Nicol Korner-Bitensky, PhD OT

Purpose

The Leeds Adult Spasticity Impact Scale (LASIS) is a measure of passive arm function, suitable for patients with spasticity and little or no active movement of the upper extremity.

In-Depth Review

Purpose of the measure

The Leeds Adult Spasticity Impact Scale (LASIS) is a measure of passive arm function that is administered by semi-structured interview to the patient or carer. It consists of 12 items of low difficulty that evaluate performance of daily functional tasks in the individual’s normal environment. The LASIS is useful for patients with minimal or no active movement or function but with self-care issues of the upper extremity (Ashford et al., 2008).

Available versions

The LASIS was originally published as the Patient Disability and Carer Burden Scale by Bhakta et al. (1996), which included 8 patient items and 4 carer items (Bhakta et al., 2000). The four carer items have been excluded from the current version of the LASIS.

Features of the measure

Items:

The LASIS consists of 12 items that measure passive and low-level active function.

Passive function items:

  • 1 Cleaning the palm (affected hand)*
  • Cutting fingernails (affected hand)*
  • Cleaning the affected elbow*
  • Cleaning the affected armpit*
  • Cleaning the unaffected elbow*
  • Putting arm through coat sleeve*
  • Difficulty putting on a glove
  • Difficulty rolling over in bed
  • Doing physiotherapy exercises to arm*

Active function items:

  • Difficulty balancing in standing*
  • Difficulty balancing when walking*
  • Hold object steady, use other hand (jar)

* Items originally included in the Patient Disability and Carer Burden Rating Scale (Bhakta et al., 2000).

Scoring:

Items are rated between 0 – 4 according to the following criteria:

  • 0 = No difficulty
  • 1 = Little difficulty
  • 2 = Moderate difficulty
  • 3 = A great deal of difficulty
  • 4 = Inability to perform the activity

The total score is calculated as the sum of individual scores, divided by the total number of questions answered. This results in a total score between 0 – 4 that represent disability or carer burden (Ashford et al., 2008).

Note: As the final score does not rely on responses to all 12 items, it may not reflect actual disability or function in the arm (Ashford et al., 2008).

Description of tasks:

The LASIS is administered through semi-structured interview with the patient or carer, with regard to the patient’s performance of tasks over the past 7 days.

Time:

The LASIS takes approximately 10 minutes to administer (Ashford et al., 2008).

Training requirements:

The LASIS should be administered by a clinician (Ashford et al., 2008).

Equipment:

Equipment such as a jar may be required to validate responses.

Alternative form of the Leeds Adult Spasticity Impact Scale (LASIS)

None reported.

Client suitability

Can be used with:

  • Patients with spasticity, including patients with stroke.

Should not be used with:

  • None reported.

Languages of the measure

No translations reported.

Summary

What does the tool measure? Passive and low-level active function of the upper limb.
What types of clients can the tool be used for? Patients with upper limb spasticity, including patients who have experienced a stroke.
Is this a screening or assessment tool? Assessment tool
Time to administer 10 minutes
Versions The LASIS was originally published as the Patient Disability and Carer Burden Scale, which included four dressing and grooming items that have been excluded from the current version of the LASIS.
Other Languages None reported
Measurement Properties
Reliability

Internal consistency:

No studies have reported on the internal consistency of the LASIS.

Test-retest:

No studies have reported on the test-retest reliability of the LASIS.

Intra-rater:

No studies have reported on the intra-rater reliability of the LASIS.

Inter-rater:

No studies have reported on the inter-rater reliability of the LASIS.

Validity

Content:

No studies have reported on the content validity of the LASIS.

Criterion:

Concurrent:

No studies have reported on the concurrent validity of the LASIS.

Predictive:

No studies have reported on the predictive validity of the LASIS.

Construct:

Convergent/Discriminant:

No studies have reported on the convergent/discriminant validity of the LASIS.

Known Groups:

No studies have reported on the known-groups validity of the LASIS.

Floor/Ceiling Effects No studies have reported on the floor or ceiling effects of the LASIS.
Does the tool detect change in patients? No studies have reported on the sensitivity of the LASIS in patients with stroke.
Acceptability The LASIS is useful for patients with minimal or no active movement or function of the upper extremity.
Feasibility Administrative burden due to calculation of total score, but not complex.
How to obtain the tool? Information pending

Psychometric Properties

Overview

A literature search was conducted to identify all relevant publications on the psychometric properties of the Leeds Adult Spasticity Impact Scale (LASIS). At the time of publication no studies have reported on the psychometric properties of the LASIS in the stroke population.

Floor/Ceiling Effects

While no studies have investigated the floor or ceiling effects of the LASIS when used with a stroke population, it ca be anticipated that ceiling effects may exist when the LASIS is used with high-functioning patients, due to the hierarchical relationship of items (Ashford et al., 2008).

Reliability

Internal consistency:
No studies have reported on the internal consistency of the LASIS.

Test-retest:
No studies have reported on the test-retest reliability of the LASIS.

Inter-rater:
No studies have reported on the inter-rater reliability of the LASIS.

Intra-rater:
No studies have reported on the intra-rater reliability of the LASIS.

Validity

Content:

No studies have reported on the content validity of the LASIS.

Criterion:

Concurrent:
No studies have reported on the concurrent validity of the LASIS.

Predictive:
No studies have reported on the predictive validity of the LASIS.

Construct:

Convergent/Discriminant:
No studies have reported on the convergent/discriminant validity of the LASIS.

Known Group:
No studies have reported on the known-groups validity of the LASIS.

Responsiveness

No studies have reported on the responsiveness of the LASIS.

Sensitivity/Specificity:
No studies have reported on the sensitivity or the specificity of the LASIS.

References

  • Ashford, S., Slade, M., Malaprade, F., & Turner-Stokes, L. (2008). Evaluation of functional outcome measures for the hemiparetic upper limb: A systematic review. Journal of Rehabilitation Medicine, 40, 787-95.
  • Bhakta, B.B., Cozens, J.A., Chamberlain, M.A., & Bamford, J.M. (2000). Impact of botulinum toxin type A on disability and carer burden due to arm spasticity after stroke: a randomised double blind placebo controlled trial. Journal of Neurological Neurosurgery and Psychiatry, 69, 217-21.

See The Measure

How to obtain the LASIS?

Information pending.

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