The
UPDRS was developed in an attempt to combine elements of a number of scales and
produce a comprehensive, efficient and flexible tool to monitor the impact of
Parkinson’s Disease and the degree of disability caused. Following several trial versions, the scale
was officially introduced in 1987 and has since been updated by specialists
from the Movement Disorder Society to include new
assessments of non-motor symptoms.
The scale has three sections which evaluate the key
areas of disability, together with a fourth section that evaluates any
complications of treatment. In addition,
this is frequently accompanied by two further scales used to report on Parkinson’s
– the Hoehn and Yahr, and the Schwab and EnglandActivities of Daily Living (ADL) scale. Although frequently used in combination with
the UPDRS, these scales are not part of the UPDRS itself.
Part I -
evaluation of mentation (mental activity or state of mind) or cognition
(ability to acquire knowledge), behaviour and mood:
- intellectual
impairment
- thought
disorder
- motivation/initiative
- depression
Part II - self evaluation of the activities of daily
life:
- speech
- salivation
- swallowing
- handwriting
- cutting
food
- dressing
- hygiene
- turning
in bed
- falling
- freezing
- walking
- tremor
- sensory
difficulties
Part III - evaluation of motor function:
- speech
- facial
expression
- tremor
at rest
- action
tremor
- rigidity
- finger
taps
- hand
movements
- rotation
of the hands and forearms so that the palms face downward
- rotation
of the hands and forearms so that the palms face upward
- leg
agility
- rising
from chair
- posture
- gait
- postural
stability
- bradykinesia
Part IV – evaluation of complications of therapy
- dyskinesia
- early
morning dystonia
- "off-period"
deterioration, including the duration
of "off" periods,
predictability based on dosage, and whether onset is sudden or gradual
- anorexia
(including nausea and/or vomiting)
- sleep
disturbance
- symptomatic
orthostasis
Part V - Hoehn and Yahr scale staging of the
severity of Parkinson’s Disease
Part VI - Schwab and England Activities of Daily
Living scale
The UPDRS
is applied by a healthcare professional and points are assigned to every item
based upon the individual’s response, as well as observation and physical
examination. Parts I, II, and III contain 44 questions, and each item is
measured on a five-point scale, while part IV contains 11 questions with the
scale ranging from 0 to 23. The final cumulative score will range from 0 (no
disability) to 199 (total disability).
For further
details on the UPDRS see www.mdvu.org/library/ratingscales/pd/updrs.pdf
and for the data collection form see www.mdvu.org/library/ratingscales/pd/upddf.pdf
