AIM:
To assess motor impairments in Parkinson’s disease
Rationale:
Assessment using items from the motor examination section of the Unified Parkinson’s Disease Rating Scale (UPDRS) includes:
1. Action tremor (item 21)
2. Finger taps (item 23)
3. Hand grips (item 24)
4. Hand pronate/supinate (item 25)
5. Leg agility (item 26)
6. Rigidity (item 22)
7. Arise from chair (item 27)
8. Postural stability (item 30)
Equipment:
- 2 chairs
Key Points
General:
- Test both sides
- Use UPDRS criteria (link to guidelines) to grade the patient’s performance
Finger taps (item 23), hand grips (item 24), hand pronate/supinate (item 25) and leg agility (item 26):
- Ensure therapist demonstrates fast, large amplitude movements
Arise from chair (item 27)
- Ensure therapist is positioned to steady patient if necessary
Postural stability (item 30):
- Ensure therapist is positioned to steady patient if necessary, but not to interfere with backwards steps taken by the patient
- Ensure therapist is positioned with a wall a couple of steps behind him/her for safety
Common Errors:
- Rigidity (item 22): In testing for arm and leg rigidity therapist does not use concurrent movements to differentiate between a grade 0 and a grade 1 response
Progression and Variety:
- Not applicable (as these tests are performed in a standardised manner)