unified parkinson disease rating scale

8/11/2019 Unified Parkinson Disease Rating Scale

1/7

Unified Parkinson Disease Rating Scale (UPDRS)

The UPDRS is a rating tool to follow the longitudinal course of Parkinson's Disease. It is made up of the) !entation" #eha$ior" and !ood" %) &D and ) !otor sections. These are e$aluated * inter$iew. Some

sections re+uire multiple grades assigned to each e,tremit*. & total of -- points are possi le. --represents the worst (total) disa ilit*)" //no disa ilit*.

I. Mentation, Behavior, Mood o Intellectual Impairment

/none/mild (consistent forgetfulness with partial recollection of e$ents with no other difficulties)

%/moderate memor* loss with disorientation and moderate difficult* handling comple, pro lems/se$ere memor* loss with disorientation to time and often place" se$ere impairment with

pro lems0/se$ere memor* loss with orientation onl* to person" una le to make 1udgments or sol$epro lems

o Thought Disorder

/none/$i$id dreaming

%/2 enign2 hallucination with insight retained/occasional to fre+uent hallucination or delusions without insight" could interfere with dail*

acti$ities0/persistent hallucination" delusions" or florid ps*chosis.

o Depression

/not present/periods of sadness or guilt greater than normal" ne$er sustained for more than a few da*s or a

week%/sustained depression for 3 week

/$egetati$e s*mptoms (insomnia" anore,ia" a ulia" weight loss)0/$egetati$e s*mptoms with suicidalit*

o Motivation/Initiative

/normal/less of asserti$e" more passi$e

%/loss of initiati$e or disinterest in electi$e acti$ities/loss of initiati$e or disinterest in da* to sa* (routine) acti$ities

0/withdrawn" complete loss of moti$ation II. Activities of Daily Living

o Speech

/normal

/mildl* affected" no difficult* eing understood%/moderatel* affected" ma* e asked to repeat

/se$erel* affected" fre+uentl* asked to repeat0/unintelligi le most of time

o Salivation

/normal/slight ut noticea le increase" ma* ha$e nighttime drooling

%/moderatel* e,cessi$e sali$a" ha* minimal drooling


2/7

/marked drooling o Swallowing

/normal/rare choking

%/occasional choking

/re+uires soft food0/re+uires 45 tu e or 5/tu e o andwriting

/normal/slightl* small or slow

%/all words small ut legi le/se$erel* affected" not all words legi le

0/ma1orit* illegi le o !utting "ood/ anding #tensils

/normal/somewhat slow and clums* ut no help needed

%/can cut most foods" some help needed/food must e cut" ut can feed self

0/needs to e fed o Dressing

/normal/somewhat slow" no help needed

%/occasional help with uttons or arms in slee$es/considera le help re+uired ut can do something alone

0/helpless o ygiene

/normal/somewhat slow ut no help needed

%/needs help with shower or ath or $er* slow in h*gienic care/re+uires assistance for washing" rushing teeth" going to athroom

0/helpless o Turning in Bed/ Ad$usting Bed !lothes

/normal/somewhat slow no help needed

%/can turn alone or ad1ust sheets ut with great difficult*/san initiate ut not turn or ad1ust alone

0/helpless o "alling%#nrelated to "ree&ing

/none/rare falls

%/occasional" less than one per da*/a$erage of once per da*

0/3 per da* o "ree&ing 'hen 'al(ing

/normal/rare" ma* ha$e start hesitation


3/7

%/occasional falls from free6ing"/fre+uent free6ing" occasional falls

0/fre+uent falls from free6in o 'al(ing

/normal

/mild difficult*" da* drag legs or decrease arm swing%/moderate difficultl* re+uires no assist/se$ere distur ance re+uires assistance

0/cannot walk at all e$en with assist o Tremor

/a sent/slight and infre+uent" not othersome to patient

%/moderate" othersome to patient/se$ere" interfere with man* acti$ities

0/marked" interferes with man* acti$ities o Sensory !omplaints )elated to *ar(insonism

/none/occasionall* has num ness" tingling" and mild aching

%/fre+uent" ut not distressing/fre+uent painful sensation

0/e,cruciating pain III. Motor + am

o Speech

/normal/slight loss of e,pression" diction"$olume

%/monotone" slurred ut understanda le" mod. impaired/marked impairment" difficult to understand

0/unintelligi le o "acial + pression

/4ormal/slight h*pom*mia" could e poker face

%/slight ut definite a normal diminution in e,pression/mod. h*pomimia" lips parted some of time

0/masked or fi,ed face" lips parted 70 of inch or more with complete loss of e,pression o Tremor at )est

"ace

/a sent/slight and infre+uent

%/mild and present most of time/moderate and present most of time0/marked and present most of time

)ight #pper + tremity -)#+.


%/mild and present most of time/moderate and present most of time

0/marked and present most of time


4/7

L#+



0/marked and present most of time )L+



0/marked and present most of time LL+



0/marked and present most of time o Action or *ostural Tremor

)#+

/a sent/slight" present with action

%/moderate" present with action/moderate present with action and posture holding

0/marked" interferes with feeding L#+

/a sent/slight" present with action

%/moderate" present with action/moderate present with action and posture holding

0/marked" interferes with feeding o )igidity

ec(

/a sent/slight or onl* with acti$ation

%/mild7moderate/marked" full range of motion

0/se$ere

)#+



0/se$ere L#+


5/7



0/se$ere)L+



0/se$ere LL+



0/se$ereo "inger taps

)ight

/normal/mild slowing" and7or reduction in amp.

%/moderate impaired. Definite and earl* fatiguing" ma* ha$e occasional arrests/se$erel* impaired. 8re+uent hesitations and arrests.

0/can arel* perform Left



0/can arel* perform o and Movements -open and close hands in rapid succession.

)ight




/normal/mild slowing" and7or reduction in amp.%/moderate impaired. Definite and earl* fatiguing" ma* ha$e occasional arrests

/se$erel* impaired. 8re+uent hesitations and arrests.0/can arel* perform

o )apid Alternating Movements -pronate and supinate hands. )ight



6/7



/normal

/mild slowing" and7or reduction in amp.%/moderate impaired. Definite and earl* fatiguing" ma* ha$e occasional arrests/se$erel* impaired. 8re+uent hesitations and arrests.

0/can arel* perform o Leg Agility -tap heel on ground, amp should 0e 1 inches.

)ight






0/can arel* perform o Arising "rom !hair -pt2 arises with arms folded across chest.

/normal/slow" ma* need more than one attempt

%/pushes self up from arms or seat/tends to fall ack" ma* need multiple tries ut can arise without assistance

0/una le to arise without help o *osture

/normal erect/slightl* stooped" could e normal for older person

%/definitel* a normal" mod. stooped" ma* lean to one side/se$erel* stooped with k*phosis

0/marked fle,ion with e,treme a normalit* of posture o 3ait

/normal/walks slowl*" ma* shuffle with short steps" no festination or propulsion

%/walks with difficult*" little or no assistance" some festination" short steps or propulsion/se$ere distur ance" fre+uent assistance

0/cannot walk o *ostural Sta0ility -retropulsion test.

/normal/reco$ers unaided

%/would fall if not caught/falls spontaneousl*

0/una le to stand o Body Brady(inesia/ ypo(inesia


7/7

/none/minimal slowness" could e normal" deli erate character

%/mild slowness and po$ert* of mo$ement" definitel* a normal" or dec. amp. of mo$ement/moderate slowness" po$ert*" or small amplitude

0/marked slowness" po$ert*" or amplitude

unified parkinson disease rating scale

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