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  • Updated 11.27.2023
  • Released 12.16.1998
  • Expires For CME 11.27.2026

Rating scales of movement disorders



Measuring disease severity is critical from a clinical and research perspective. Utilizing standardized rating scales allows for a universally understood means of quantifying disease states regarding both disease progression and treatment response. Detecting changes in an underlying disease process commonly relies on changes in rating scales as a surrogate marker. In this article, the authors provide an introduction to several of the rating scales that have been used to quantify specific involuntary movements (ie, tremor) as a symptom or within the context of a defined movement disorder (ie, Parkinson disease). Scales for each of the following involuntary movements or diseases are discussed: Parkinson disease, tics, chorea, dystonia, myoclonus, ataxia, tremor, medication-induced dyskinesia, and gait and balance in any movement disorder. The scales are summarized and presented to highlight clinical relevance, statistical rigor, and limitations using current published evaluations. There are numerous scales available; however, the ones discussed are the ones that have been most used and thoroughly tested. This article also reflects the most updated revisions and critiques of these scales.

Key points

• The ability to measure movement disorder characteristics over time allows for universally accepted, standardized outcome measures.

• The ability of scales to produce consistent results and, therefore, to be useful instruments in monitoring patients and conducting research, depends on the investigator’s experience administering and interpreting each scale as well as the psychometric properties of each scale.

• Rating scales in movement disorders focus on two primary concepts: impairment and disability.

• Items rated by the investigator and based on the neurologic examination assess impairment and relate to objective deficits.

• Interviews that involve the patient’s, the caregiver’s, and the investigator’s assessments of activities of daily living or quality of life rate disability and, thus, assess the impact of the disease on daily function.

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ISSN: 2831-9125