Skip to main content Accessibility help
×
Hostname: page-component-745bb68f8f-v2bm5 Total loading time: 0 Render date: 2025-01-08T21:50:05.195Z Has data issue: false hasContentIssue false

Chapter 55 - Motor and Functional Scales for Movement Disorders

from Section 5: - Objectifying Movement Disorders

Published online by Cambridge University Press:  07 January 2025

Erik Ch. Wolters
Affiliation:
Universität Zürich
Christian R. Baumann
Affiliation:
Universität Zürich
Get access

Summary

Measurement is an essential activity in neurology, as it allows for collecting and sharing data that can be used for description, comparison and decision making regarding the health status of patients. The adequate assessment of motor and functional signs and symptoms of movement disorders must be done with instruments that have been developed and tested following a standardized methodology. The validation of a scale or instrument is an iterative process that includes several phases and the testing of a number of psychometric properties following the principles of the Classical Test Theory or the Latent Test Theory, each with its own methods and statistical procedures. In this chapter, we review the characteristics and psychometric properties of the main measurement instruments and scales for assessing motor and functional symptoms in movement disorders, particularly those recommended by the Movement Disorders Society.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2025

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Nunnally, JC, Bernstein, IH. Psychometric Theory. New York: McGraw Hill; 1994.Google Scholar
Hobart, JC, Cano, SJ, Zajicek, JP, Thompson, AJ. Rating scales as outcome measures for clinical trials in neurology: problems, solutions, and recommendations. Lancet Neurol 2007;6(12):10941105.CrossRefGoogle ScholarPubMed
Terwee, CB, Bot, SDM, de Boer, MR, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007;60(1):3442.CrossRefGoogle ScholarPubMed
Streiner, DL, Norman, GR. Health Measurement Scales. A Practical Guide to Their Development and Use, 4th ed. Oxford: Oxford University Press; 2008.CrossRefGoogle Scholar
Scientific Advisory Committee of the Medical Outcomes Trust. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res 2002;11(3):193205.CrossRefGoogle Scholar
Mokkink, LB, Terwee, CB, Patrick, DL, et al. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res 2010;19(4):539549.CrossRefGoogle ScholarPubMed
Martinez-Martin, P, Rodriguez-Blazquez, C, Kurtis, MM. Scales and tests in movement disorders. In: Wolters, ECh, Baumann, CR, eds. Parkinson Disease and Other Movement Disorders: Motor Behavioural Disorders and Behavioural Motor Disorders. Amsterdam: VU University Press; 2014: 755770.Google Scholar
Movement Disorders Society. MDS Rating Scales [Internet]. [cited 2021 Jul 10]. Available from: www.movementdisorders.org/MDS/MDS-Rating-Scales.htmGoogle Scholar
Barnes, TR. A rating scale for drug-induced akathisia. Br J Psychiatry 1989;154:672676.CrossRefGoogle ScholarPubMed
Schmitz-Hübsch, T, du Montcel, ST, Baliko, L, et al. Scale for the assessment and rating of ataxia: development of a new clinical scale. Neurology 2006;66(11):17171720.CrossRefGoogle ScholarPubMed
Perez‐Lloret, S, Warrenburg, B, Rossi, M, et al. Assessment of ataxia rating scales and cerebellar functional tests: critique and recommendations. Mov Disord 2021;36(2):283297.CrossRefGoogle ScholarPubMed
Trouillas, P, Takayanagi, T, Hallett, M, et al. International Cooperative Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome. The Ataxia Neuropharmacology Committee of the World Federation of Neurology. J Neurol Sci 1997;145(2):205211.CrossRefGoogle ScholarPubMed
