What is Parkinson's disease and how can you perform a motor examination?

Parkinson's disease is a progressive nervous system disorder which damages parts of the brain over many years. There is currently no cure for Parkinson's disease; however, there are many treatments to alleviate pain. The motor symptoms of Parkinson's disease are slowness in movement, shaking, rigidity, postural instability, and difficulty with walking and gait. The most popular gold standard scale to use for motor assessment is known as Movement Disorders Society- Unified Parkinson's Disease Rating Scale (MDS-UPDRS).

What is the Unified Parkinson's Disease Rating Scale (UPDRS)?

UPDRS scale is the most precise way to measure conditions of patients with Parkinson's disease. The MDS-UPDRS scale consists of a range of ratings for Parkinson's symptoms, which cover all of the movement restraints of Parkinson's disease. There are five sections, and the focus is on part three (Motor assessment) of the five parts. The motor examination is used to assess motor abnormalities in Parkinson's disease. The items included are speech/facial expression, rigidity, tremor, bradykinesia, gait, and postural stability. These are assessed by using a severity scale; the score scale ranges from 0 (normal/no impairment) to 4 (severe/cannot perform tasks or is very slow). The total motor UPDRS score ranges from 0 to 108. Only a qualified assessor can provide the item scores rather than the patient themselves.

Instructions for recording MDS-UPDRS tests

For all the assessments please apply steps 1-6:

1. Finger tapping
2. Facial movement
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3. Rigidity
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4. Speech
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5. Hand Movement
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6. Pronation Supination movements of hand
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7. Toe tapping
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8. Leg agility
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9. Arising from chair
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10. Gait
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11. Position stablilty
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12. Posture
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13. Posture tremor of the hand.
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14. Kinetic Tremor of the hand
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15. Rest Tremor Amplitude
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