Maryam Razavi

maryam.razavi2009@gmail.com

@CambioCDS

To assess the severity of Parkinson's disease and its complications.

Measuring of disabilities caused by Parkinson's disease. FORMULA Addition of the selected points: Parameter /Finding/ Points Bradykinesia of hands: None=0 Detectable slowing of supination-pronation rate; beginning difficulty in handling tools, buttoning clothes, handwriting=+1 Moderate slowing of supination-pronation rate (one or both sides); moderate impairment of hand function; handwriting greatly impaired, micrographia present=+2 Severe slowing of supination-pronation rate; unable to write or button clothes; marked difficulty in handling utensils=+3 Rigidity: Non-detectable=0 Detectable rigidity in neck and shoulders; activation phenomenon present; mild negative resting arm rigidity (one or both)=+1 Moderate rigidity (neck and shoulders); resting rigidity present if not on meds=+2 Severe rigidity (neck and shoulders); resting rigidity cannot be reversed by meds=+3 Posture: Normal posture; head flexed forward <4”=0 Beginning poker spine; head flexed forward >5”=+1 Beginning arm flexion; head flexed up ≤6”; arms raised (one or both) but still below waist=+2 Onset of simian posture; head flexed forward >6”; hands elevated above waist (one or both); sharp flexion of hands; beginning interphalangeal extension; beginning flexion of knees=+3 Upper extremity swing: Swings both arms well=0 One arm swing definitely decreased=+1 One arm fails to swing=+2 Both arms fail to swing=+3 Gait: Steps out will with 18-30” stride, turns about effortlessly=0 Gait shortened to 12-18” stride; beginning to strike one heel; turnaround time slowing; requires several steps=+1 Stride moderately shortened to 6-12”; both heels beginning to strike floor forcefully=+2 Onset of shuffling gait; steps <3”; occasional stuttering-type or blocking gait; walks on toes; turns around very slowly=+3 Tremor No detectable tremor=0 <1” of peak-to-peak tremor movement (limbs or head) at rest, or in either hand while walking or during finger-to-nose test=+1 Maximum tremor envelope fails to exceed 4”;. severe but not constant tremor; patient retains some control of hands=+2 Tremor envelope >4”; constant severe tremor; persistent while awake unless pure cerebellar type; writing and feeding self are impossible=+3 Facies: Normal; full animation; no stare=0 Detectable immobility; mouth closed; beginning anxiety/depression features=+1 Moderate immobility; emotion breaks through at markedly increased threshold; lips parted some of the time; moderate appearance of anxiety or depression; drooling may be present=+2 Frozen facies; mouth opens ≥0.25”; severe drooling=+3 Seborrhea: None=0 Increased perspiration, secretions thin=+1 Obvious oiliness present, secretion much thicker=+2 Marked seborrhea, entire face and head covered by thick secretions=+3 Speech: Clear, loud, resonant, easily understood=0 Beginning of hoarseness, loss of inflection and resonance; good volume, still easily understood=+1 Moderate hoarseness/weakness; constant monotone unvaried pitch; beginning of dysarthria, hesitance, stuttering, difficult to understand=+2 Marked harshness/weakness, very difficult to hear and understand=+3 Self-care: No impairment=0 Still provides full self-care but rate of dressing definitely impeded; able to live alone, may be employable=+1 Requires help in certain critical areas; very slow in performing most activities but manages by taking much time=+2 Continuously disabled; unable to dress/feed self or walk alone=+3

Cannot be used for measuring handicaps's disabilities.

Webster DD. Critical analysis of the disability in Parkinson's disease. Mod Treat. 1968;5(2):257-82. Swash, Michael. (2002). Clinical Trials in Neurology. (Book Reviews).(Book Review). Journal of Neurology, Neurosurgery and Psychiatry. British Medical Association. https://doi.org/10.1136/jnnp.73.4.463-a

OBSERVATION.webster_rating_scale_for_parkinsons_disease.v0, EVALUATION.webster_rating_scale_for_parkinsons_disease.v0