Subramony, SH, May, W, Lynch, D, et al. Measuring Friedreich ataxia: interrater reliability of a neurologic rating scale. Neurology 2005;64(7):12611262.CrossRefGoogle ScholarPubMed
Huntington Study Group. Unified Huntington’s Disease Rating Scale: reliability and consistency. Mov Disord 1996;11(2):136142.CrossRefGoogle Scholar
Mestre, TA, Forjaz, MJ, Mahlknecht, P, et al. Rating scales for motor symptoms and signs in Huntington’s disease: critique and recommendations. Mov Disord Clin Pract 2018;5(2):111117.CrossRefGoogle ScholarPubMed
Siesling, S, Zwinderman, AH, van Vugt, JP, Kieburtz, K, Roos, RA. A shortened version of the motor section of the Unified Huntington’s Disease Rating Scale. Mov Disord 1997;12(2):229234.CrossRefGoogle ScholarPubMed
Bylsma, FW, Rothlind, J, Hall, MR, Folstein, SE, Brandt, J. Assessment of adaptive functioning in Huntington’s disease. Mov Disord 1993;8(2):183190.CrossRefGoogle ScholarPubMed
Timman, R, Claus, H, Slingerland, H, et al. Nature and development of Huntington disease in a nursing home population: the Behavior Observation Scale Huntington (BOSH). Cogn Behav Neurol 2005;18(4):215222.CrossRefGoogle Scholar
Teixeira, AL Jr, Maia, DP, Cardoso, F. UFMG Sydenham’s chorea rating scale (USCRS): reliability and consistency. Mov Disord 2005;20(5):585591.CrossRefGoogle ScholarPubMed
Simpson, GM, Angus, JW. A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl 1970;212:1119.CrossRefGoogle ScholarPubMed
Chouinard, G, Rosschouinard, A, Annable, L, Jones, B. Extrapyramidal Symptom Rating Scale. Can J Neurol Sci 1980;7(3):233233.Google Scholar
Burke, RE, Fahn, S, Marsden, CD, et al. Validity and reliability of a rating scale for the primary torsion dystonias. Neurology 1985;35(1):7377.CrossRefGoogle ScholarPubMed
Albanese, A, Sorbo, FD, Comella, C, et al. Dystonia rating scales: critique and recommendations. Mov Disord 2013;28(7):874883.CrossRefGoogle ScholarPubMed
Comella, CL, Leurgans, S, Wuu, J, Stebbins, GT, Chmura, T. Rating scales for dystonia: a multicenter assessment. Mov Disord 2003;18(3):303312.CrossRefGoogle ScholarPubMed
Jankovic, J, Kenney, C, Grafe, S, Goertelmeyer, R, Comes, G. Relationship between various clinical outcome assessments in patients with blepharospasm. Mov Disord 2009;24(3):407413.CrossRefGoogle ScholarPubMed
Consky, ES, Lang, AE. Clinical assessments of patients with cervical dystonia. In: Jankovic, J, Hallett, M, eds. Therapy with Botulinum Toxin. New York: Marcel Dekker; 1994: 211237.Google Scholar
Jost, WH, Hefter, H, Stenner, A, Reichel, G. Rating scales for cervical dystonia: a critical evaluation of tools for outcome assessment of botulinum toxin therapy. J Neural Transm (Vienna) 2013;120(3):487496.CrossRefGoogle ScholarPubMed
O’Brien, C, Brashear, A, Cullis, P, et al. Cervical dystonia severity scale reliability study. Mov Disord 2001;16(6):10861090.CrossRefGoogle ScholarPubMed
Tsui, JK, Eisen, A, Stoessl, AJ, Calne, S, Calne, DB. Double-blind study of botulinum toxin in spasmodic torticollis. Lancet 1986;2(8501):245247.CrossRefGoogle ScholarPubMed
Wissel, J, Kabus, C, Wenzel, R, et al. Botulinum toxin in writer’s cramp: objective response evaluation in 31 patients. J Neurol Neurosurg Psychiatry 1996;61(2):172175.CrossRefGoogle ScholarPubMed
Yoshida, K. Development and validation of a disease-specific Oromandibular Dystonia Rating Scale (OMDRS). Front Neurol 2020;11:583177.CrossRefGoogle ScholarPubMed
