Follow-up Form B3: Evaluation Form Unified Parkinson s Disease Rating Scale (UPDRS 1 ) Motor Exam
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1 phone: (206) ; fax: (206) website: NACC Uniform Data Set (UDS) Follow-up Form B3: Evaluation Form Unified Parkinson s Disease Rating Scale (UPDRS 1 ) Motor Exam Center: ADC Subject ID: Form Date: / / Examiner s initials: [Optional] If the clinician completes the UPDRS examination and determines all items are normal, check this box and end form here. 1. Speech 1 Slight loss of expression, diction and/or volume. 2 Monotone, slurred but understandable; moderately impaired. 3 Marked impairment, difficult to understand. 4 Unintelligible. 2. Facial expression 1 Minimal hypomimia, could be normal poker face. 2 Slight but definitely abnormal diminution of facial expression. 3 Moderate hypomimia; lips parted some of the 4 Masked or fixed facies with severe or complete loss of facial expression; lips parted ¼ inches or more. 3. Tremor at rest 3a. Face, lips, chin 3b. Right 1 Fahn S, Elton RL, UPDRS Development Committee. The Unified Parkinson s Disease Rating Scale. In Fahn S, Marsden CD, Calne DB, Goldstein M, eds. Recent developments in Parkinson s disease, Vol. 2. Florham Park, NJ: Macmillan Healthcare Information, 1987: , Reproduced by permission of the author. (version 2.0, February 2008) Page 1 of 5
2 3c. Left 3d. Right foot 3e. Left foot 4. Action or postural tremor of s 4a. Right 1 Slight; present with action. 2 Moderate in amplitude, present with action. 3 Moderate in amplitude with posture holding as well as action. 4 Marked in amplitude; interferes with feeding. 4b. Left 1 Slight; present with action. 2 Moderate in amplitude, present with action. 3 Moderate in amplitude with posture holding as well as action. 4 Marked in amplitude; interferes with feeding. 5. Rigidity (judged on passive movement of major joints with patient relaxed in sitting position; cogwheeling to be ignored) 5a. Neck UDS Follow-up Form B3: Evaluation UPDRS Motor Exam (version 2.0, February 2008) Page 2 of 5
3 5b. Right upper 5c. Left upper 5d. Right lower 5e. Left lower 6. Finger taps (patient taps thumb with index finger in rapid succession) 6a. Right 6b. Left 7. Hand movements (patient opens and closes s in rapid succession) 7a. Right UDS Follow-up Form B3: Evaluation UPDRS Motor Exam (version 2.0, February 2008) Page 3 of 5
4 7b. Left 8. Rapid alternating movements of s (pronation-supination movements of s, vertically and horizontally, with as large an amplitude as possible, both s simultaneously) 8a. Right 8b. Left 9. Leg agility (patient taps heel on the ground in rapid succession, picking up entire leg; amplitude should be at least 3 inches) 9a. Right leg 9b. Left leg UDS Follow-up Form B3: Evaluation UPDRS Motor Exam (version 2.0, February 2008) Page 4 of 5
5 10. Arising from chair (patient attempts to rise from a straight-backed chair, with arms folded across chest) 1 Slow; or may need more than one attempt. 2 Pushes self up from arms of seat. 3 Tends to fall back and may have to try more than one time, but can get up without help. 4 Unable to arise without help. 11. Posture 1 Not quite erect, slightly stooped posture; could be normal for older person. 2 Moderately stooped posture, definitely abnormal; can be slightly leaning to one side. 12. Gait 1 Walks slowly; may shuffle with short steps, but no festination (hastening steps) or propulsion. 2 Walks with difficulty, but requires little or no assistance; may have some festination, short steps, or propulsion. 3 Severely stooped posture with kyphosis; can be moderately leaning to one side. 4 Marked flexion with extreme abnormality of posture. 3 Severe disturbance of gait requiring assistance. 4 Cannot walk at all, even with assistance. 13. Posture stability (response to sudden, strong posterior displacement produced by pull on shoulders while patient erect with eyes open and feet slightly apart; patient is prepared) 14. Body bradykinesia and hypokinesia (combining slowness, hesitancy, decreased arm swing, small amplitude, and poverty of movement in general) 0 Normal erect. 1 Retropulsion, but recovers unaided. 2 Absence of postural response; would fall if not caught by examiner. 0 None. 1 Minimal slowness, giving movement a deliberate character; could be normal for some persons; possibly reduced 2 Mild degree of slowness and poverty of movement which is definitely abnormal. Alternatively, some reduced 3 Very unstable, tends to lose balance spontaneously. 4 Unable to stand without assistance. 3 Moderate slowness, poverty or small amplitude of 4 Marked slowness, poverty or small amplitude of UDS Follow-up Form B3: Evaluation UPDRS Motor Exam (version 2.0, February 2008) Page 5 of 5
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