UNIFIED PARKINSON'S DISEASE RATING SCALE統(tǒng)一帕金森病評定量表

UNIFIEDPARKINSON'SDISEASERATINGSCALE

[PLEASESELECTYOUROPTIONBYCHNGEITINTOREDCOLORANDSENDUSBACK]

MENTATION,BEHAVIORANDMOOD

0=None.

=Mild.Consistentforgetfulnesswithpartialrecollectionofeventsandnootherdifficulties.

=Moderatememoryloss,withdisorientationandmoderatedifficultyhandlingcomplexproblems.Mildbutdefiniteimpairmentoffunctionathomewithneedofoccasionalprompting.

=Severememorylosswithdisorientationfortimeandoftentoplace.Severeimpairmentinhandlingproblems.

=Severememorylosswithorientationpreservedtopersononly.Unabletomakejudgementsorsolveproblems.

Requiresmuchhelpwithpersonalcare.Cannotbeleftaloneatall.

IntellectualImpairment

(Duetodementiaordrugintoxication)

0=None.

=Vividdreaming.

="Benign"hallucinationswithinsightretained.

=Occasionaltofrequenthallucinationsordelusions;withoutinsight;couldinterferewithdailyactivities.

=Persistenthallucinations,delusions,orflorridpsychosis.Notabletocareforself.

ThoughtDisorder

=Periodsofsadnessorguiltgreaterthannormal,neversustainedfordaysorweeks.

=Sustaineddepression(1weekormore).

=Sustaineddepressionwithvegetativesymptoms(insomnia,anorexia,weightloss,lossofinterest).

=Sustaineddepressionwithvegetativesymptomsandsuicidalthoughtsorintent.

Depression

0=Normal.

=Lessassertivethanusual;morepassive.

=Lossofinitiativeordisinterestinelective(nonroutine)activities.

=Lossofinitiativeordisinterestindaytoday(routine)activities.

=Withdrawn,completelossofmotivation.

Motivation/Initiative

ACTIVITIESOFDAILYLIVING(forboth"on"and"off")

0=Normal.

=Mildlyaffected.Nodifficultybeingunderstood.

=Moderatelyaffected.Sometimesaskedtorepeatstatements.

=Severelyaffected.Frequentlyaskedtorepeatstatements.

=Unintelligiblemostofthetime.

Speech

0=Normal.

=Slightbutdefiniteexcessofsalivainmouth;mayhavenighttimedrooling.

=Moderatelyexcessivesaliva;mayhaveminimaldrooling.

=Markedexcessofsalivawithsomedrooling.

=Markeddrooling,requiresconstanttissueorhandkerchief.

Salivation

0=Normal.

=Rarechoking.

=Occasionalchoking.

=Requiressoftfood.

=RequiresNGtubeorgastrotomyfeeding.

Swallowing

0=Normal.

=Slightlysloworsmall.

=Moderatelysloworsmall;allwordsarelegible.

=Severelyaffected;notallwordsarelegible.

=Themajorityofwordsarenotlegible.

Handwriting

0=Normal.

=Somewhatslowandclumsy,butnohelpneeded.

=Cancutmostfoods,althoughclumsyandslow;somehelpneeded.

=Foodmustbecutbysomeone,butcanstillfeedslowly.

=Needstobefed.

Cuttingfoodandhandlingutensils

0=Normal.

=Somewhatslow,butnohelpneeded.

=Occasionalassistancewithbuttoning,gettingarmsinsleeves.

=Considerablehelprequired,butcandosomethingsalone.

=Helpless.

Dressing

0=Normal.

=Somewhatslow,butnohelpneeded.

=Needshelptoshowerorbathe;orveryslowinhygieniccare.

=Requiresassistanceforwashing,brushingteeth,combinghair,goingtobathroom.

=Foleycatheterorothermechanicalaids.

Hygiene

0=Normal.

=Somewhatslowandclumsy,butnohelpneeded.

=Canturnaloneoradjustsheets,butwithgreatdifficulty.

=Caninitiate,butnotturnoradjustsheetsalone.

=Helpless.

Turninginbedandadjustingbedclothes

0=None.

=Rarefalling.

=Occasionallyfalls,lessthanonceperday.

=Fallsanaverageofoncedaily.

=Fallsmorethanoncedaily.

Falling(unrelatedtofreezing)

0=None.