Jacobson, BH, Johnson, A, Grywalski, C, et al. The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 1997;6(3):6670.CrossRefGoogle Scholar
Carding, PN, Horsley, IA, Docherty, GJ. A study of the effectiveness of voice therapy in the treatment of 45 patients with nonorganic dysphonia. J Voice 1999;13(1):72104.CrossRefGoogle ScholarPubMed
Martí, MJ, Tolosa, E, Alom, J. Botulinum toxin in hemifacial spasm: a double-blind controlled trial. In: Bartko, D, ed. New Trends in Clinical Neuropharmacology: Calcium Antagonists, Acute Neurology, Headache and Movement Disorders. London: John Libbey & Co.; 1988.Google Scholar
Frucht, SJ, Leurgans, SE, Hallett, M, Fahn, S. The Unified Myoclonus Rating Scale. Adv Neurol 2002;89:361376.Google ScholarPubMed
Hyppönen, J, Hakala, A, Annala, K, et al. Automatic assessment of the myoclonus severity from videos recorded according to standardized Unified Myoclonus Rating Scale protocol and using human pose and body movement analysis. Seizure 2020;76:7278.CrossRefGoogle ScholarPubMed
Wenning, GK, Tison, F, Seppi, K, et al. Development and validation of the Unified Multiple System Atrophy Rating Scale (UMSARS). Mov Disord 2004;19(12):13911402.CrossRefGoogle ScholarPubMed
Matsushima, M, Yabe, I, Oba, K, et al. Comparison of different symptom assessment scales for multiple system atrophy. Cerebellum 2016;15(2):190200.CrossRefGoogle ScholarPubMed
Fahn, S, Elton, R, UPDRS Program Members. Unified Parkinson’s disease rating scale. In: Fahn, S, Marsden, C, Goldstein, M, Calne, D, eds. Recent Developments in Parkinson’s Disease. Florham Park, NJ: Macmillan Healthcare Information; 1987: 153163.Google Scholar
Movement Disorder Society Task Force on Rating Scales for Parkinsons’s Disease. The Unified Parkinson’s Disease Rating Scale (UPDRS): status and recommendations. Mov Disord 2003;18(7):738750.CrossRefGoogle Scholar
Goetz, CG, Fahn, S, Martinez-Martin, P, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): process, format, and clinimetric testing plan. Mov Disord 2007;22(1):4147.CrossRefGoogle ScholarPubMed
Regnault, A, Boroojerdi, B, Meunier, J, et al. Does the MDS-UPDRS provide the precision to assess progression in early Parkinson’s disease? Learnings from the Parkinson’s progression marker initiative cohort. J Neurol 2019;266(8):19271936.CrossRefGoogle ScholarPubMed
Horváth, K, Aschermann, Z, Kovács, M, et al. Minimal clinically important differences for the experiences of daily living parts of Movement Disorder Society-sponsored unified Parkinson’s disease rating scale. Mov Disord 2017;32(5):789793.CrossRefGoogle ScholarPubMed
Horváth, K, Aschermann, Z, Ács, P, et al. Minimal clinically important difference on the Motor Examination part of MDS-UPDRS. Parkinsonism Relat Disord 2015;21(12):14211426.CrossRefGoogle ScholarPubMed
Jha, A, Menozzi, E, Oyekan, R, et al. The CloudUPDRS smartphone software in Parkinson’s study: cross-validation against blinded human raters. NPJ Parkinsons Dis 2020;6(1):36.CrossRefGoogle ScholarPubMed
Schneider, RB, Myers, TL, Tarolli, CG, et al. Remote administration of the MDS-UPDRS in the time of COVID-19 and beyond. J Parkinsons Dis 2020;10(4):13791382.CrossRefGoogle ScholarPubMed
Stocchi, F, Radicati, FG, Chaudhuri, KR, et al. The Parkinson’s Disease Composite Scale: results of the first validation study. Eur J Neurol 2018;25(3):503511.CrossRefGoogle ScholarPubMed
Martinez-Martin, P, Radicati, FG, Rodriguez Blazquez, C, et al. Extensive validation study of the Parkinson’s Disease Composite Scale. Eur J Neurol 2019;26(10):12811288.CrossRefGoogle ScholarPubMed
