The soundstorm (boards with the MCP-T, not nVidia boards with generic on board sound) is the only card (to my knowledge) that does the on the fly DD encoding which is needed to get 5.1 sound from a digital cable in games.
Every other card will output in stereo accross a coax or optical cable unless an AC3/DTS stream is passed through.
Creative cards from the Live 5.1 and above have a seperate custom digital output which will do 5.1 etc, but only when used with Creative speakers.
Basicaly:
If you have a soundstorm and Digital speakers, you can use the digital cable to get 5.1 in games.
If you have any other card, the digital cable will output stereo in games.
If you have a creative card and creative speakers, you can use the custom digital cable to get 5.1 in games.