=Rarefreezingwhenwalking;mayhavestarthesitation.

=Occasionalfreezingwhenwalking.

=Frequentfreezing.Occasionallyfallsfromfreezing.

=Frequentfallsfromfreezing.

Freezingwhenwalking

0=Normal.

=Milddifficulty.Maynotswingarmsormaytendtodragleg.

=Moderatedifficulty,butrequireslittleornoassistance.

=Severedisturbanceofwalking,requiringassistance.

=Cannotwalkatall,evenwithassistance.

Walking

(Symptomaticcomplaintoftremorinanypartofbody.)

0=Absent.

=Slightandinfrequentlypresent.

=Moderate;bothersometopatient.

=Severe;interfereswithmanyactivities.

=Marked;interfereswithmostactivities.

Tremor

0=None.

=Occasionallyhasnumbness,tingling,ormildaching.

=Frequentlyhasnumbness,tingling,oraching;notdistressing.

=Frequentpainfulsensations.

=Excruciatingpain.

Sensorycomplaintsrelatedtoparkinsonism

MOTOREXAMINATION

0=Normal.

=Slightlossofexpression,dictionand/orvolume.

=Monotone,slurredbutunderstandable;moderatelyimpaired.

=Markedimpairment,difficulttounderstand.

=Unintelligible.

Speech

0=Normal.

=Minimalhypomimia,couldbenormal"PokerFace".

=Slightbutdefinitelyabnormaldiminutionoffacialexpression

=Moderatehypomimia;lipspartedsomeofthetime.

=Maskedorfixedfacieswithsevereorcompletelossoffacialexpression;lipsparted1/4inchormore.

FacialExpression

(head,upperandlowerextremities)

0=Absent.

=Slightandinfrequentlypresent.

=Mildinamplitudeandpersistent.Ormoderateinamplitude,butonlyintermittentlypresent.

=Moderateinamplitudeandpresentmostofthetime.

=Markedinamplitudeandpresentmostofthetime.

Tremoratrest

0=Absent.

=Slight;presentwithaction.

=Moderateinamplitude,presentwithaction.

=Moderateinamplitudewithpostureholdingaswellasaction.

=Markedinamplitude;interfereswithfeeding.

ActionorPosturalTremorofhands

(Judgedonpassivemovementofmajorjointswithpatientrelaxedinsittingposition.Cogwheelingtobeignored.)

0=Absent.

=Slightordetectableonlywhenactivatedbymirrororothermovements.

=Mildtomoderate.

=Marked,butfullrangeofmotioneasilyachieved.

=Severe,rangeofmotionachievedwithdifficulty.

Rigidity

(Patienttapsthumbwithindexfingerinrapidsuccession.)

0=Normal.

=Mildslowingand/orreductioninamplitude.

=Moderatelyimpaired.Definiteandearlyfatiguing.Mayhaveoccasionalarrestsinmovement.

=Severelyimpaired.Frequenthesitationininitiatingmovementsorarrestsinongoingmovement.

=Canbarelyperformthetask.

FingerTaps

(Patientopensandcloseshandsinrapidsuccesion.)

0=Normal.

=Mildslowingand/orreductioninamplitude.

=Moderatelyimpaired.Definiteandearlyfatiguing.Mayhaveoccasionalarrestsinmovement.

=Severelyimpaired.Frequenthesitationininitiatingmovementsorarrestsinongoingmovement.

=Canbarelyperformthetask.

HandMovements

(Pronation-supinationmovementsofhands,verticallyandhorizontally,withaslargeanamplitudeaspossible,bothhandssimultaneously.)

0=Normal.

=Mildslowingand/orreductioninamplitude.

=Moderatelyimpaired.Definiteandearlyfatiguing.Mayhaveoccasionalarrestsinmovement.

=Severelyimpaired.Frequenthesitationininitiatingmovementsorarrestsinongoingmovement.

=Canbarelyperformthetask.

RapidAlternatingMovementsofHands

(Patienttapsheelonthegroundinrapidsuccessionpickingupentireleg.Amplitudeshouldbeatleast3inches.)

0=Normal.

=Mildslowingand/orreductioninamplitude.

=Moderatelyimpaired.Definiteandearlyfatiguing.Mayhaveoccasionalarrestsinmovement.

=Severelyimpaired.Frequenthesitationininitiatingmovementsorarrestsinongoingmovement.