Balestrino, R, Hurtado-Gonzalez, CA, Stocchi, F, et al. Applications of the European Parkinson’s Disease Association-sponsored Parkinson’s Disease Composite Scale (PDCS). NPJ Parkinsons Dis 2019;5:26.CrossRefGoogle ScholarPubMed
Pintér, D, Martinez-Martin, P, Janszky, J, Kovács, N. The Parkinson’s Disease Composite Scale is adequately responsive to acute levodopa challenge. Parkinsons Dis 2019;2019:1412984.Google ScholarPubMed
Hoehn, MM, Yahr, MD. Parkinsonism: onset, progression and mortality. Neurology 1967;17(5):427442.CrossRefGoogle ScholarPubMed
Goetz, CG, Poewe, W, Rascol, O, et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord 2004;19(9):10201028.CrossRefGoogle ScholarPubMed
Martínez-Martín, P, Rodríguez-Blázquez, C, Forjaz, MJ, de Pedro, J. The Clinical Impression of Severity Index for Parkinson’s disease: international validation study. Mov Disord 2009;24(2):211217.CrossRefGoogle ScholarPubMed
Marinus, J, Visser, M, Stiggelbout, AM, et al. A short scale for the assessment of motor impairments and disabilities in Parkinson’s disease: the SPES/SCOPA. J Neurol Neurosurg Psychiatry 2004;75(3):388395.CrossRefGoogle Scholar
Bianchi, MLE, Riboldazzi, G, Mauri, M, Versino, M. Efficacy of safinamide on non-motor symptoms in a cohort of patients affected by idiopathic Parkinson’s disease. Neurol Sci 2019;40(2):275279.CrossRefGoogle Scholar
Jost, ST, Sauerbier, A, Visser-Vandewalle, V, et al. A prospective, controlled study of non-motor effects of subthalamic stimulation in Parkinson’s disease: results at the 36-month follow-up. J Neurol Neurosurg Psychiatry 2020;91(7):687694.CrossRefGoogle ScholarPubMed
McRae, C, Diem, G, Vo, A, O’Brien, C, Seeberger, L. Schwab & England: standardization of administration. Mov Disord 2000;15(2):335336.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Goetz, CG, Nutt, JG, Stebbins, GT. The Unified Dyskinesia Rating Scale: presentation and clinimetric profile. Mov Disord 2008;23(16):23982403.CrossRefGoogle ScholarPubMed
Ren, X, Lin, J, Luo, S, Goetz, CG, Stebbins, GT, Cubo, E. Successful use of the Unified Dyskinesia Rating Scale regardless of PD- or dyskinesia-duration. Parkinsonism Relat Disord 2019;67:113116.CrossRefGoogle ScholarPubMed
Luo, S, Liu, Y, Teresi, JA, Stebbins, GT, Goetz, CG. Differential item functioning in the Unified Dyskinesia Rating Scale (UDysRS). Mov Disord 2017;32(8):12441249.CrossRefGoogle ScholarPubMed
Luo, S, Ren, X, Han, W, Goetz, CG, Stebbins, GT. Missing data in the Unified Dysksinesia Rating Scale (UDysRS). Mov Disord Clin Pract 2018;5(5):523526.CrossRefGoogle ScholarPubMed
Mestre, TA, Beaulieu-Boire, I, Aquino, CC, et al. What is a clinically important change in the Unified Dyskinesia Rating Scale in Parkinson’s disease? Parkinsonism Relat Disord 2015;21(11):13491354.CrossRefGoogle ScholarPubMed
Colosimo, C, Martínez-Martín, P, Fabbrini, G, et al. Task force report on scales to assess dyskinesia in Parkinson’s disease: critique and recommendations. Mov Disord 2010;25(9):11311142.CrossRefGoogle ScholarPubMed
Goetz, CG, Stebbins, GT, Shale, HM, et al. Utility of an objective dyskinesia rating scale for Parkinson’s disease: inter- and intrarater reliability assessment. Mov Disord 1994;9(4):390394.CrossRefGoogle ScholarPubMed
Stacy, M, Bowron, A, Guttman, M, et al. Identification of motor and nonmotor wearing-off in Parkinson’s disease: comparison of a patient questionnaire versus a clinician assessment. Mov Disord 2005;20(6):726733.CrossRefGoogle ScholarPubMed
Stacy, M, Hauser, R. Development of a patient questionnaire to facilitate recognition of motor and non-motor wearing-off in Parkinson’s disease. J Neural Transm (Vienna) 2007;114(2):211217.CrossRefGoogle ScholarPubMed
Stacy, MA, Murphy, JM, Greeley, DR, et al. The sensitivity and specificity of the 9-item Wearing-off Questionnaire. Parkinsonism Relat Disord 2008;14(3):205212.CrossRefGoogle ScholarPubMed
Martinez-Martin, P, Hernandez, B. The Q10 questionnaire for detection of wearing-off phenomena in Parkinson’s disease. Parkinsonism Relat Disord 2012;18(4):382385.CrossRefGoogle ScholarPubMed
Antonini, A, Martinez-Martin, P, Chaudhuri, RK, et al. Wearing-off scales in Parkinson’s disease: critique and recommendations. Mov Disord 2011;26(12):21692175.CrossRefGoogle ScholarPubMed
Guy, W. Abnormal Involuntary Movement Scale. ECDEU Assessment Manual for Psychopharmacology. Washington, DC: US Government Printing Office; 1976: 534537.Google Scholar
Rolland, Y, Vérin, M, Payan, CA, et al. A new MRI rating scale for progressive supranuclear palsy and multiple system atrophy: validity and reliability. J Neurol Neurosurg Psychiatry 2011;82(9):10251032.CrossRefGoogle ScholarPubMed
Piot, I, Schweyer, K, Respondek, G, et al. The Progressive Supranuclear Palsy Clinical Deficits Scale. Mov Disord 2020;35(4):650661.CrossRefGoogle ScholarPubMed
Hinson, VK, Cubo, E, Comella, CL, Goetz, CG, Leurgans, S. Rating scale for psychogenic movement disorders: scale development and clinimetric testing. Mov Disord 2005;20(12):15921597.CrossRefGoogle ScholarPubMed
Nielsen, G, Ricciardi, L, Meppelink, AM, et al. A simplified version of the Psychogenic Movement Disorders Rating Scale: the Simplified Functional Movement Disorders Rating Scale (S-FMDRS). Mov Disord Clin Pract 2017;4(5):710716.CrossRefGoogle ScholarPubMed
Walters, AS, LeBrocq, C, Dhar, A, et al. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med 2003;4(2):121132.Google Scholar
Allen, RP, Earley, CJ. Validation of the Johns Hopkins restless legs severity scale. Sleep Med 2001;2(3):239242.CrossRefGoogle ScholarPubMed
Hening, WA, Allen, RP, Thanner, S, et al. The Johns Hopkins telephone diagnostic interview for the restless legs syndrome: preliminary investigation for validation in a multi-center patient and control population. Sleep Med 2003;4(2):137141.CrossRefGoogle Scholar
Leckman, JF, Riddle, MA, Hardin, MT, et al. The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry 1989;28(4):566573.CrossRefGoogle ScholarPubMed
Harcherik, DF, Leckman, JF, Detlor, J, Cohen, DJ. A new instrument for clinical studies of Tourette’s syndrome. J Am Acad Child Psychiatry 1984;23(2):153160.CrossRefGoogle ScholarPubMed
Shapiro, AK, Shapiro, E. Controlled study of pimozide vs. placebo in Tourette’s syndrome. J Am Acad Child Psychiatry 1984;23(2):161173.CrossRefGoogle ScholarPubMed
Shytle, RD, Silver, AA, Sheehan, KH, et al. The Tourette’s Disorder Scale (TODS): development, reliability, and validity. Assessment 2003;10(3):273287.CrossRefGoogle ScholarPubMed
Martino, D, Pringsheim, TM, Cavanna, AE, et al. Systematic review of severity scales and screening instruments for tics: critique and recommendations. Mov Disord 2017;32(3):467473.CrossRefGoogle ScholarPubMed
Woods, DW, Piacentini, J, Himle, MB, Chang, S. Premonitory Urge for Tics Scale (PUTS): initial psychometric results and examination of the premonitory urge phenomenon in youths with tic disorders. J Dev Behav Pediatr 2005;26(6):397403.CrossRefGoogle ScholarPubMed
Louis, ED, Ottman, R, Ford, B, et al. The Washington Heights–Inwood Genetic Study of Essential Tremor: methodologic issues in essential-tremor research. Neuroepidemiology 1997;16(3):124133.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×