=Canbarelyperformthetask.

LegAgility

(Patientattemptstorisefromastraightbackedchair,witharmsfoldedacrosschest.)

0=Normal.

=Slow;ormayneedmorethanoneattempt.

=Pushesselfupfromarmsofseat.

=Tendstofallbackandmayhavetotrymorethanonetime,butcangetupwithouthelp.

=Unabletoarisewithouthelp.

ArisingfromChair

0=Normalerect.

=Notquiteerect,slightlystoopedposture;couldbenormalforolderperson.

=Moderatelystoopedposture,definitelyabnormal;canbeslightlyleaningtooneside.

=Severelystoopedposturewithkyphosis;canbemoderatelyleaningtooneside.

=Markedflexionwithextremeabnormalityofposture.

Posture

0=Normal.

=Walksslowly,mayshufflewithshortsteps,butnofestination(hasteningsteps)orpropulsion.

=Walkswithdifficulty,butrequireslittleornoassistance;mayhavesomefestination,shortsteps,orpropulsion.

=Severedisturbanceofgait,requiringassistance.

=Cannotwalkatall,evenwithassistance.

Gait

(Responsetosudden,strongposteriordisplacementproducedbypullonshoulderswhilepatienterectwitheyesopenandfeetslightlyapart.Patientisprepared.)

0=Normal.

=Retropulsion,butrecoversunaided.

=Absenceofposturalresponse;wouldfallifnotcaughtbyexaminer.

=Veryunstable,tendstolosebalancespontaneously.

=Unabletostandwithoutassistance.

PosturalStability

(Combiningslowness,hesitancy,decreasedarmswing,smallamplitude,andpovertyofmovementingeneral.)

0=None.

=Minimalslowness,givingmovementadeliberatecharacter;couldbenormalforsomepersons.Possiblyreducedamplitude.

=Milddegreeofslownessandpovertyofmovementwhichisdefinitelyabnormal.Alternatively,somereducedamplitude.

=Moderateslowness,povertyorsmallamplitudeofmovement.

=Markedslowness,povertyorsmallamplitudeofmovement.

BodyBradykinesiaandHypokinesia

COMPLICATIONSOFTHERAPY(Inthepastweek)

DYSKINESIAS

(Historicalinformation.)

0=None

=1-25%ofday.

=26-50%ofday.

=51-75%ofday.

=76-100%ofday.

Duration:Whatproportionofthewakingdayaredyskinesiaspresent?(Historicalinformation;maybemodifiedbyofficeexamination.)

0=Notdisabling.

=Mildlydisabling.

=Moderatelydisabling.

=Severelydisabling.

=Completelydisabled.

Disability:Howdisablingarethedyskinesias?

0=Nopainfuldyskinesias.

=Slight.

=Moderate.

=Severe.

=Marked.

PainfulDyskinesias:Howpainfularethedyskinesias?

(Historicalinformation.)

0=No

=Yes

PresenceofEarlyMorningDystonia

CLINICALFLUCTUATIONS

0=No

1=Yes

Are"off"periodspredictable?

0=No

1=Yes

Are"off"periodsunpredictable?

0=No

1=Yes

Do"off"periodscomeonsuddenly,withinafewseconds?

0=None

1=1-25%ofday.

=26-50%ofday.

=51-75%ofday.

=76-100%ofday.

Whatproportionofthewakingdayisthepatient"off"onaverage?

OTHERCOMPLICATIONS

0=No

1=Yes

Doesthepatienthaveanorexia,nausea,orvomiting?

0=No

1=Yes

Anysleepdisturbances,suchasinsomniaorhypersomnolence?(Recordthepatient'sbloodpressure,heightandweightonthescoringform)

0=No

1=Yes

Doesthepatienthavesymptomaticorthostasis?

MODIFIEDHOEHNANDYAHRSTAGING

STAGE0=Nosignsofdisease.

STAGE1=Unilateraldisease.

STAGE1.5=Unilateralplusaxialinvolvement.

STAGE2=Bilateraldisease,withoutimpairmentofbalance.

STAGE2.5=Mildbilateraldisease,withrecoveryonpulltest.

STAGE3=Mildtomoderatebilateraldisease;someposturalinstability;physicallyindependent.

STAGE4=Severedisability;stillabletowalkorstandunassisted.

STAGE5=Wheelchairboundorb